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Cross-model validation of public health microsimulation models; comparing two models on estimated effects of a weight management intervention.

Published version
Peer-reviewed

Repository DOI


Change log

Authors

Bates, Sarah 
Breeze, Penny 
Thomas, Chloe 
Jackson, Christopher 
Church, Oliver 

Abstract

BACKGROUND: Health economic modelling indicates that referral to a behavioural weight management programme is cost saving and generates QALY gains compared with a brief intervention. The aim of this study was to conduct a cross-model validation comparing outcomes from this cost-effectiveness analysis to those of a comparator model, to understand how differences in model structure contribute to outcomes. METHODS: The outcomes produced by two models, the School for Public Health Research diabetes prevention (SPHR) and Health Checks (HC) models, were compared for three weight-management programme strategies; Weight Watchers (WW) for 12 weeks, WW for 52 weeks, and a brief intervention, and a simulated no intervention scenario. Model inputs were standardised, and iterative adjustments were made to each model to identify drivers of differences in key outcomes. RESULTS: The total QALYs estimated by the HC model were higher in all treatment groups than those estimated by the SPHR model, and there was a large difference in incremental QALYs between the models. SPHR simulated greater QALY gains for 12-week WW and 52-week WW relative to the Brief Intervention. Comparisons across socioeconomic groups found a stronger socioeconomic gradient in the SPHR model. Removing the impact of treatment on HbA1c from the SPHR model, running both models only with the conditions that the models have in common and, to a lesser extent, changing the data used to estimate risk factor trajectories, resulted in more consistent model outcomes. CONCLUSIONS: The key driver of difference between the models was the inclusion of extra evidence-based detail in SPHR on the impacts of treatments on HbA1c. The conclusions were less sensitive to the dataset used to inform the risk factor trajectories. These findings strengthen the original cost-effectiveness analyses of the weight management interventions and provide an increased understanding of what is structurally important in the models.

Description

Acknowledgements: We thank Dr Amy Ahern and Dr Fiona Whittle for their support in this study.

Keywords

Cross-model comparison, Health economic modelling, Weight management, Humans, Glycated Hemoglobin, Public Health, Risk Factors, Cost-Benefit Analysis, Quality-Adjusted Life Years

Journal Title

BMC Public Health

Conference Name

Journal ISSN

1471-2458
1471-2458

Volume Title

24

Publisher

Springer Science and Business Media LLC
Sponsorship
Programme Grants for Applied Research (RP-PG-0216-20010, RP-PG-0216-20010, RP-PG-0216-20010, RP-PG-0216-20010)
UK Medical Research Council programme (MRC_MC_UU_00002/11, MRC_MC_UU_00002/11)