Probabilities, costs and utilities for the decision model
| Variable | Estimate (range) | Distribution |
|---|---|---|
| Probability | ||
| First fall | 0.32 (0.27 to 0.37) | β (14) |
| Subsequent fall | 0.58 (0.39 to 0.97) | β (14) |
| HR bleed after a fall | 1.39 (1.05 to 1.84) | Lognormal (24) |
| Any bleed | ||
| HAS-BLED score high, annual | 0.166 (0.111 to 0.221) | β (13) |
| HAS-BLED score low, annual | 0.091 (0.061 to 0.121) | β (13) |
| Major bleed given any bleed | 0.31 (0.25 to 0.46) | β (25) |
| Intracranial bleed given major bleed | 0.21 (0.14 to 0.28) | β (26) |
| Bed-bound after intracranial bleed (modified Rankin Scale score ≥ 5) | 0.176 (0.117 to 0.235) | β (27) |
| Any stroke | ||
| High CHADS score | 0.037 (0.025 to 0.049) | Lognormal (28) |
| Low CHADS score | 0.083 (0.055 to 0.111) | Lognormal (28) |
| Major stroke given stroke | 0.41 (0.20 to 0.61) | β (29) |
| Bed-bound after major stroke (modified Rankin Scale score ≥ 5) | 0.176 (0.117 to 0.235) | β (30) |
| OR death due to atrial fibrillation | 1.6 (1.2 to 2.2) | Lognormal (31) |
| HR death after major stroke | 5.29 (3.53 to 7.93) | Lognormal (32) |
| HR death after major bleed | 3.35 (2.12 to 5.27) | Lognormal (32) |
| HR death given bed-bound | 3.81 (3.37 to 4.31) | Lognormal (33) |
| Cost* | ||
| Fall, single event | 7286.01 (5464.51 to 9107.51) | γ (34) |
| Major bleed, initial event | 5358.98 (3572.64 to 7145.28) | γ (35) |
| Major bleed, monthly | 6942.54 (4627.99 to 9255.99) | γ (35) |
| Minor bleed, single event | 84.38 (55.89 to 111.78) | γ (35) |
| Major stroke, initial event | 7227.47 (3613.74 to 14 441.79) | γ (35) |
| Major stroke, monthly | 6476.51 (4384.7 to 8768.31) | γ (35) |
| Minor stroke, single event | 3613.74 (500.15 to 7227.47) | γ (35) |
| Bed-bound (long-term care assumed) | 4304.91 (2869.94 to 5739.88) | γ (36) |
| Utility/disutility | ||
| Atrial fibrillation | 0.95 (0.93 to 0.98) | β (37) |
| Fall, per event† | −0.11 (−0.08 to 0.14) | β (38) |
| Major bleed, long-term | 0.60 (0.40 to 0.80) | β (39) |
| Minor bleed, 1 mo† | −0.13 (−0.08 to −0.13) | β (39) |
| Major stroke, first year | 0.26 (0.20 to 0.50) | β (39) |
| Major stroke, long-term | 0.71 (0.40 to 0.96) | β (39) |
| Minor stroke, first year† | −0.25 (−0.15 to −0.25) | β (39) |
| Bed-bound (modified Rankin Scale score ≥ 5) | 0.14 (−0.01 to 0.29) | β (37) |
Note: CHADS = congestive heart failure, hypertension, age ≥ 75 yr, diabetes, stroke; HAS-BLED = hypertension, abnormal renal and liver function, stroke, bleeding, labile international normalized ratio, elderly (age > 65), drugs or alcohol (≥ 8 drinks/wk); HR = hazard ratio; OR = odds ratio.
↵* In 2018 Canadian dollars.
↵† Disutilities.