Background
Methods
Current method of estimation in the IMPACT model
Single treatment
Combination of treatments
DPP calculation and case fatality rate
Description of the proposed method
Probabilistic framework
Potential impact fraction and single treatment
Combination of treatments
Comparison of the two methods
Single treatment
Results
Synthetic example
Reducing cardiovascular mortality in Ontario: a case study
Disease | Treatment | Original method | PIF-based method | Percentage difference in DPP | ||
---|---|---|---|---|---|---|
DPP | % mortality reduction |
DPP
| % mortality reduction | |||
AMI |
223.05
|
2.22
|
236.16
|
2.35
| 5.88 | |
Beta blockers |
7.13
|
0.07
|
7.29
|
0.07
| 2.24 | |
ACE inhibitors |
43.98
|
0.44
|
45.25
|
0.45
| 2.89 | |
Reperfusion |
164.78
|
1.64
|
179.59
|
2.04
| 8.99 | |
Statins |
7.16
|
0.07
|
8.29
|
0.08
| 15.78 | |
2’ Prevention post AMI |
176.82
|
1.76
|
178.50
|
1.77
| 0.95 | |
Beta blockers |
8.08
|
0.08
|
9.36
|
0.09
| 15.84 | |
ACE inhibitors |
31.83
|
0.32
|
35.12
|
0.35
| 10.34 | |
Statins |
2.58
|
0.03
|
2.98
|
0.03
| 15.50 | |
Rehabilitation |
134.33
|
1.34
|
138.11
|
1.37
| 2.81 | |
ACS |
21.26
|
0.21
|
22.66
|
0.23
| 6.59 | |
Beta blockers |
1.77
|
0.02
|
1.81
|
0.02
| 2.26 | |
ACE inhibitors |
9.56
|
0.10
|
9.82
|
0.10
| 2.72 | |
Statins |
9.93
|
0.10
|
11.29
|
0.11
| 13.70 | |
Chronic angina and CHD: medical therapy |
703.81
|
7.00
|
743.31
|
7.39
| 5.61 | |
Aspirin |
106.61
|
1.06
|
116.16
|
1.16
| 8.96 | |
ACE inhibitors |
436.83
|
4.34
|
463.12
|
4.60
| 6.02 | |
Statins |
160.37
|
1.59
|
182.27
|
1.81
| 13.66 | |
Chronic angina and CHD: PCI |
7.06
|
0.07
|
7.51
|
0.08
| 6.37 | |
Aspirin |
0.64
|
0.01
|
0.70
|
0.01
| 9.37 | |
ACE inhibitors |
5.70
|
0.06
|
6.06
|
0.06
| 6.32 | |
Statins |
0.72
|
0.01
|
0.83
|
0.01
| 15.28 | |
Chronic angina and CHD- CABG |
14.10
|
0.14
|
15.16
|
0.15
| 7.52 | |
Aspirin |
2.09
|
0.02
|
2.29
|
0.02
| 9.57 | |
ACE inhibitors |
10.33
|
0.10
|
11.11
|
0.11
| 7.55 | |
Statins |
1.68
|
0.02
|
1.94
|
0.02
| 15.48 | |
Hospital heart failure |
149.80
|
1.49
|
165.17
|
1.64
| 10.26 | |
ACE inhibitors |
47.00
|
0.47
|
51.46
|
0.51
| 9.49 | |
Beta blockers |
102.80
|
1.02
|
118.81
|
1.18
| 15.57 | |
Community heart failure |
601.33
|
5.98
|
686.99
|
6.83
| 14.25 | |
ACE inhibitors |
199.61
|
1.98
|
221.30
|
2.20
| 10.87 | |
Beta blockers |
401.72
|
3.99
|
480.61
|
4.78
| 19.64 | |
Hypertension Treatment |
60.25
|
0.60
|
62.10
|
0.62
| 3.07 | |
all treatments |
60.25
|
0.60
|
62.10
|
0.62
| 3.07 | |
Hyperlipidemia Treatment |
135.15
|
1.34
|
145.02
|
1.44
| 7.30 | |
Statins 1’ prevention |
135.15
|
1.34
|
145.02
|
1.44
| 7.30 | |
Total
|
2092.63
|
20.80
|
2262.59
|
22.49
|
8.12
|