ORCID Profile
0000-0003-3383-8953
Current Organisation
Epidemiology Unit
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 06-2015
Abstract: The study was designed to model the effectiveness and cost effectiveness of oral Vitamin D supplementation as a primary prevention strategy for cardiovascular disease among a migrant population in Australia. It was carried out in the Community Health Service, Kensington, Melbourne. Best-case scenario analysis using a Markov model was employed to look at the health care providers' perspective. Adult migrants who were vitamin D deficient and free from cardiovascular disease visiting the medical centre at least once during the period from 1 January 2010 to 31 December 2012 were included in the study. The blood pressure-lowering effect of vitamin D was taken from a published meta-analysis and applied in the Framingham 10 year cardiovascular risk algorithm (with and without oral vitamin D supplements) to generate the probabilities of cardiovascular events. A Markov decision model was used to estimate the provider costs associated with the events and treatments. Uncertainties were derived by Monte Carlo simulation. Vitamin D oral supplementation (1000 IU/day) for 10 years could potentially prevent 31 (interquartile range (IQR) 26 to 37) non-fatal and 11 (IQR 10 to 15) fatal cardiovascular events in a migrant population of 10,000 assuming 100% compliance. The provider perspective incremental cost effectiveness per year of life saved was AU$3,992 (IQR 583 to 8558). This study suggests subsidised supplementation of oral vitamin D may be a cost effective intervention to reduce non-fatal and fatal cardiovascular outcomes in high-risk migrant populations.
Publisher: Wiley
Date: 26-03-2015
Abstract: The objectives were to review the currently available and widely used cardiovascular risk assessment models and to examine the evidence available on new biomarkers and the nonclinical measures in improving the risk prediction in the population level. Identification of in iduals at risk of cardiovascular disease (CVD), to better target prevention and treatment, has become a top research priority. Cardiovascular risk prediction has progressed with the development and refinement of risk prediction models based upon established clinical factors, and the discovery of novel biomarkers, lifestyle, and social factors may offer additional information on the risk of disease. However, a significant proportion of in iduals who have a myocardial infarction still are categorized as low risk by many of the available methods. Although novel biomarkers can improve risk prediction, including B-type natriuretic peptides which have shown the best predictive capacity per unit cost, there is concern that the use of risk prediction strategies which rely upon new/or expensive biomarkers could further broaden social inequalities in CVD. In contrast, nonclinical factors such as work stress, social isolation, and early childhood experience also appear to be associated with cardiovascular risk and have the potential to be utilized for the baseline risk stratification at the population level. A stepwise approach of nonclinical methods followed by risk scores consisting of clinical risk factors may offer a better option for initial and subsequent screening, preserving more specialized approaches including novel biomarkers for enhanced risk stratification at population level in a cost-effective manner.
Publisher: Elsevier BV
Date: 04-2022
No related grants have been discovered for Thilanga Ruwanpathirana.