Table 19:
Sensitivity Analyses for Continuous Glucose Monitoring Model
| Parameters | Mean Value | Plausible Range | Source | |
|---|---|---|---|---|
| Minimum | Maximum | |||
| Discount rates, % | 1.5 | 0 | 5.0 | Paulden et al75 |
| Annual Transition Probabilities | ||||
| First year onward | ||||
| No complications to retinopathy (exponential) | 0.0764 | 0.0461 | 0.0829 | DCCT, 2009,76 DCCT, 201474 |
| No complications to nephropathy (exponential) | 0.0094 | 0.0008 | 0.0526 | DCCT, 200976 |
| No complications to neuropathy | 0.0235 | 0.0218 | 0.0252 | DCCT, 200976 |
| No complications to CVD (exponential) | 0.0045 | 0.0310 | 0.0084 | Hoerger et al, 2004,81 DCCT, 2005101 |
| No complications to severe hypoglycemic event | 0.0982 | 0.0526 | 0.1513 | DCCT, 200976 |
| Second year onward | ||||
| Retinopathy to blindness | 0.0064 | 0.0010 | 0.1010 | Hoerger et al, 2004,81 McQueen et al, 201151 |
| Neuropathy to lower-extremity amputation | 0.1200 | 0.0620 | 0.1690 | Hoerger et al, 2004,81 McQueen et al, 201151 |
| Nephropathy to end-stage renal disease | 0.072 | 0.0041 | 0.096 | Hoerger et al, 2004,81 McQueen et al, 201151 |
| Neuropathy to CVD | 0.0200 | 0.0160 | 0.0440 | Hoerger et al, 2004,81 McQueen et al, 201151 |
| Neuropathy to nephropathy | 0.0970 | 0.0550 | 0.1490 | Wu et al, 199880 |
| Retinopathy to CVD | 0.0155 | 0.0100 | 0.0430 | Klein et al, 2004,66 McQueen et al, 201151 |
| Nephropathy to CVD | 0.0224 | 0.0130 | 0.0340 | Klein et al, 2004,66 McQueen et al, 201151 |
| Utilities | ||||
| No complications | 0.814 | 0.710 | 0.918 | Clarke et al, 2002,88 Currie et al, 200690 |
| Nephropathy | 0.575 | 0.545 | 0.606 | Sullivan et al, 200692 |
| Neuropathy | 0.624 | 0.573 | 0.632 | McQueen et al, 2011,51 Palmer et al, 200465 |
| Retinopathy | 0.612 | 0.581 | 0.643 | McQueen et al, 2011,51 Sullivan et al, 200692 |
| CVD | 0.685 | 0.513 | 0.742 | Clarke et al, 2002,88 and Palmer et al, 200465 |
| Severe hypoglycemia | 0.66 | 0.544 | 0.764 | Vexiau et al, 2008,102 Marrett et al, 2009,103 Currie et al, 200690 |
| Blindness | 0.569 | 0.540 | 0.734 | Clarke et al, 2002,88 and Palmer et al, 200465 |
| Lower-extremity amputation | 0.534 | 0.425 | 0.644 | Clarke et al, 2002,88 Sullivan et al, 200692 |
| End-stage renal disease | 0.49 | 0.45 | 0.53 | Tengs and Wallace, 200091 |
| Cost, First Year, 2017 Canadian Dollars | ||||
| No complications | 2,262 | 1,667 | 2,262 | McQueen et al, 2015,97 O'Reilly et al, 200796 |
| Nephropathy | 80 | 70 | 90 | McQueen et al, 2015,97 O'Brien et al 2003,95 assumption |
| Neuropathy | 192 | 150 | 213 | O'Brien et al, 2003,95 assumption |
| Retinopathy | 492 | 400 | 642 | McQueen et al, 2015,97 O'Brien et al 2003,95 assumption |
| CVD | 18,682 | 7,471 | 24,170 | OCCI, O'Brien et al, 200395 |
| Severe hypoglycemia | 3,775 | 1,500 | 4,000 | Assumption, OCCI |
| Blindness | 3,483 | 2,738 | 5,000 | McQueen et al, 2015,97 O'Brien et al, 2003,95 assumption |
| Lower-extremity amputation | 43,984 | 31,884 | 50,000 | McQueen et al, 2015,97 O'Brien et al 2003,95 assumption |
| End-stage renal disease | 28,221 | 25,841 | 81,769 | McQueen et al, 2015,97 O'Brien et al 200395 |
| Relative Risk From Lowering A1C by 1% | ||||
| Nephropathy | 0.038 | 0.032 | 0.043 | DCCT, 2009,76 DCCT, 201474 |
| Neuropathy | 0.025 | 0.020 | 0.030 | DCCT, 2009,76 DCCT, 201474 |
| Retinopathy | 0.029 | 0.023 | 0.034 | DCCT, 2009,76 DCCT, 201474 |
| CVD | 0.040 | 0.035 | 0.045 | DCCT, 2009,76 DCCT, 201474 |
| Severe hypoglycemia | 0.061 | 0.055 | 0.066 | DCCT, 2009,76 DCCT, 201474 |
Abbreviations: A1C, glycated hemoglobin; CVD, cardiovascular disease; DCCT, Diabetes Control and Complications Trial; OCCI, Ontario Case Costing Initiative.