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Title: An individual life history model for heart disease, stroke and death : structure, parameterisation and applications
Author: Chatterjee, Tushar
Awarding Body: Heriot-Watt University
Current Institution: Heriot-Watt University
Date of Award: 2008
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We have developed' a multiple - state stochastic Markov model incorporating the factors hypertension, hypercholesterolaemia, diabetes, body mass index and the events ischaemic heart disease, stroke and death. Smoking is treated deterministically in our model. The model is specified by transition intensities obtained from Framingham Heart Study data and adjusted using Health Survey for England data to produce results that are consistent with the English population. We can calculate the expected future lifetime for an individual using the model. 'In terms of the expected future lifetime we have estimated the effect of treatment with a statin, a cholesterol lowering drug that reduces the intensity of having myocardial infarction and stroke. Statins can increase expected future iifetime by more than a year for certain classes of individuals. Also current smokers have a substantially reduced lifetime compared to those who never smoke and expected lifetime increases on giving up smoking. We have used the model to project future levels of obesity which can increase to very high levels if present trends continue, but this is unlikely to have a substantial effect on expected future lifetime. Due to unavailability of suitable longitudinal data from the UK, the model was parameterised using data from USA and adjusted to obtain results for the English population. As a result we have been unable to measure the uncertainty in the results for the English population directly. We have used parameter simulation to quantify the uncertainty in the results obtained. The results obtained in this thesis are based on the Framingham data sets and some of the results may be affected by characteristics specific to this population.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available