Original ArticleEpidemiology of Kawasaki Disease: Prevalence from National Database and Future Trends Projection by System Dynamics Modeling
Section snippets
Methods
Health care records from the period between January 1, 2000 and December 31, 2010 were retrieved from the NHI database. For estimates of incidence, patients with KD were defined as those who were admitted to a hospital with a diagnosis based on the International Classification of Diseases, 9th Revision, Clinical Modification code, 446.1. The hospital admissions primarily for cardiac interventions or procedures were excluded.
System dynamics modeling consisted of 3 major sequential steps: (1)
Results
Figure 2, A shows the incidence of patients with KD between 2000 and 2010. The average annual incidence in the groups <5 years, 5-10 years, 10-15 years, and 15-20 years was 67.3, 5.75, 0.79, and 0.26 cases per 100 000. The lowest incidence was observed in 2003.
The pediatric population estimated by the model and the historic population from vital statistics fit well. The estimated size of the patient population with KD based on the system dynamics model was 20 254 by the year 2010 (Figure 2, B).
Discussion
System dynamics is an analytical approach for representing complex human systems and predicting trends in data over time.18 Simulations based on system dynamics models, consisting of equations for flows and parameters, are developed to represent unique scenarios, and system dynamics have been applied to population analysis related to chronic diseases.17, 19, 20
KD is the leading cause of acquired heart disease in children.1, 2, 3, 4, 5 Because of a lack of effective strategies for the prevention
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Supported in part by the National Science Council (97-2314-B-002-062-MY3). The authors declare no conflicts of interest.