@article{emamipour_transferability_2022,
	title = {The transferability and validity of a population-level simulation model for the economic evaluation of interventions in diabetes: the {MICADO} model},
	issn = {1432-5233},
	url = {https://link.springer.com/10.1007/s00592-022-01891-2},
	doi = {10.1007/s00592-022-01891-2},
	shorttitle = {The transferability and validity of a population-level simulation model for the economic evaluation of interventions in diabetes},
	abstract = {Abstract
            
              Aims
              Valid health economic models are essential to inform the adoption and reimbursement of therapies for diabetes mellitus. Often existing health economic models are applied in other countries and settings than those where they were developed. This practice requires assessing the transferability of a model developed from one setting to another. We evaluate the transferability of the {MICADO} model, developed for the Dutch 2007 setting, in two different settings using a range of adjustment steps. {MICADO} predicts micro- and macrovascular events at the population level.
            
            
              Methods
              {MICADO} simulation results were compared to observed events in an Italian 2000–2015 cohort (Casale Monferrato Survey [{CMS}]) and in a Dutch 2008–2019 (Hoorn Diabetes Care Center [{DCS}]) cohort after adjusting the demographic characteristics. Additional adjustments were performed to: (1) risk factors prevalence at baseline, (2) prevalence of complications, and (3) all-cause mortality risks by age and sex. Model validity was assessed by mean average percentage error ({MAPE}) of cumulative incidences over 10 years of follow-up, where lower values mean better accuracy.
            
            
              Results
              For mortality, {MAPE} was lower for {CMS} compared to {DCS} (0.38 vs. 0.70 following demographic adjustment) and adjustment step 3 improved it to 0.20 in {CMS}, whereas step 2 showed best results in {DCS} (0.65). {MAPE} for heart failure and stroke in {DCS} were 0.11 and 0.22, respectively, while for {CMS} was 0.42 and 0.41.
            
            
              Conclusions
              The transferability of the {MICADO} model varied by event and per cohort. Additional adjustments improved prediction of events for {MICADO}. To ensure a valid model in a new setting it is imperative to assess the impact of adjustments in terms of model accuracy, even when this involves the same country, but a new time period.},
	journaltitle = {Acta Diabetologica},
	shortjournal = {Acta Diabetol},
	author = {Emamipour, Sajad and Pagano, Eva and Di Cuonzo, Daniela and Konings, Stefan R. A. and van der Heijden, Amber A. and Elders, Petra and Beulens, Joline W. J. and Leal, Jose and Feenstra, Talitha L.},
	urldate = {2022-05-11},
	date = {2022-04-21},
	langid = {english},
	keywords = {{WP}8},
}