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

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Abstract

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.

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Acknowledgements

This work is funded by the National Health and Medical Research Council (NHMRC) (grant number APP1127827). L.S. is supported by an NHMRC Early Career Fellowship (grant number GNT1139826).

Data availability statement

The data that support the findings of this study are available from the corresponding author on reasonable request.

Author information

Authors and Affiliations

  1. The George Institute for Global Health, UNSW Sydney, Kensington, Australia

    L. Si

  2. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia

    L. Si, T. Winzenberg & A. J. Palmer

  3. School of Health Policy & Management, Nanjing Medical University, Nanjing, China

    L. Si

  4. Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia

    J. A. Eisman, J. R. Center, T. V. Nguyen & T. Tran

  5. School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia

    J. A. Eisman

  6. St Vincent’s Hospital, UNSW Sydney, Sydney, New South Wales, Australia

    J. A. Eisman, J. R. Center & T. V. Nguyen

  7. Department of Medicine–Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia

    K. M. Sanders

  8. School of Health and Social Development, Deakin University, Geelong, Victoria, Australia

    K. M. Sanders

  9. School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia

    T. V. Nguyen

  10. Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia

    A. J. Palmer

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  1. L. Si
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Corresponding authors

Correspondence to L. Si or A. J. Palmer.

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Conflicts of interest

J.A.E. reported consulting and research support from Actavis, Amgen, Aspen, Lilly, Merck Sharp & Dohme, Novartis, Sanofi-Aventis, Servier and Theramex. T.W. received funds for education consultancy from AMGEN. T.V.N. received research grant from Amgen, honoraria for consulting, or speaking in symposia sponsored by Amgen, Merck Sharp & Dohme, Roche, Sanofi-Aventis, Novartis and Bridge Healthcare Pty Ltd (Vietnam). J.R.C. received honoraria from Amgen, Actavis and Bayer for educational meetings and/or advisory boards. L.S., K.M.S., T.T. and A.J.P. declare that they have no conflicts of interest.

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Si, L., Eisman, J.A., Winzenberg, T. et al. Development and validation of the risk engine for an Australian Health Economics Model of Osteoporosis. Osteoporos Int 32, 2073–2081 (2021). https://doi.org/10.1007/s00198-021-05955-x

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