The purpose of this project is to develop an integrated Cardiovascular Disease (CVD) Prevention Model which can be used to estimate the health and economic consequences of various screening, prevention, and treatment strategies for coronary heart disease, stroke, and congestive heart failure (CHF) in the U.S. population over the age of 35 and several subpopulations. The project is to help achieve strategic Goal 3 of the NHLBI Strategic Plan set out in 2007 to "translate research into practice" by specifically answering Challenge 3.2 to "identify cost-effective approaches to prevention, diagnosis and treatment". The CVD Prevention Model will be a comprehensive model of CHD, CHF, stroke and their risk factors as well as the costs related to care for CVD. The model will be fit to the observed epidemiological data, natural history data, and trends from the published literature and publicly available databases in the US with the flexibility to be adapted to other developing regions and sub-populations of the U.S. The micro-simulation model will be parameterized using the best available data and is then calibrated to U.S. population data using a likelihood- based approach that formally compares how well model outcomes produced by each unique parameter set match targets based on epidemiologic data, such as age- and other risk factors as well as disease incidence rates. Model outcomes include intermediate outcomes (e.g., cases of myocardial infarction, stroke, number of catheterizations, and CHF hospitalizations) as well as long-term outcomes (e.g., CHD incidence and mortality, life expectancy, quality-adjusted life expectancy, and lifetime costs). It will incorporate risk factor distributions in the U.S. population based on NHANES studies and other sources, changes in risk factors with age, mathematical relationships between risk factors and disease incidence. The model will also incorporate the effectiveness and costs of population and individually based preventive interventions. It will incorporate the sensitivity, specificity, costs, and risks of screening, and the costs and risks of early intervention. It will be designed so that analyses can be conducted for specific subpopulations defined according to demographic and socio- economic characteristics such as race, ethnicity, and occupation. The model will also be calibrated to several subpopulations in the U.S. as well as to the country of South Africa.

Public Health Relevance

The purpose of this project is to develop a Cardiovascular Disease Prevention Model which can be used to estimate the health and economic consequences of cardiovascular screening, treatment, and prevention interventions in the U.S. population and several subpopulations. The model will involve the relationship between lifestyle, and environmental risk factors for the development of the three main contributors of cardiovascular disease (CVD) morbidity and mortality-CHD, CHF, and stroke. It will incorporate the sensitivity, specificity, costs, and benefits of screening, and the costs and benefits of early intervention.

Agency
National Institute of Health (NIH)
Type
Research Project (R01)
Project #
5R01HL104284-04
Application #
8530270
Study Section
Health Services Organization and Delivery Study Section (HSOD)
Program Officer
Bonds, Denise
Project Start
Project End
Budget Start
Budget End
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Harvard University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
City
Boston
State
MA
Country
United States
Zip Code
02115
Pandya, Ankur; Weinstein, Milton C; Salomon, Joshua A et al. (2014) Who needs laboratories and who needs statins?: comparative and cost-effectiveness analyses of non-laboratory-based, laboratory-based, and staged primary cardiovascular disease screening guidelines. Circ Cardiovasc Qual Outcomes 7:25-32
Gaziano, Thomas A; Pagidipati, Neha (2013) Scaling up chronic disease prevention interventions in lower- and middle-income countries. Annu Rev Public Health 34:317-35
Valluri, Sruthi; Gaziano, Thomas A (2013) Progress in national and regional guidelines development and deployment for the clinical prevention and control of CVD and diabetes in Africa. Prog Cardiovasc Dis 56:336-43
Pagidipati, Neha Jadeja; Gaziano, Thomas A (2013) Estimating deaths from cardiovascular disease: a review of global methodologies of mortality measurement. Circulation 127:749-56
Pandya, Ankur; Gaziano, Thomas A; Weinstein, Milton C et al. (2013) More americans living longer with cardiovascular disease will increase costs while lowering quality of life. Health Aff (Millwood) 32:1706-14