William H. Herman, MD, MPH; Thomas J. Hoerger, PhD; Katherine Hicks, MS; Michael Brandle, MD, MS; Stephen W. Sorensen, PhD; Ping Zhang, PhD; Michael M. Engelgau, MD, MS; Richard F. Hamman, MD, DrPH; David G. Marrero, PhD; Ronald T. Ackermann, MD, MPH; Robert E. Ratner, MD
Potential Financial Conflicts of Interest: None disclosed.
Herman WH, Hoerger TJ, Hicks K, Brandle M, Sorensen SW, Zhang P, et al. Managing People at High Risk for Diabetes. Ann Intern Med. 2006;144:66-67. doi: 10.7326/0003-4819-144-1-200601030-00018
Download citation file:
Published: Ann Intern Med. 2006;144(1):66-67.
TO THE EDITOR:
We are writing in response to the report by Eddy and colleagues (1). We have several questions about their simulations, conclusions, and representation of our work. Unlike the authors, we found a favorable cost-effectiveness ratio for the Diabetes Prevention Program lifestyle intervention (2).
The Archimedes model may or may not represent a quantum leap in diabetes modeling. For simulation models to aid decision making, they must be transparent and have face validity. By using complex differential equations fitted to empirical data, the Archimedes model can simulate an infinite number of physiologic processes. Unfortunately, the equations governing disease progression are not transparent. In contrast, Markov models can simulate only a finite number of health states. Yet, as demonstrated in the appendix to the report by Eddy and colleagues, Markov models are transparent and invite critics to debate their validity.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only