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Open Access 01-12-2019 | Dementia | Technical advance

New ways of estimating excess mortality of chronic diseases from aggregated data: insights from the illness-death model

Authors: Ralph Brinks, Thaddäus Tönnies, Annika Hoyer

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Recently, we have shown that the age-specific prevalence of a disease can be related to the transition rates in the illness-death model via a partial differential equation (PDE). The transition rates are the incidence rate, the remission rate and mortality rates from the ‘Healthy’ and ‘Ill’ states. In case of a chronic disease, we now demonstrate that the PDE can be used to estimate the excess mortality from age-specific prevalence and incidence data. For the prevalence and incidence, aggregated data are sufficient - no individual subject data are needed, which allows application of the methods in contexts of strong data protection or where data from individual subjects is not accessible.

Methods

After developing novel estimators for the excess mortality derived from the PDE, we apply them to simulated data and compare the findings with the input values of the simulation aiming to evaluate the new approach. In a practical application to claims data from 35 million men insured by the German public health insurance funds, we estimate the population-wide excess mortality of men with diagnosed type 2 diabetes.

Results

In the simulation study, we find that the estimation of the excess mortality is feasible from prevalence and incidence data if the prevalence is given at two points in time. The accuracy of the method decreases as the temporal difference between these two points in time increases. In our setting, the relative error was 5% and below if the temporal difference was three years or less. Application of the new method to the claims data yields plausible findings for the excess mortality of type 2 diabetes in German men.

Conclusions

The described approach is useful to estimate the excess mortality of a chronic condition from aggregated age-specific incidence and prevalence data.

Trial registration

The article does not report the results of any health care intervention.

Available only for authorised users

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Title: New ways of estimating excess mortality of chronic diseases from aggregated data: insights from the illness-death model
Authors: Ralph Brinks
Thaddäus Tönnies
Annika Hoyer
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Dementia
Dementia
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7201-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

New ways of estimating excess mortality of chronic diseases from aggregated data: insights from the illness-death model

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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