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The need for microsimulation to evaluate osteoporosis interventions

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Abstract

Simulations play an increasingly important role in the evaluation of osteoporosis interventions. Existing evaluations have been based on “reduced-form” cohort simulations that do not reflect the complexity and heterogeneity of osteoporosis and its outcomes. Such simplified models offer parsimony and ease of use, but they also are limited in their ability to explain and extrapolate outcomes in a way that is most useful for both clinical and health policy decision makers. Alternatively, evaluations could be based on “structural” microsimulations, which explicitly model the underlying biology of osteoporosis at the individual level. The structural approach presents technical challenges, including the need to obtain more-detailed data and the requirement that underlying biological models be validated. However, evaluations based on structural microsimulation may ultimately provide substantially more useful information, resulting in improved decision making.

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Acknowledgements

We wish to thank Loretta Pearson, Mary Roberts and Deb Fogarty for assistance with the preparation of the manuscript. We also thank the constructive comments of two anonymous reviewers. This work was supported by a grant (AG12262) that is co-funded by the National Institute on Aging and the National Institute of Arthritis, Musculoskeletal and Skin Diseases, the U.S. Public Health Service.

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Authors and Affiliations

  1. Department of Population Health Sciences, University of Wisconsin Medical School, Madison, WI, 53726, USA

    David J. Vanness

  2. Department of Medicine, Dartmouth Medical School, Lebanon, NH, USA

    Anna N. A. Tosteson

  3. Department of Community and Family Medicine, Dartmouth Medical School, NH, Lebanon, USA

    Anna N. A. Tosteson

  4. Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA

    Sherine E. Gabriel & L. Joseph Melton III

Authors
  1. David J. Vanness
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  2. Anna N. A. Tosteson
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  3. Sherine E. Gabriel
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  4. L. Joseph Melton III
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Correspondence to David J. Vanness.

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Vanness, D.J., Tosteson, A.N.A., Gabriel, S.E. et al. The need for microsimulation to evaluate osteoporosis interventions. Osteoporos Int 16, 353–358 (2005). https://doi.org/10.1007/s00198-004-1826-8

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  • DOI: https://doi.org/10.1007/s00198-004-1826-8

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