Event simulation and external validation applied in published health economic models for obesity: a systematic review

Expert Rev Pharmacoecon Outcomes Res. 2018 Oct;18(5):529-541. doi: 10.1080/14737167.2018.1501680. Epub 2018 Jul 24.


Introduction: This study aims to determine methodological variations in the event simulation approaches of published health economic decision models, in the field of obesity, and to investigate whether their predictiveness and validity were investigated via external event validation techniques, which investigate how well the model reproduces reality.

Areas covered: A systematic review identified a total of 87 relevant papers, of which 72 that simulated obesity-associated events were included. Most frequently simulated events were coronary heart disease (≈ 83%), type 2 diabetes (≈ 74%), and stroke (≈ 66%). Only for ten published model-based health economic assessments in obesity an external event validation was performed (14%; 10 of 72), and only for one the predictiveness and validity of the event simulation was investigated in a cohort of obese subjects.

Expert commentary: We identified a wide range of obesity related event simulation approaches. Published obesity models lack information on the predictive quality and validity of the applied event simulation approaches. Further work on comparing and validating these event simulation approaches is required to investigate their predictiveness and validity, which will offer guidance future modelling in the field of obesity.

Keywords: Obesity; clinical events; coronary heart disease; decision models; external event validation; health economic assessment; simulation; stroke; systematic review; type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Computer Simulation
  • Coronary Disease / economics
  • Coronary Disease / etiology
  • Decision Making*
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / etiology
  • Humans
  • Models, Economic*
  • Obesity / complications*
  • Obesity / economics
  • Reproducibility of Results
  • Stroke / economics
  • Stroke / etiology