ArticleBMC medical informatics and decision making2018
The effect of model selection on cost-effectiveness research: a comparison of kidney function-based microsimulation and disease grade-based microsimulation in chronic kidney disease modeling.
Article in BMC medical informatics and decision making, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Humanistic and Economic Burden of IgA Nephropathy: Systematic Literature Reviews and Narrative Synthesis.PharmacoEconomics - open · 2023Pooled it
- Trial
- Cost-effectiveness of multidisciplinary care for patients with chronic kidney disease in Japan.Clinical and experimental nephrology · 2026Article
- A Microsimulation-Based Approach for Mitigating Societal Bias in Chronic Kidney Disease Data.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- A microsimulation-based framework for mitigating societal bias in primary care data.medRxiv : the preprint server for health sciences · 2025Article
- Cost-Effectiveness of Empagliflozin in CKD with or without Albuminuria.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Impact of Proteinuria and Kidney Function Decline on Health Care Costs and Resource Utilization in Adults With IgA Nephropathy in the United States: A Retrospective Analysis.Kidney medicine · 2023Article
- Cost-Effectiveness Analysis of Nefecon versus Best Supportive Care for People with Immunoglobulin A Nephropathy (IgAN) in the United States.ClinicoEconomics and outcomes research : CEOR · 2023Article
- A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy.Journal of health economics and outcomes research · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCost effectiveness research is emerging in the chronic kidney disease (CKD) research field. Especially, an individual-level state transition model (microsimulation) is widely used for these researches. Some researchers set CKD grades as discrete health states, and the transition probabilities between these states were dependent on the CKD grades (disease grade-based microsimulation, MSM-dg), while others set estimated glomerular filtration rate value which determines the severity of CKD as a main variable describing patients' continuous status (kidney function-based microsimulation, MSM-kf). MSM-kf seems to reflect the real world more precisely but is more difficult to implement. We compared the calculation results of these two microsimulation models to evaluate the effect of model selection on CKD cost-effectiveness analysis.
methodsWe implemented simplified MSM-dg and MSM-kf emulating natural course of CKD in general, and compared models using parameters derived from an IgA nephropathy cohort. After checking these models' overall behavior, life-years, utilities, and thresholds regarding intervention costs below which the intervention is thought as dominant (V0) or cost-effective (V1) were calculated. In addition, one-way and probabilistic sensitivity analyses were performed.
resultsWith base-case parameters, the calculated life-years was shorter in MSM-dg (73.89 vs. 75.80 years) while the thresholds were almost equal (86.87 vs. 90.43 (V0), 132.29 vs. 146.25 [V1 in 1000 USD]) compared to MSM-kf. Sensitivity analyses showed a tendency of the MSM-dg to show shorter results in life-years. V0 and V1 were distributed by approximately ±100,000 USD (V0) and ± 150,000 USD (V1) between models.
conclusionsEstimated cost-effectiveness thresholds by both models were not the same and its difference distributed too wide to be ignored. This result indicated that model selection in CKD cost-effectiveness research has large effect on their conclusions.
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