The conceptualisation of cardiometabolic disease policy model in the UK

Abstract

Background: Decision models are increasingly used to inform policy-making processes, and there is a need to improve their credibility. The estimation of health and economic outcomes generated from decision models is influenced by the development process itself. This paper aims to present the conceptual model development process of cardiometabolic disease (CMD) policy models in the UK setting.

Methods: This conceptual model followed the International Society of Pharmacoeconomics and Outcomes Research-Society of Medical Decision Making (ISPOR-SMDM) Modelling Good Research Practices Task Force-2.

Results: First, for the conceptualisation of the problem, the CMD disease staging, progression and current clinical guidelines were summarised, followed by a systematic review of published policy models. We critically appraised policy models such as cardiovascular disease and type 2 diabetes. Key messages from the review emphasised the importance of understanding various determinants influencing model development, including risk factors, model structure, models' parameters, data utilisation, economic perspective, equality/equity consideration, transparency and validation process. Second, as a sequential process, is model conceptualisation, to determine which modelling types and their attributes best represent the defined problem. Expert opinions, including a clinician and experienced modellers, provided input on the state transition model to ensure the structure is clinically relevant. From this stage, the consideration and agreement to establish a disease state in a state transition model was discussed.

Conclusion: This conceptual model serves as a basis for representing the systematic process for structuring a CMD policy model to enhance its transparency and credibility.

Keywords: Cardiometabolic disease; Conceptual model; Decision model; Health economics; Policy model.

Fig. 1

Schematic flow diagram of conceptual model development

Fig. 2

Risk factors included in policy model

Fig. 3

Final conceptual model. T2DM: type 2 diabetes, BMI: body mass index, BP: blood pressure, CVD: cardiovascular disease, QALE: quality-adjusted life expectancy, QALY: quality-adjusted life years

Fig. 4

State transition model structure