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Development and validation of the CHIME simulation model to assess lifetime health outcomes of prediabetes and type 2 diabetes in Chinese populations: A modeling study

PLoS Medicine Jun 28, 2021

Quan J, Ng CS, Kwok HHY, et al. - In the present study, the researchers sought to develop and externally validate a patient-level simulation model for prediabetes and type 2 diabetes in the East Asian population for anticipating lifetime health outcomes. They developed a health outcomes model from a population-based cohort of people with prediabetes or type 2 diabetes: Hong Kong Clinical Management System (CMS, 97,628 candidates) from 2006 to 2017. The Chinese Hong Kong Integrated Modeling and Evaluation (CHIME) simulation model includes 13 risk equations for predicting mortality, micro- and macrovascular complications, and development of diabetes. External validation of the CHIME model was evaluated in the China Health and Retirement Longitudinal Study (CHARLS, 4,567 candidates) from 2011 to 2018 for mortality, ischemic heart disease, cerebrovascular disease, renal failure, cataract, and development of diabetes; and against 80 observed endpoints from 9 published trials using 100,000 simulated individuals per trial. The study demonstrates that the CHIME model is a new validated tool for predicting diabetes progression and outcomes, particularly among Chinese and East Asian populations, which has previously been lacking. Health service planners and policymakers can use the CHIME model to develop population-level strategies, such as setting HbA1c and lipid targets, to improve health outcomes.

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