Structuring the Markov Model: Group Exercise

Model Diagram

H Asympomatic (A) H->H S Progressive Disease (P) H->S Db Death from other causes (Db) H->Db S->S S->Db Dd Death from disease (Dd) S->Dd Db->Db Dd->Dd

Natural History Parameters

  • Progressive disease incidence rate (r_AP): 0.4 over 10 years
  • Background mortality rate (r_Db): 0.006 per year
  • Hazard rate of death from progressive disease relative to background mortality (HR_PDd): 3.0

Strategy A: Preventive Measure

  • Relative risk of developing progressive disease (RR_AP): 0.75

Strategy B: Disease Treatment

  • Odds-ratio of death from progressive disease (OR_PDd): 0.80
  • Baseline annual probability of death in underlying clinical trial (p0_OR_PDd): 0.03

Strategy C: Cure

  • 10-year disease remission rate (i.e., return to asymptomatic state; r_PA_trtC): 0.50

Parameter Table

Parameter Description Value
r_AP 10-year progressive disease incidence rate 0.40
r_Db Background mortality rate 0.006
HR_PDd Hazard rate of death from progressive disease relative to background mortality 3.0
RR_AP Relative risk of developing progressive disease (Strategy A) 0.75
OR_PDd Odds-ratio of death from progressive disease (Strategy B) 0.80
p0_OR_PDd Baseline probability of death in underlying clinical trial (Strategy B) 0.03
r_PA_trtC 10-year disease remission rate (Strategy C) 0.50

Key

Rate adjusted for timestep
Hazard Ratio
Probability
Relative Risk
Odds Ratio
Constructed from other cells

Goal: Natural History Transition Probability Matrix

m_P0 =

Asymptomatic Progressive Disease Disease Mortality Background Mortality
Asymptomatic \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\)
Progressive Disease \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\)
Disease Mortality \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\)
Background Mortality \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\) \(\quad \quad \quad \quad \quad\)
Rate adjusted for timestep
Hazard Ratio
Probability
Relative Risk
Odds Ratio
Constructed from other cells