Simulating the early detection and intervention of vascular disease in the Caerphilly cohort

Timmaraju, Venkat Krishna Chaitanya. 2007. Simulating the early detection and intervention of vascular disease in the Caerphilly cohort. PhD Thesis, Cardiff University.

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Abstract

Introduction: The purpose of the project is to simulate the effect of hypothetical intervention on risk of vascular disease in the Caerphilly cohort. The cohort comprises a total population sample of 2959 men aged 45--59 years at the recruitment who has been followed up for 20 years. During that time there has been particular emphasis on assessing exposure to vascular risk factors and assessing vascular related outcomes. Aim: The aim of the thesis is to estimate the effects at population level of public health interventions to change the levels of modifiable risk factors for the vascular disease. Methods: Various statistical techniques such as logistic, fractional polynomial and Cox's proportional hazards models along with various parametric models were used to analyse the data. New risk prediction models were estimated and compared with the existing models in the literature. Various standard simulation techniques were used to simulate hypothetical data using Caerphilly data parameters. Hypothetical interventions were carried out on these generated samples to assess the public health impact. Results: Multivariate analysis suggested that the combined effect of psychological variables measured in the study were significantly associated with the increased risk of MI. New risk prediction models constructed using the Caerphilly study data showed that they were significantly different from the standard available models from the literature. Simulation results suggested that there could be a reduction MI events by 25--30% and stroke events by 50--55% using plausible intervention scenarios available from the literature review. Conclusion: A hypothetical intervention to modify psychological factors showed a higher reduction in MI events. Therefore, plausible interventions to modify psychological factors should be commissioned along with the standard biological and behavioural interventions.

Item Type:	Thesis (PhD)
Status:	Unpublished
Schools:	Medicine
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine
ISBN:	9781303182402
Date of First Compliant Deposit:	30 March 2016
Last Modified:	12 Feb 2016 23:14
URI:	https://orca.cardiff.ac.uk/id/eprint/55711

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