预测多种癌症早期检测对晚期发病率的影响,使用多种状态疾病建模
Jane M Lange1, Kemal Caglar Gogebakan2, Roman Gulati2
1Cancer Early Detection Advanced Research Center, Oregon Health and Science University, Portland, Oregon.
概括
多种癌症早期检测 (MCED) 测试可以减少晚期癌症的发生率. 即使是短期试验也显示出具有足够早期测试灵敏度的显著降级潜力.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 医疗信息学 医疗信息学
背景情况:
- 降低晚期癌症发病率的降低,是多种癌症早期检测 (MCED) 试验的建议终点.
- 目前对下降阶段的理解对于缺乏现有查的癌症以及涵盖这些类型的MCED测试是有限的.
研究的目的:
- 开发和应用癌症自然史模型来预测MCED试验中的下降阶段.
- 评估测试性能和临床前延迟对癌症下降阶段的影响,而没有现有的查.
主要方法:
- 开发了一种癌症自然史模型,与12种癌症的监测,流行病学和最终结果 (SEER) 注册表发病率数据相匹配.
- 该模型用于在模拟的MCED试验中预测降级,考虑可变的临床前延迟和特定阶段的测试灵敏度.
主要成果:
- 在一个假设的三屏MCED试验中,在合理的临床前延迟期中,模拟的下降阶段从21%到43%不等.
- 在查开始后不久就观察到晚期发病率的减少.
- 下降阶段有效性随着早期延迟时间的延长和早期测试灵敏度的提高而增加.
结论:
- 短期MCED试验可以实现实质性的降级,如果早期的测试灵敏度是充足的.
- 这种建模框架支持对新型MCED产品和试验设计的分析,特别是那些使用晚期发病率作为主要终点的试验设计.
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