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Table 4 Parameter values (deterministic, in ranges) for modelling: Inputs for effectiveness (including data on identification, screening uptake, progression, further investigation and treatment)

From: Access to health care for older people with intellectual disability: a modelling study to explore the cost-effectiveness of health checks

 

Data

Source and details

Effectiveness of annual health checks in terms of: identification; uptake of national screening; management of conditions (in probabilities, annual health check vs. standard care group)

 Hypertension identified and managed

85 to 95·3% vs. 71·4 to 87·8%

Buszewicz and colleagues [23]

 Participation in bowel cancer screening (FOBT), difference between AHC and standard care, in percentage points

4·1 to 7·8%

Hewitson and colleagues [52] and expert views

 Participation in breast cancer screening (mammogram)

54·3 to 59·3% vs. 47 to 52%

Derived from IDS-TILDA by McCarron and colleagues [17], Gardner and colleagues [53] and expert views

 Diabetes managed (identification found similar in both groups)

69·9% (SD 34·2) vs. 56.8% (SD 29·4)

Cooper and colleagues [16]; refers to proportion of people whose health monitoring needs are met

 Osteoporosis investigated

85 to 95% vs. 66·2 to 86·8%

Derived from Lennox and colleagues [49] and expert views

 Person with eye problem (cataract or glaucoma) is referred to eye exam

90% vs. 58.9% (SD 0·24)

Derived from Buszewicz and colleagues [23] and expert views

 Person with hearing problems is referred to hearing assessment

90% vs. 27·6 to 33%

As above

Effectiveness of: identification; uptake of national screening; management of conditions

Relative Risk (RR) in stroke, CHD and death, managed versus unmanaged hypertension

Stroke

 40 to 59 years

0·61 to 0·65

Moran and colleagues [52]

 60 years +

0·66 to 0·71

As above

CHD

 40 to 59 years

0·72 to 0·74

As above

 60 years +

0·74 to 0·78

As above

Death

 40 to 59 years+

0·83 to 0·89

As above

 60 years +

0·91 to 0·92

As above

 Increased risk of stroke in people with hypertension

3 to 5

Straus and colleagues [55]

 Increased risk of CHD in people with hypertension

2 to 3

Padwal and colleagues [54]

 Absolute risk reductions (in percentage points) in death for people participating in bowel screening

1·01%

Scholefield and colleagues [57]

 Progression probabilities for glaucoma, treatment vs. not in treatment

 Progression from mild to moderate

22% vs. 25%

Burr and colleagues [44]

 Progression from moderate to severe

7% vs. 11%

As above

 Progression from severe to visual impairment

6% vs. 10%

As above

 Relative risk reduction of death from breast cancer for women invited for mammography

0·73 to 0·89

Pharoah and colleagues [31]

Probabilities for further investigations and treatment (after screening or diagnosis)

Hypertension

 Adherence to management

75% (in one-way SA: 50%)

Moran and colleagues [54]

Bowel cancer

 Screening positive and requiring further investigation

1·84 to 2·1%

Raine and colleagues [58]

 Visit at specialist clinic for further investigation if screening was positive

74·7 to 91·3%

Logan and colleagues [59]

 Bowel cancer if screening was positive

9·09 to 11·11%

As above

 Pre-cancer polyps if screening was positive

24·48 to 29·92%

As above

 Admission for bleeding due to further investigation

0·39 to 0·48%

Tappenden and colleagues [37]

Osteoporosis

 Prescription of drugs to person identified with osteoporosis

99·6%

Presentation by Shepstone at National Osteoporosis Conference 2016; [58] refers to findings from SCOOP study

Cataract

 Corrected with glasses if referred to eye exam

50 to 67%

Lennox and colleagues [51]

 Surgery if referred to eye exam

5 to 9%

Expert view

Glaucoma

 Adherence to treatment

63·9 to 78·1%

Okeke and colleagues [61]; mean of 71%, value range +/− 10%

Hearing problems

 Hearing problem due to blocked ear wax (i.e. no referral required)

15·7 to 50%

Robertson and colleagues [20] and Clegg and colleagues [48]

 Hearing problem not due to blocked ear wax and referral made to specialist

50 to 84·7%

Derived as residual from above

 Person referred to specialist assessment attends it

80 to 90%

Expert view

 Person assessed by specialist as requiring hearing aid

42·2 to 51·6%

Lennox and colleagues [50]

 Person requiring hearing aid accepts and starts using it

36·8 to 86%

Morris and colleauges [59]

Breast cancer

 Breast cancer identified through mammogram

73·3 to 93·8%

Sinclair and colleagues [63]

 Relative risk of over-diagnosis for women invited to mammography

1·19

As above