Canadian Osteoarthritis Simulation Team (COAST)

COAST Meeting, March 7-8, 2003, Vancouver, BC
(from left to right): Jacek Kopec, Jean-Marie Berthelot, Jolanda Cibere, Aslam Anis, Elizabeth Badley, Boris Sobolev, Lisa Ronald

Project Description

Computer models of population health issues provide a realistic view of their overall impact. This study modeled osteoarthritis in the Canadian population to develop preventive strategies and highlight the optimal use of available health services.

Why do this Research?

The purpose of the study was to develop a simulation model of osteoarthritis (OA) for Canada that can be used to quantify the future health and economic burden of OA under a range of plausible scenarios for changes in risk factors and treatments. The substantive issues this study has addressed are crucial for better planning of healthcare services, development of preventive strategies, and optimization of medical and surgical treatment of this disease. Because population-based computer simulation models provide a more realistic view of the population impact of different burden reduction strategies, the results of this project will be useful to policymakers, researchers, as well as clinicians and patients facing difficult treatment decisions.

Who is being studied?

No subjects were recruited for this study. Data was obtained from national health surveys, administrative data and the available literature.

How was it done?

Data was taken from a variety of published and unpublished reports, provincial and national administrative databases, Canadian census and vital statistics and surveys including the National Population Health survey, Canadian Community Health Survey as well as other provincial and national surveys. The Population Health Model (POHEM) developed at Statistics Canada is a state-of-the-art tool for modeling complex chronic-diseases. POHEM creates and ages a large population representative of Canada, one individual at a time, until death.

What was found?

Several simulations have been run since the project began in 2002. The simulation model of physician-diagnosed OA, which incorporates the effect of Body Mass Index (BMI) on OA incidence, predicted a 31% increase in OA prevalence between 2001 and 2021. This rate of increase is higher than previously published estimates that considered age and sex only. If all new cases of OA could be prevented, average health-adjusted life expectancy in Canada would improve by more than a year.

Why is this relevant to people living with arthritis?

OA is the most common form of arthritis and a leading cause of physical disability. Despite much research we do not have a complete and coherent picture of the natural history and population health impact of this disease. There is no primary prevention strategy for OA and no macro-economic studies, evaluating the different preventive strategies, have been undertaken. A simulation model is the best way to address such questions. A well-designed and validated model can effectively synthesize data from different sources, reveal important gaps in knowledge, provide new insights into the dynamics of a chronic disease, estimate costs and impact on quality of life, and suggest more optimal approaches to prevention and treatment.

Were consumers involved?

Consumers were not involved in this study.

Who helped pay for the research?

This study was funded by the Canadian Institute of Health Research (CIHR).

Can I learn more?

Results from the study have been presented at local rounds as well as national and international conferences. Several manuscripts have been published or are in preparation. Please see the list of references in the Publications/Presentations section.

Publications / Presentations

1. Kopec, J. A Proposal to Develop a Computer Simulation Model of Osteoarthritis. UBC Centre for Clinical Epidemiology and Evaluation, Rounds. June 23, 2003.
2. Kopec JA. A proposal to develop a computer simulation model of osteoarthritis. Presented at Clinical Epidemiology Rounds, Vancouver General Hospital, June 23, 2003
3. Kopec JA. Development of a computer simulation model of osteoarthritis. Presented at a meeting with the Minister of Health Services, Hon. Shirley Bond, on December 17, 2003
4. Kopec JA. Canadian Osteoarthritis Simulation Team (COAST). Presented at the Centre for Hip Health Project Team meeting on February 8, 2005
5. Kopec JA. Prevalence and Incidence of Osteoarthritis in BC: Preliminary results from an analysis of the BC Linked Health Database. Presented at the Arthritis in Canada Consultation Workshop, Public Health Agency of Canada, March 30-31, 2005.
6. Kopec JA, Rahman MM, Le Petit C, Berthelot JM, Aghajanian J, Cibere J, Anis AH, Badley EM. Using an administrative database to estimate the prevalence and incidence of osteoarthritis.  Arthritis Rheum 2005. Presented at the Scientific Meeting of the American College of Rheumatology, San Diego, 2005.
7. Kopec JA, Sayre EC, Schwartz T, Badley EM, Jordan J. Socio-demographic factors, pain, and radiographic progression of hip and knee osteoarthritis. Presented at the Clinical Research Conference at the Annual Meeting of the American College of Rheumatology, Washington DC, November 10, 2006.
8. Kopec JA, Rahman M, Le Petit C, Berthelot J-M, Aghajanian J, Sayre EC, Cibere J, Anis AH, Badley EM. Incidence of osteoarthritis in British Columbia, Canada, 1995-2001. J Rheumatol 2006;33(2):399. Presented at the Annual Meeting of the Canadian Rheumatology Association in Acapulco, February 17-20, 2006
9. Kopec JA, Sayre EC, Berthelot JM, Flanagan W, Fines P, Le Petit C, Cibere J, Rahman M, Lima VD, Aghajanian J, Bansback NJ, Anis AH, Jordan JM, Sobolev B, Greidanus NV, Garbuz DS, Hawker GA, Badley EM. Development of a computer simulation model of osteoarthritis in Canada. Osteoarthritis Cartilage 2006; 14, Supp B: Abstract P234. Presented at the Annual Meeting of the OsteoArthritis Research Society International (OARSI) in Prague, Czech Republic, December 7-10, 2006
10. Kopec JA, Rahman M, Garbuz DS, Greidanus NV, Cibere J, Sayre EC, Fines P, Flanagan  W, Aghajanian J, Bansback NJ, Anis AH, Badley EM. Epidemiology of knee and hip revision procedures following total arthroplasty for osteoarthritis in British Columbia, Canada. Osteoarthritis Cartilage 2006; 14, Supp B: Abstract P214. Presented at the Annual Meeting of the OsteoArthritis Research Society International (OARSI) in Prague, Czech Republic, December 7-10, 2006
11. Kopec JA. Microsimulation modeling in health research: development of a population-based model of osteoarthritis. Presented at HCEP Grand Rounds, November 16th, 2007
12. Kang W, Atashband S, Aghajanian J, Bansback N, Rahman MM, Sayre EC, Cibere J, Jordan JM, Anis A, Badley EM, Kopec JA. Estimation of the effect of the four major categories of drugs in the treatment of osteoarthritis. Presented at the Annual Meeting of the Canadian Arthritis Network in Halifax, October 2007.
13. Rahman MM, Kopec JA, Finès P, Flanagan W, Sayre EC, Garbuz DS, Greidanus NV, Aghajanian J, Anis AH, Cibere J, Jordan JM, Badley EM.  Effect of Socio-demographic Factors on Time to Surgical Consultation and Hip/ Knee Replacement Surgery for Osteoarthritis Patients in British Columbia, Canada. Arthritis Rheum 2007;56:9(Suppl):S350. Presented as a poster presentation for the ACR/ARHP Annual Scientific Meeting, November 6-11, 2007, Boston, Massachusetts, USA.
14. Finès P, Flanagan W, Kopec JA, Rahman MM, Sayre EC, Cibere J, Badley LM. Projecting Number of Osteoarthritis Patients from 2001 to 2021 in Canada Using Microsimulation. Arthritis Rheum 2007;56:9(Suppl):S341. Presented at the ACR/ARHP Annual Scientific Meeting, November 6-11, 2007, Boston, MA, USA.
15. Kang W, Atashband S, Aghajanian J, Bansback N, Rahman MM, Sayre EC, Cibere J, Jordan JM, Anis A, Badley EM, Kopec JA. Direct comparison of efficacy of the four major categories of drugs in the treatment of osteoarthritis. Osteoarthritis Cartilage 2007;15(Suppl C):C155. Presented at the Annual Meeting of the OsteoArthritis Research Society International (OARSI) in Ft. Lauderdale, USA, December 6-9, 2007.
16. Sayre EC, Rahman M, Cibere J, Aghajanian J, Kopec JA, Anis AH, Jordan JM, Badley EM.  A comparison of provincial prescription-only pharmaceutical database with self-reported usage of acetaminophen and NSAIDs according to osteoarthritis stage in British Columbia. Presented at ISPOR meeting in Toronto, in May 2008
17. Kang W, Rahman M, Sayre EC, Aghajanian J, Bansback N, Cibere J, Jordan J, Anis AH, Badley EM, Kopec JA. Population impact of adverse effects associated with pain medication on health- related quality of life in people with osteoarthritis. (Abstract and poster), 2008 Segal North American Osteoarthritis Workshop. May 2008. Chicago, IL.
18. Flanagan WM, Kopec JA, Finès P, Rahman MM, Sayre EC, Cibere J, Anis AH, Badley EM. Estimating prevalence of physician-diagnosed osteoarthritis in Canada using microsimulation. Osteoarthritis Cartilage 2008; 16 (Suppl. 4):S153 (Abstract 351). Presented at the 2008 World Congress on Osteoarthritis (OARSI), Rome, Italy, September 18-21, 2008.
19. Rahman MM, Aghanjanian J. Kopec JA, Cibere J. Validation of osteoarthritis diagnosis in administrative data using a clinically and radiologically defined population-based cohort of osteoarthritis. Osteoarthritis Cartilage 2008; 16 (Suppl. 4):S150 (Abstract 342). Presented at the 2008 World Congress on Osteoarthritis (OARSI), Rome, Italy, September 18-21, 2008.
20. Finès P, Kopec JA, Flanagan WM, Sayre EC, Rahman MM, Cibere J, Kang W, Aghajanian J, Badley EM, Bansback N, Anis AH. Building a microsimulation model to estimate health-related quality of life over the course of osteoarthritis. Qual Life Res 2008 Supplement (abstract). Poster presented at the 15th Annual Scientific Meeting of the International Society for Quality of Life Research, Montevideo, Uruguay, October 22-25, 2008.
21. Sayre EC, Jordan JM, Cibere J, Murphy L, Myers EL, Schwartz TA, Helmick CG, Rahman MM, Aghajanian J, Kang W, Badley EM, Kopec JA. Modeling the multivariate distribution of radiographic osteoarthritis in knees and hips: a population-based study in rural North Carolina. Arthritis Care Res (Abstract). Poster presented at the 2008 American College of Rheumatology ACR/AHRP Annual Scientific Meeting, San Francisco, CA, USA, October 24-29, 2008.
22. Kopec JA, Finès P, Flanagan WM, Sayre EC, Rahman M, Bansback N, Cibere J, Anis H, Jordan JM, Badley EM. Projecting the burden of osteoarthritis in Canada using microsimulation. Submitted to the Annual Meeting of the European League Against Rheumatism (EULAR) in Copenhagen, June 10-13, 2009

Journal articles

1. Kopec JA, Rahman MM, Berthelot J-M, Le Petit C, Aghajanian J, Sayre EC, Cibere J, Anis AH, Badley EM. Descriptive Epidemiology of Osteoarthritis in British Columbia, Canada. J Rheumatol 2007;34(2):386-93.
2. Kopec JA, Rahman MM, Aghajanian J, Sayre EC, Cibere J, Anis AH, Badley EM. Trends in physician-diagnosed osteoarthritis incidence in an administrative database in British Columbia, Canada, 1996/7 – 2003/4. Arthritis Rheum 2008 Jun 24;59(7):929-934.
3. Kopec JA, Sayre EC, Flanagan WM, Fines P, Cibere J, Rahman MdM, Bansback NJ, Anis AH, Jordan JM, Sobolev B, Aghajanian J, Kang W, Greidanus NV, Garbuz DS, Hawker GA, Badley EM. Development of a microsimulation population model of osteoarthritis in Canada. Osteoarthritis and Cartilage. (To be submitted in March 2009)
4. Rahman MM, Kopec JA, Fines P, Flanagan W, Sayre EC, Garbuz DS, Greidanus NV, Aghajanian J, Anis AH, Cibere J, Badley E.  Effect of socio-demographic factors on time to surgical consultation and hip/knee replacement surgery for osteoarthritis patients in British Columbia, Canada. (To be submitted in April 2009)

COAST Team Members:

Principal Investigator

Jacek Kopec  MD, PhD
Research Scientist, ARC

Co-Investigators

Aslam Anis  PhD
Research Scientist, ARC

Donald Garbuz  MD MHSc  FRCSC
Research Scientist, ARC

Nelson Greidanus  MD, MPH, FRCSC
Research Scientist, ARC

Jolanda Cibere  MD, FRCPC, PhD
Research Scientist, ARC

Elizabeth Badley  PhD
Professor, Public Health Sciences
University of Toronto

Jean-Marie Berthelot  PhD
Manager, Health Analysis and Modelling Group, Statistics Canada

Stephen Marion  MD, MHSc, CCFP, FRCPC
Associate Professor, Health Care & Epidemiology, University of British Columbia

Boris Sobolev  PhD
Associate Professor, Health Care & Epidemiology, University of British Columbia

William Flanagan
Chief POHEM Programmer, Statistic s Canada

Philippe Finès, PhD
Senior Analyst, Statistics Canada

Data Analyst

Eric Sayre  BSc, MSc, PhD Candidate

Study Coordinator

Paul Doerfling  BA, MA

Contact Person:

Karen Joe
Research Coordinator, ARC