使用主动学习和蒙特卡洛模拟进行结肠直肠癌查策略的成本效益分析
Amirhossein Fouladi1, Amin Asadi2, Eric A Sherer3
1Senior Consultant, UNCOMN, Chatham, IL, USA.
概括
多模式结肠直肠癌 (CRC) 查,结合视觉和便测试,提供了具有成本效益的早期检测. 像50岁时结肠镜检查和每年便检查这样的政策对于改善患者存活率是有效的.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 生物统计学 生物统计学
背景情况:
- 通过查早期发现结肠直肠癌 (CRC) 可以显著提高患者的生存率.
- 多模式查政策提供多种选择,平衡患者的风险和益处.
研究的目的:
- 调查各种多模式结直肠癌查政策的成本效益.
- 将拟议政策的表现与当前查实践进行比较.
主要方法:
- 开发了一个蒙特卡洛模拟框架来模拟CRC动态.
- 利用机器学习进行创新的校准过程,以估计多的进展和回归率.
- 分析了超过44,000份结肠镜检查报告和现有文献数据.
主要成果:
- 确定了两个高效的多式联络政策:50岁时进行结肠镜检查,每年进行便隐性血液测试 (60-75) 或便免疫化学测试 (70-75).
- 这两种政策都证明了成本效益,愿意支付5万美元.
- 政策表现出对查测试成本变化的稳定性,但对遵守行为更敏感.
结论:
- 结合基于便和视觉查测试,患者的预期寿命更长,与单模式政策相比成本更低,有利于患者.
- 建议在年轻时进行结肠镜检查,在年长时进行便检查,以进行有效的CRC查.
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