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Coronary heart disease risk factors in Canada: a Microsimulation predictive model

Doug Manuel, MD, MSc, William M. Flanagan, BM, Meltem Tuna, PhD, Anya Okhmatovskaia, PhD, Philippe Finès, PhD; Carol Bennett, MSc. Coronary heart disease risk factors in Canada: a Microsimulation predictive model. Simulated Technology for Applied Research (STAR).

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Coronary heart disease risk factors in Canada: a Microsimulation predictive model

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  1. Doug Manuel, MD, MSc, William M. Flanagan, BM, Meltem Tuna, PhD, Anya Okhmatovskaia, PhD, Philippe Finès, PhD; Carol Bennett, MSc Coronary heart disease risk factors in Canada: a Microsimulation predictive model

  2. Simulated Technology for Applied Research (STAR) • A Canadian Institute for Health Research New Emerging Team including: • Behnam Sharif, MSc, • Jacek A. Kopec, MD, PhD, • Hubert Wong, PhD, • Aslam Anis , PhD, • Eric C. Sayre, PhD, M. • Mushfiqur Rahman, MSc, • David Buckeridge, MD, PhD, • Jillian Oderkirk, MSc, • Michal Abrahamowicz, PhD, • Sam Harper, PhD, • Michael C. Wolfson, PhD

  3. Chronic Diseases • Major cause of death and disability worldwide. • Reason of more than 55 thousand deaths in Canada so far this year. • 57% of those under 65 live with at least one chronic condition. • An additional chronic disease raises the risk of hospitalization by 44% among people under age 60.

  4. Behavioural Smoking Physical Inactivity Biophysical Obesity Elevated Cholesterol Blood Pressure Risk Factors

  5. Micro-simulation at Statistics Canada POHEM: Population Health Model

  6. Characteristics of POHEM • case-by-case, longitudinal, continuous time, stochastic, Monte Carlo microsimulation • directly encompasses competing risks and comorbidity • longitudinal risk factor and disease sub-modules • projects population forward in continuous time • generates plausible health biographies over the life course of synthetic individuals from empirical observations

  7. Process for projecting coronary heart disease risks in Canada, 2001 to 2020 Canadian population (2001) Canadian Community Health Survey (2001) Update for births, deaths, immigration, emigration and change in CAD risks Update yearly (2002 – 2009) Compare births, deaths, immigration , emigration and prevalence of CAD. Validate (2002 – 2009) Generate predictive estimates (2010 – 2020)

  8. Data sources

  9. Births and DeathsYearly Updates

  10. Immigration and Emigration Yearly Updates

  11. Socioeconomic Yearly Updates

  12. CAD Risks Yearly Updates

  13. Coronary heart disease risk factors, prevalence in 2001

  14. Observed vs. Predicted

  15. Multiple Risk Factors: Diabetes – Obesity - Smoking

  16. Predicted and observed risk factors, 2009 Canada

  17. References • M.C. Wolfson , POHEM—a framework for understanding and modelling the health of human populations. Wld. Hlth. Statist. Quart.47 (1994), pp. 157–176 • Statistics Canada. Canadian Community Health Surveys, Cycles 1.1-4.1, 2009-2010.

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