{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:22:14Z","timestamp":1768695734547,"version":"3.49.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["PharmacoEconomics"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>Most type 2 diabetes simulation models utilise equations mapping out lifetime trajectories of risk factors [e.g. glycated haemoglobin (HbA<jats:sub>1c<\/jats:sub>)]. Existing equations, using historic data or assuming constant risk factors, frequently underestimate or overestimate complication rates. Updated risk factor time path equations are needed for simulation models to more accurately predict complication rates.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aims<\/jats:title>\n                <jats:p>(1) Update United Kingdom Prospective Diabetes Study Outcomes Model (UKPDS-OM2) risk factor time path equations; (2) compare quality-adjusted life-years (QALYs) using original and updated equations; and (3) compare QALY gains for reference case simulations using different risk factor equations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Using pooled contemporary data from two randomised trials EXSCEL and TECOS (<jats:italic>n<\/jats:italic> = 28,608), we estimated: dynamic panel models of seven continuous risk factors (high-density lipoprotein cholesterol, low density lipoprotein cholesterol, HbA<jats:sub>1c<\/jats:sub>, haemoglobin, heart rate, blood pressure and body mass index); two-step models of estimated glomerular filtration rate; and survival analyses of peripheral arterial disease, atrial fibrillation and albuminuria. UKPDS-OM2-derived lifetime QALYs were extrapolated over 70 years using historical and the new risk factor equations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All new risk factor equation predictions were within 95% confidence intervals of observed values, displaying good agreement between observed and estimated values. Historical risk factor time path equations predicted trial participants would accrue 9.84 QALYs, increasing to 10.98 QALYs using contemporary equations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Incorporating updated risk factor time path equations into diabetes simulation models could give more accurate predictions of long-term health, costs, QALYs and cost-effectiveness estimates, as well as a more precise understanding of the impact of diabetes on patients\u2019 health, expenditure and quality of life.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial Registration<\/jats:title>\n                <jats:p>ClinicalTrials.gov NCT01144338 and NCT00790205<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40273-024-01398-4","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T06:02:50Z","timestamp":1719381770000},"page":"1017-1028","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Estimating Risk Factor Time Paths Among People with Type 2 Diabetes and QALY Gains from Risk Factor Management"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2099-0112","authenticated-orcid":false,"given":"Ni","family":"Gao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3255-748X","authenticated-orcid":false,"given":"Helen A.","family":"Dakin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1256-874X","authenticated-orcid":false,"given":"Rury R.","family":"Holman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-6924","authenticated-orcid":false,"given":"Lee-Ling","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Leal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"1398_CR1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s40273-016-0466-0","volume":"35","author":"X Hua","year":"2017","unstructured":"Hua X, Lung TW-C, Palmer A, Si L, Herman WH, Clarke P. 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H.A.D., J.L., R.R.H. and P.C. are involved in the ongoing development of the UKPDS-OM, which is licensed by University of Oxford. L.L.L. reported receiving grants and\/or honoraria for giving lectures and consultancy from Abbott, AstraZeneca, Boehringer Ingelheim, Merck Sharp and Dohme, Novo Nordisk, Pfizer, Procter and Gamble Health, Roche, Sanofi, Servier and Zuellig Pharma. H.A.D. and J.L. have received a research grant from AstraZeneca outside the submitted work. R.R.H. reports research support from AstraZeneca, Bayer and Merck Sharp and Dohme, and personal fees from Anji Pharmaceuticals, AstraZeneca, Novartis and Novo Nordisk outside the submitted work. Other authors declare that they have no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest statements"}},{"value":"Concept and design: N.G., H.A.D., J.L., P.C. Acquisition of data: R.R.H. Analysis and interpretation of data: N.G., H.A.D., J.L., R.R.H., L.-L.L., P.C. Drafting of the manuscript: N.G., H.A.D., J.L., P.C. Critical revision of the paper for important intellectual content: N.G., H.A.D., J.L., R.R.H., L.-L.L., P.C. Obtaining funding: J.L., R.R.H., L.-L.L., P.C. Supervision: H.A.D., J.L., P.C.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author Contributions"}},{"value":"This work was funded by supported by the Medical Research Council (MR\/T018593\/1). The project was supported also by the NIHR Oxford Biomedical Research Centre and the UK\u2212Malaysia Joint Partnership on Non-Communicable Diseases under the Malaysia Partnership and Alliances in Research (MyPAiR), funded by the Ministry of Education, Malaysia (Grant number: IF076-2019). H.A.D. was partly funded by an NIHR Senior Research Fellowship through the Oxford Biomedical Research Centre at the time the research was conducted. J.L. acknowledges support from the Innovative Medicines Initiative 2 Joint Undertaking under Grant agreement no. 115881 (RHAPSODY). P.C. is partly supported by funding from the NIHR Oxford Biomedical Research Centre (BRC) and the Health Foundation. Exenatide Study of Cardiovascular Event Lowering (EXSCEL) was sponsored and funded by Amylin Pharmaceuticals, Inc., a wholly owned subsidiary of AstraZeneca. Trial Evaluating Cardiovascular Outcomes With Sitagliptin (TECOS) was funded by Merck Sharp and Dohme Corp, a subsidiary of Merck and Co, Inc. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Role of the Funder\/Sponsor"}},{"value":"Requests for data access and proposals for analyses of EXSCEL and TECOS data can be submitted to the respective study Publications Committee using instructions found at  and .","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability Statement"}}]}}