A Model to Estimate the Lifetime Health Outcomes of Patients With Type 2 Diabetes: The United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS No. 68)

Clarke PM, Gray AM, Briggs A, Farmer AJ, Fenn P, Stevens RJ, Matthews DR, Stratton IM, Holman RR. Diabetologia. 2004;47:1747-1759.

The United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model is a computer simulation model consisting of a comprehensive integrated system of equations developed from data on 3,642 patients. The model can be used to estimate lifetime outcomes and quality-adjusted life expectancy based on estimates of the first occurrence of 7 diabetes-related complications (myocardial infarction, other ischemic heart disease, stroke, heart failure, amputation, renal failure, and eye disease) and death.

The validity of the model was tested using the UKPDS population, and the model’s forecasts were found to be consistent with the occurrence of observed events in the study. The model was also used to compare intensive blood glucose control and conventional therapy in terms of quality-adjusted life expectancy, which was found to be 16.35 years and 16.62 years, respectively (95% CI: –0.48 to 1.03).

Computer simulation models of the progression of type 2 diabetes and lifetime outcomes serve a wide range of purposes. Their primary use is for the estimation of the cost-effectiveness of disease management strategies. Computer simulation models are also used to estimate diabetes-related healthcare costs, future occurrence of complications, and life expectancy. Compared with previously developed models, the UKPDS Outcomes Model offers a number of advantages: the data are based on a single, large, well-validated trial with a long median follow-up period of 10.3 years and low loss of data during follow-up, and full clinical histories were obtained for all participants.

This paper provides a detailed description of the model, demonstrating its validity in accurately forecasting outcomes in the UKPDS and its use in extrapolating lifetime outcomes. The next step is external validation of the model using other populations of subjects with type 2 diabetes.