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Welcome to bravo™ diabetes simulation model

What is the BRAVOTM Model?

The Building, Relating, Assessing, and Validating Outcomes (BRAVO) diabetes model is a person-level discrete-time microsimulation model. The model simulates the progression of diabetes complications on the basis of individuals’ dynamic characteristics and treatment regimens over a lifetime. The predicted outcomes include macrovascular events (i.e., Myocardial infarction, congestive heart failure, stroke, angina, revascularization), microvascular events (i.e., chronic kidney disease, end-stage renal disease, retinopathy, blindness, neuropathy, amputation), and adverse events (e.g., hypoglycemia, diabetic ketoacidosis) over a user-specified time horizon. It was internally validated across different age/race/complication subgroups and externally validated against 18 large diabetes clinical trials conducted after 2000. We calibrated the BRAVO diabetes model to a national representative sample of individuals with diabetes in the US, to enhance its capacity to assist national policy evaluation and economic burden surveillance. We’ve further developed our signature “Globalization Module” to calibrate the BRAVO model’s prediction capacity from the US population to numerous regions globally, using data from more than 100,000 individuals internationally.

Application Area includes but not limited to:


The BRAVO model can be linked to a health system/ insurance plan to conduct risk stratification in the covered people with diabetes. Each patient will be assigned to the corresponding risk strata based on their predicted short-term/long-term risks of cardiovascular diseases and mortality. Thus, the BRAVO model can help the health system/ insurance to maximize the effectiveness of diabetes management by pinpointing the high-risk population.

Trial Simulation

The BRAVO simulation model can extrapolate the short-term (e.g., six-month) efficacy trials to a long-term cardiovascular outcomes trial (CVOT). It can serve as the real-world extension of the existing trials to explore the long-term benefit of the corresponding treatments.



It can be applied to conduct classic pharmacoeconomics evaluation, comparing the cost-effectiveness between alternative drugs/treatments.

Go to program evaluation

program evaluation

The BRAVO model can be used to evaluate the benefit and cost-effectiveness of a policy/program/guideline. We have applied the model to evaluate the Medicare PartD Senior Saving Mode, the ADA’s diabetes insight program, and the American College of Physicians’ guidance statement on glycemic control.


A Diabetes Microsimulation Model that Simulate the Progression of Diabetes Complications
Save Life, Lower Cost, Answer Fast

bravo™ model compares to other diabetes models

BW and BMI

Better capturing impact of body weight on cardiovascular risks, cost and QALY.


Better capturing impact of hypoglycemia


Has a globalization module to calibrate regional variation of cardiovascular risks.

utility and cost

Has both QALY equation and COST equation already developed and installed.

Publications and Presentations