Development and validation of the risk engine for an Australian Health Economics Model of Osteoporosis

• Published in: Osteoporosis international Vol. 32; no. 10; pp. 2073 - 2081
• Main Authors: Si, L., Eisman, J. A., Winzenberg, T., Sanders, K. M., Center, J. R., Nguyen, T. V., Tran, T., Palmer, A. J.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.10.2021; Springer Nature B.V
• Subjects: Decision making; Economics; Endocrinology; Epidemiology; Health care; Health economics; Medicine; Medicine & Public Health; Original Article; Orthopedics; Osteoporosis; Public health; Rheumatology; Risk assessment; Australia; Osteoporosis; Osteoporotic fracture; Australian; Economic evaluation; Health economics model
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-021-05955-x

Summary The Australian Health Economics Model of Osteoporosis (AusHEMO) has shown good face, internal and cross validities, and can be used to assist healthcare decision-making in Australia. Purpose This study aimed to document and validate the risk engine of the Australian Health Economics Model of Osteoporosis (AusHEMO). Methods AusHEMO is a state-transition microsimulation model. The fracture risks were simulated using fracture incidence rates from the Dubbo Osteoporosis Epidemiology Study. The AusHEMO was validated regarding its face, internal and cross validities. Goodness-of-fit analysis was conducted and Lin’s coefficient of agreement and mean absolute difference with 95% limits of agreement were reported. Results The development of AusHEMO followed general and osteoporosis-specific health economics guidelines. AusHEMO showed good face validity regarding the model’s structure, evidence, problem formulation and results. In addition, the model has been proven good internal and cross validities in goodness-of-fit test. Lin’s coefficient was 0.99, 1 and 0.94 for validation against the fracture incidence rates, Australian life expectancies and residual lifetime fracture risks, respectively. Conclusions In summary, the development of the risk engine of AusHEMO followed the best practice for osteoporosis disease modelling and the model has been shown to have good face, internal and cross validities. The AusHEMO can be confidently used to predict long-term fracture-related outcomes and health economic evaluations when costs data are included. Health policy-makers in Australia can use the AusHEMO to select which osteoporosis interventions such as medications and public health interventions represent good value for money.