Figure 3 shows the adjusted estimates of the mean annual postbronchodilator FEV1 decline (primary outcome) and 95% confidence intervals for base case population smokers and non-smokers in each category.
This being one of the first simulation models evaluating screening and treatment to delay or prevent clinical AD, we provide explicit assumptions related to the base-case population and their adherence and persistence with treatment when a screen is positive.
One of the particular strengths of our study is the large number of respiratory symptomatic subjects (3,324 in the base case population) with repeated postbronchodilator spirometry tests that could be included in our analysis.
While the HR of patients on target dose therapy (HR: 0.68) was close to the HR observed in the base case population (HR: 0.62), the underlying clinical event rate was insufficient to provide statistical significance.
The model was populated with cost and epidemiological data for Belgium from a healthcare perspective, and the base-case population was defined from the FREEDOM trial.
The RRs resulting from the model for sustaining a fracture at the hip, spine, wrist, or "other sites" for the base-case population (T-score ≤2.5 or less, started treatment at age 65 years, and 28% prevalence of osteoporotic fracture) compared with the overall population were 4.36, 3.20, 1.68, and 2.00, respectively.
This study included the cost of preventive therapy, cost of acute treatment, and indirect costs (time lost from work) for a base-case population of people who experience a mean of 6 migraine attacks per month in the absence of preventive therapy.
This confirms the higher risk of fracture of the base-case population compared with the overall population.
Despite the base-case population in the model being well matched with the clinical trial population; there are generalizability issues with the base-case estimates.
The remainder of this discussion will therefore focus on the results generated in the base-case population of chronic dialysis patients.
