Development of a cardiometabolic disease policy model: leveraging the role of UK primary care data

Putri, Septiara (2025) Development of a cardiometabolic disease policy model: leveraging the role of UK primary care data. PhD thesis, University of Glasgow.

Abstract

Cardiometabolic diseases, including type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), pose a growing public health burden globally and in the UK. Effective policy responses require robust modeling tools to evaluate the long-term clinical and economic impacts, particularly for preventative interventions. This thesis presents the development of a cardiometabolic disease (CMD) policy model designed to simulate the natural history and progression of major cardiometabolic conditions.

The model adopts a multi-state survival analysis model with semi-Markov structure, by utilising real-world patient-level data from the Clinical Practice Research Datalink (CPRD) Aurum, linked with Hospital Episode Statistics (HES), mortality records, and the Index of Multiple Deprivation (IMD). It estimates transition probabilities across key health states: disease-free, T2DM, first and recurrent cardiovascular events, and death.

Both parametric and flexible survival models are explored to estimate transition risks and enable long-term extrapolation. The model also incorporates time-dependent covariates, allowing risks to evolve as patient characteristics change. Model performance is assessed through rigorous diagnostics and validation.

A key feature of this model is its hybrid approach, which combines cohort-based transitions with microsimulation components. This structure captures both population-level trends and individual-level heterogeneity, enhancing the model’s flexibility and relevance for policy analysis. Model outputs include life-years, quality-adjusted life years (QALYs), and healthcare costs, with also the extended ability to assess outcomes across different ethnic groups and explore health inequalities.

This CMD policy model offers a flexible, real-world-informed decision-support tool for policymakers, health economists, and public health planners. Its hybrid structure provides a foundation for supporting the long-term clinical and economic impacts of interventions to reduce the burden of cardiometabolic diseases in the UK population.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Additional Information: Supported by funding from the Indonesian Endowment Fund for Education (LPDP), Ministry of Finance, Indonesia.
• Subjects: R Medicine > R Medicine (General)
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Funder's Name: Indonesian Endowment Fund for Education (LPDP), Ministry of Finance, Indonesia
• Supervisor's Name: Geue, Dr. Claudia, Ciminata, Dr. Giorgio and Lewsey, Professor Jim
• Date of Award: 2025
• Depositing User: Theses Team
• Unique ID: glathesis:2025-85672
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 13 Jan 2026 14:45
• Last Modified: 13 Jan 2026 15:47
• Thesis DOI: 10.5525/gla.thesis.85672
• URI: https://theses.gla.ac.uk/id/eprint/85672

Related URLs

• Article DOI
• Article DOI
• Article DOI
• Article DOI
• Article DOI
• Article DOI
• Article DOI
• Article DOI