The Conceptualization of Cardiometabolic Disease Policy Model in the UK

Abstract

Background Decision models are increasingly used to inform the policy-making processes, and there is a need to improve their credibility. The estimation of health and economic outcomes generated from the 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 conceptualization of the problem, the CMD disease staging, progression, and current clinical guidelines are summarized. We critically appraised published CMD models such as cardiovascular disease (CVD) and type 2 diabetes (T2DM). Key challenges of the modelling from this review include the importance of understanding complex risk factors, the economic perspective used, the need to improve the validation process of the state transition model, model structure, and assumptions. Second, as a sequential process, is model conceptualization, to determine which modelling types and their attributes best represent the defined problem. Expert opinions, including a clinician and experienced modellers, provided some input on the state transition model to ensure the structure is clinically relevant. From this stage, Atrial Fibrillation (AF) is considered as a potential covariate, removing further complication state for T2DM, and reconsidering myocardial infarction (MI) as a CHD state. Conclusion This conceptual model serves as a basis for representing the systematic process for structuring the CMD policy model to enhance its transparency and credibility.