Jacek Andrzej Kopec

 
Prospective Graduate Students / Postdocs

This faculty member is currently not actively recruiting graduate students or Postdoctoral Fellows, but might consider co-supervision together with another faculty member.

Professor

Research Classification

Epidemiology
Arthritis / Osteo-Arthritis

Relevant Degree Programs

 

Research Methodology

Epidemiology
Measurement
Simulation models

Graduate Student Supervision

Doctoral Student Supervision (Jan 2008 - May 2019)
Direct cost of osteoarthritis in Canada : an application of microsimulation modeling with uncertainty analysis (2014)

Introduction: While OA is a debilitating disease with an immense economic burden on the Canadian society, there is a lack of understanding about OA’s direct costs and its future trend in Canada. Objectives: The overall goal of this thesis is to illustrate the application of population-based disease microsimulation (PDMS) modeling in estimating the economic burden of a disease by performing the direct cost analyses for osteoarthritis (OA) using Population Health Microsimulation Model for OA (POHEM-OA). Specific objectives were: 1) To estimate the average direct costs of OA from 2003 to 2010 in Canada; 2) To estimate the future direct cost of OA from 2010 to 2031 in Canada; 3) to estimate the uncertainty around the prevalence and total cost of OA in future years. Methods: I used administrative health data from the province of British Columbia (BC), Canada, a survey of a random sample of BC residents diagnosed with OA (Ministry of Health of BC data), Canadian Institute of Health Information (CIHI) cost data and literature estimates to perform a bottom-up cost of illness (COI) study for OA. I then implemented the results of the COI study into POHEM-OA and constructed cost profiles for each individual. Finally, I developed a framework and adapted an ANOVA-based approach for performing uncertainty analysis (UA) for OA outcomes. Results: I showed that the average cost increased from $735 to $811 between 2003 and 2010 (in 2010 $CAD). From 2010 to 2031, while the prevalence of OA increases from 13.8% to 18.6%, the total direct cost of OA is projected to increase from $2.9 billion (95% uncertainty interval (UI): $2.4-$3.1 billion), to $7.6 billion ($6.2-$9.1 billion), an almost 2.6-fold increase (in 2010 $CAD). From the highest to the lowest, the cost components that will constitute the total direct cost of OA in 2031 are hospitalization cost, outpatient services, drugs, and out-of-pocket cost categories.Conclusions: By further developing a PDMS model of OA, I were able to project trends in the cost of OA and identify the key cost drivers, while predicting significant shifts in distribution of cost in the future.

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The epidemiology of osteoarthritis and its association with cardiovascular disease and diabetes (2014)

Background: Osteoarthritis (OA) is a highly prevalent chronic condition and the most common form of rheumatic disease. The relationship between OA and cardiovascular disease (CVD) and diabetes has not been observed prospectively and the data on descriptive epidemiology of administratively defined OA are limited. Objectives: 1) to determine whether OA increases the risk of CVD (myocardial infarction, ischemic heart disease, congestive heart failure, and stroke) and diabetes; 2) to examine the association between OA and prevalent CVD; 4) to estimate the prevalence, incidence, and trends of OA; and 5) to validate the administrative diagnosis of OA. Methods: Using a random sample (n = 640,000) from the British Columbia administrative database during the period 1991-2009, the crude and age-standardized incidence rates and the prevalence of OA were calculated. Administrative OA Definition 1 required at least one physician diagnosis or hospital admission, and Definition 2 required, at least two physician diagnoses in two years or one hospital admission. The relative risks (RR) of CVD and diabetes in persons with OA, compared to age-sex matched non-OA individuals, were estimated using Cox proportional hazards models. Based on the Canadian Community Health Survey (CCHS) data, odds ratio (OR) between OA and heart disease was obtained. The validity of the two administrative definitions was determined using four clinical reference standards.Results: The overall prevalence of OA on March 2009, was 19.7%, and the incidence rate in the year 2008/09 was 14.6/1000 person-years under Definition 1. The adjusted RRs (95% CI) for CVD were 1.26 (1.13-1.42), 1.17 (1.07-1.26), 1.08 (0.97-1.19), and 1.15 (1.04-1.27), among younger women, older women, younger men, and older men, respectively. For diabetes, adjusted RRs (95% CI) were 1.27 (1.18-1.38), 1.23 (1.12-1.34), 1.19 (1.09-1.29), and 0.94 (0.82-1.09) for younger women, older women, younger men, and older men, respectively. In the CCHS sample, ORs (95% CI) for heart disease were 1.35 (1.21-1.50) among men and 1.51 (1.39-1.64) among women. Conclusions: These novel findings update current knowledge of OA epidemiology and highlight the risks of CVD and diabetes among persons with OA. These data are useful in formulating public health policies around OA treatment and prevention.

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Lifetime physical activity and osteoarthritis (2011)

Introduction: The overall goal of this thesis is to improve understanding of physical activity (PA), one of the most important, modifiable but controversial risk factors in osteoarthritis (OA). OA is the major public health problem in musculoskeletal medicine and leading cause of physical disability in older adults. The ultimate purpose is to provide evidence to inform OA prevention strategies, something not currently available.Objectives: 1) To construct and describe lifetime trajectories of hip and knee joint force from physical activity in a large Canadian sample; 2) To validate self-report measures of medically-diagnosed OA and novel measures of joint vulnerability against clinical criteria; 3) To evaluate the relationship of lifetime joint force and hip and knee OA.Methods: PA data were collected online from 4,269 subjects via a validated PA survey in a national population-based cohort from 2005 to 2007 and subjects ranked and lifetime trajectories plotted in terms of the ‘cumulative peak force index’, a novel joint force measure. Validation studies were conducted in a sub-sample. Population-based multivariable studies examining the relationship between joint force and incident hip and prevalent knee OA were conducted.Results: 1) Overall women had slightly higher lifetime PA-related force then men. Six percent of subjects developed hip OA and seven percent knee OA during follow up. There was no risk from sport/recreational activity. Very high levels of total lifetime force (hip and knee), occupational force in men (knee) and household-related force in women (knee) were associated with an approximate 2-fold increase in risk of OA, as was previous joint injury (5-fold increase hip, 3-fold knee). At the knee, lower limb malalignment but not joint hypermobility, was associated with knee OA. Higher coordination was protective.Conclusions: Taken collectively, the results show that lifelong physical activity-related joint force is generally safe for the hip and knee, and the promotion of exercise as a major public health initiative should continue without concern for increased rates of OA. Very high levels of occupational force in men and household force in women were risk factors for knee OA. Joint injury, lower limb malalignment and lower coordination were associated with OA.

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A Comparison of Participation Instruments based upon the International Classification of Functioning, Disability, and Health (2009)

No abstract available.

 
 

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