scholarly journals Health Benefits and Cost-Effectiveness From Promoting Smartphone Apps for Weight Loss: Multistate Life Table Modeling

10.2196/11118 ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. e11118 ◽  
Author(s):  
Christine Cleghorn ◽  
Nick Wilson ◽  
Nisha Nair ◽  
Giorgi Kvizhinadze ◽  
Nhung Nghiem ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Life Table ◽  
Health Benefits ◽  
Smartphone Apps ◽  
Multistate Life Table

scholarly journals Health Benefits and Cost-Effectiveness From Promoting Smartphone Apps for Weight Loss: Multistate Life Table Modeling (Preprint)

2018 ◽  
Author(s):  
Christine Cleghorn ◽  
Nick Wilson ◽  
Nisha Nair ◽  
Giorgi Kvizhinadze ◽  
Nhung Nghiem ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Mass Media ◽  
Health System ◽  
Life Table ◽  
Total Population ◽  
Smartphone App ◽  
Smartphone Apps ◽  
The Mass Media ◽  
Multistate Life Table

BACKGROUND Obesity is an important risk factor for many chronic diseases. Mobile health interventions such as smartphone apps can potentially provide a convenient low-cost addition to other obesity reduction strategies. OBJECTIVE This study aimed to estimate the impacts on quality-adjusted life-years (QALYs) gained and health system costs over the remainder of the life span of the New Zealand population (N=4.4 million) for a smartphone app promotion intervention in 1 calendar year (2011) using currently available apps for weight loss. METHODS The intervention was a national mass media promotion of selected smartphone apps for weight loss compared with no dedicated promotion. A multistate life table model including 14 body mass index–related diseases was used to estimate QALYs gained and health systems costs. A lifetime horizon, 3% discount rate, and health system perspective were used. The proportion of the target population receiving the intervention (1.36%) was calculated using the best evidence for the proportion who have access to smartphones, are likely to see the mass media campaign promoting the app, are likely to download a weight loss app, and are likely to continue using this app. RESULTS In the base-case model, the smartphone app promotion intervention generated 29 QALYs (95% uncertainty interval, UI: 14-52) and cost the health system US $1.6 million (95% UI: 1.1-2.0 million) with the standard download rate. Under plausible assumptions, QALYs increased to 59 (95% UI: 27-107) and costs decreased to US $1.2 million (95% UI: 0.5-1.8) when standard download rates were doubled. Costs per QALY gained were US $53,600 for the standard download rate and US $20,100 when download rates were doubled. On the basis of a threshold of US $30,000 per QALY, this intervention was cost-effective for Māori when the standard download rates were increased by 50% and also for the total population when download rates were doubled. CONCLUSIONS In this modeling study, the mass media promotion of a smartphone app for weight loss produced relatively small health gains on a population level and was of borderline cost-effectiveness for the total population. Nevertheless, the scope for this type of intervention may expand with increasing smartphone use, more easy-to-use and effective apps becoming available, and with recommendations to use such apps being integrated into dietary counseling by health workers.

The cost-effectiveness of a mass media campaign to promote smartphone apps for weight loss: an updated modeling study (Preprint)

2021 ◽  
Author(s):  
Amanda C Jones ◽  
Leah Grout ◽  
Wilson Nick ◽  
Nhung Nghiem ◽  
Christine L Cleghorn
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Mass Media ◽  
Health System ◽  
Adult Population ◽  
Health Gain ◽  
Mass Media Campaign ◽  
Media Campaign ◽  
Smartphone Apps ◽  
Promote Weight Loss

UNSTRUCTURED Background Evidence suggests that smartphone apps can be effective in the self-management of weight. Given the low cost, broad reach, and apparent effectiveness of apps at promoting weight loss, governments may seek to encourage the uptake of such apps as an opportunity for reducing excess weight among the population. However, the cost and potential cost-effectiveness are important considerations. Our study used a modeling approach to assess the health impacts, health system costs, cost-effectiveness, and health equity of a mass media campaign to promote high quality smartphone apps for weight loss in New Zealand. Methods We used an established proportional multistate life table model that simulates the 2011 New Zealand (NZ) adult population over the lifetime, sub-grouped by age, sex, and ethnicity (Māori [Indigenous]/non-Māori). The key risk factor was BMI. The model compared business-as-usual to a one-off mass media campaign intervention, which included the pooled effect size from a recent meta-analysis of smartphone weight loss apps. The resulting impact on BMI and BMI-related diseases was captured through changes in health gain (quality-adjusted life years; QALYs) and in health system costs (health system perspective). The difference in total health system costs was the net sum of interventions costs and downstream cost offsets due to altered disease rates. A discount rate of 3% was applied to health gains and health system costs. Multiple scenario and sensitivity analyses were also conducted, including an equity adjustment. Results Across the remaining lifetime of the modeled 2011 NZ population, the mass media campaign to promote weight loss apps usage had an estimated overall health gain of 181 (95% uncertainty interval [UI]: 113, 270) QALYs and health care costs of NZ$ -606,000 (95%UI: -2,540,000, 907,000). The mean health care costs were negative, representing an overall savings to the health system and a likely cost-saving intervention. Across the outcomes examined in this study, the modeled mass media campaign to promote weight loss apps among the general population would be expected to provide higher per capita health gain for Māori and hence reduce health inequalities arising from high BMI. Conclusions A modeled mass media campaign to encourage the adoption of smartphone apps to promote weight loss among the NZ adult population is expected to yield an overall gain in health and to be cost-saving to the health system. While other interventions in the nutrition and physical activity space are even more beneficial to health and produce larger cost-savings (eg, fiscal policies, food reformulation), governments may choose to include strategies to promote health app usage as complementary measures.

scholarly journals PRIMEtime CE: a multistate life table model for estimating the cost-effectiveness of interventions affecting diet and physical activity

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Adam D. M. Briggs ◽  
Linda J. Cobiac ◽  
Jane Wolstenholme ◽  
Peter Scarborough
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Life Table ◽  
Diet And Physical Activity ◽  
Table Model ◽  
Life Table Model ◽  
The Cost ◽  
Multistate Life Table

scholarly journals The cost-effectiveness of a mass media campaign to promote smartphone apps for weight loss: an updated modeling study (Preprint)

10.2196/29291 ◽  
2021 ◽  
Author(s):  
Amanda C Jones ◽  
Leah Grout ◽  
Wilson Nick ◽  
Nhung Nghiem ◽  
Christine L Cleghorn
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Mass Media ◽  
Mass Media Campaign ◽  
Media Campaign ◽  
Smartphone Apps ◽  
The Cost ◽  
Modeling Study

scholarly journals Carrier screening by next‐generation sequencing: health benefits and cost effectiveness

2016 ◽  
Vol 4 (3) ◽  
pp. 292-302 ◽  
Author(s):  
Mohammad Azimi ◽  
Kyle Schmaus ◽  
Valerie Greger ◽  
Dana Neitzel ◽  
Robert Rochelle ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Next Generation Sequencing ◽  
Health Benefits ◽  
Carrier Screening ◽  
Next Generation ◽  
Generation Sequencing

scholarly journals Bariatric surgery, lifestyle interventions and orlistat for severe obesity: the REBALANCE mixed-methods systematic review and economic evaluation

2018 ◽  
Vol 22 (68) ◽  
pp. 1-246 ◽  
Author(s):  
Alison Avenell ◽  
Clare Robertson ◽  
Zoë Skea ◽  
Elisabet Jacobsen ◽  
Dwayne Boyers ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Weight Regain ◽  
Severe Obesity ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Research Unit ◽  
Look Ahead ◽  
Obesity Trends

Background Adults with severe obesity [body mass index (BMI) of ≥ 35 kg/m2] have an increased risk of comorbidities and psychological, social and economic consequences. Objectives Systematically review bariatric surgery, weight-management programmes (WMPs) and orlistat pharmacotherapy for adults with severe obesity, and evaluate the feasibility, acceptability, clinical effectiveness and cost-effectiveness of treatment. Data sources Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials and the NHS Economic Evaluation Database were searched (last searched in May 2017). Review methods Four systematic reviews evaluated clinical effectiveness, cost-effectiveness and qualitative evidence for adults with a BMI of ≥ 35 kg/m2. Data from meta-analyses populated a microsimulation model predicting costs, outcomes and cost-effectiveness of Roux-en-Y gastric bypass (RYGB) surgery and the most effective lifestyle WMPs over a 30-year time horizon from a NHS perspective, compared with current UK population obesity trends. Interventions were cost-effective if the additional cost of achieving a quality-adjusted life-year is < £20,000–30,000. Results A total of 131 randomised controlled trials (RCTs), 26 UK studies, 33 qualitative studies and 46 cost-effectiveness studies were included. From RCTs, RYGB produced the greatest long-term weight change [–20.23 kg, 95% confidence interval (CI) –23.75 to –16.71 kg, at 60 months]. WMPs with very low-calorie diets (VLCDs) produced the greatest weight loss at 12 months compared with no WMPs. Adding a VLCD to a WMP gave an additional mean weight change of –4.41 kg (95% CI –5.93 to –2.88 kg) at 12 months. The intensive Look AHEAD WMP produced mean long-term weight loss of 6% in people with type 2 diabetes mellitus (at a median of 9.6 years). The microsimulation model found that WMPs were generally cost-effective compared with population obesity trends. Long-term WMP weight regain was very uncertain, apart from Look AHEAD. The addition of a VLCD to a WMP was not cost-effective compared with a WMP alone. RYGB was cost-effective compared with no surgery and WMPs, but the model did not replicate long-term cost savings found in previous studies. Qualitative data suggested that participants could be attracted to take part in WMPs through endorsement by their health-care provider or through perceiving innovative activities, with WMPs being delivered to groups. Features improving long-term weight loss included having group support, additional behavioural support, a physical activity programme to attend, a prescribed calorie diet or a calorie deficit. Limitations Reviewed studies often lacked generalisability to UK settings in terms of participants and resources for implementation, and usually lacked long-term follow-up (particularly for complications for surgery), leading to unrealistic weight regain assumptions. The views of potential and actual users of services were rarely reported to contribute to service design. This study may have failed to identify unpublished UK evaluations. Dual, blinded numerical data extraction was not undertaken. Conclusions Roux-en-Y gastric bypass was costly to deliver, but it was the most cost-effective intervention. Adding a VLCD to a WMP was not cost-effective compared with a WMP alone. Most WMPs were cost-effective compared with current population obesity trends. Future work Improved reporting of WMPs is needed to allow replication, translation and further research. Qualitative research is needed with adults who are potential users of, or who fail to engage with or drop out from, WMPs. RCTs and economic evaluations in UK settings (e.g. Tier 3, commercial programmes or primary care) should evaluate VLCDs with long-term follow-up (≥ 5 years). Decision models should incorporate relevant costs, disease states and evidence-based weight regain assumptions. Study registration This study is registered as PROSPERO CRD42016040190. Funding The National Institute for Health Research Health Technology Assessment programme. The Health Services Research Unit and Health Economics Research Unit are core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.

Metabolic health status determines short- and long-term health benefits of weight loss

2021 ◽  
Author(s):  
D Soll ◽  
J Gawron ◽  
J Spranger ◽  
K Mai
Keyword(s):  
Weight Loss ◽  
Health Status ◽  
Health Benefits ◽  
Metabolic Health ◽  
Short And Long Term

Multistate life tables using Stata

2020 ◽  
Vol 20 (3) ◽  
pp. 721-745
Author(s):  
Jerônimo Oliveira Muniz
Keyword(s):  
Life Table ◽  
Input Data ◽  
Average Duration ◽  
Transition Rates ◽  
Absorbing State ◽  
Multistate Life Tables ◽  
The Mean ◽  
Time Specific ◽  
Number Of Individuals ◽  
Multistate Life Table

The mslt command calculates the functions of a multistate life table and plots a graph of conditional and unconditional life expectancies by time. The command provides linear and exponential solutions to estimate the number of individuals, transitions, probabilities, person-years, and years of life in a given cohort and state of occupancy. The input data are time-specific transition rates (or survivorship proportions) between nonabsorbing and at most one absorbing state. In addition to the mean age at transfer between states, mslt calculates the following summary measures: the mean age, the probability of dying, the average duration, and the proportion of life spent in a specific state.

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