DYNAMO-HIA–A Dynamic Modeling Tool for Generic Health Impact Assessments
For every risk-factor biography, a disease life table is constructed. Diseases incidence, i.e. transition from a healthy to a diseased status, equals the baseline incidence – that is, the incidence when in a risk-factor class with a relative risk of one for the specific age- and sex-category – times the relative risk due to the given risk-factor and diseases status (in the case of an intermediate disease). The transition from healthy to dead equals the baseline other-cause mortality of the healthy, i.e. age- and sex-specific total mortality rate minus the excess mortality rate of the diseases included in the disease life table, multiplied by the relative risk due to the given risk-factor status on other-cause mortality. The transition from diseased to dead equals the sum of the excess mortality of the disease (given each age and sex) and the baseline other-cause mortality of the healthy, multiplied by the relative risk in the given risk-factor status. Remission is not explicitly modeled, but for diseases with cured fraction the excess mortality is zero in a “cured”, i.e. user-specified, fraction. Partly acutely fatal diseases, i.e. diseases with very high mortality immediately after contracting the disease while for those who survive this critical period the excess mortality only depends on age and sex, are modeled by specifying the fraction of the incidence cases that die immediately.