The Coronary Heart Disease (CHD) Policy Model is a computer simulation model that forecasts the long=-term effects of treatment technologies and risk factor interventions on CHD incidence, prevalence, mortality, and economic cost. This project will extend and apply the model in four new areas: (1) incorporate and forecast the effects of new treatment modalities including thrombolysis (tissue plasminogen activator, streptokinase), percutaneous transluminal coronary angioplasty, and drug therapies for persons with established CHD: (2) perform a series of comparative forecasts of risk-factor intervention strategies, including serum cholesterol reduction, aspirin use, and exercise, with particular attention to the comparative effects of targeted versus population-wide interventions, multiple- versus single-factor interventions, and secondary prevention(in persons with established CHD) versus primary prevention; (3) forecast manpower and facilities requirements (cardiologists, cardiac surgeons, hospital beds, catheterization laboratories) in addition to summary measures of resource use such as annual and present-value economic cost; and (4) include non-CHD related direct costs, indirect costs, and pension costs among the economic outcome measures, and include quality of life (quality-adjusted life expectancy) as a health outcome measure. Also planned for the project period will be a major reprogramming of the model for microcomputer use and recalibrations of the parameters of the model based on 1985 vital and health statistics, the Third National Health and Nutrition Examination Survey, and current follow-up data from the Framingham heart Study.
| Gaspoz, Jean-Michel; Coxson, Pamela G; Goldman, Paula A et al. (2002) Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. N Engl J Med 346:1800-6 |
| Prosser, L A; Stinnett, A A; Goldman, P A et al. (2000) Cost-effectiveness of cholesterol-lowering therapies according to selected patient characteristics. Ann Intern Med 132:769-79 |
| Hunink, M G; Goldman, L; Tosteson, A N et al. (1997) The recent decline in mortality from coronary heart disease, 1980-1990. The effect of secular trends in risk factors and treatment. JAMA 277:535-42 |
| Tosteson, A N; Weinstein, M C; Hunink, M G et al. (1997) Cost-effectiveness of populationwide educational approaches to reduce serum cholesterol levels. Circulation 95:24-30 |
| Goldman, L; Goldman, P A; Williams, L W et al. (1993) Cost-effectiveness considerations in the treatment of heterozygous familial hypercholesterolemia with medications. Am J Cardiol 72:75D-79D |
