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用风险分层对口腔癌发展进行模拟建模:如何评估潜在的查计划
Mutita Siriruchatanon1, Emily R Brooks1, Alexander R Kerr2
1Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA.
MDM policy & practice
|August 25, 2025
概括
一个新的模拟模型,SCORE,通过识别高风险个体来帮助早期发现口腔癌. 包含风险分层活检的查策略提高了诊断效率,减少了不必要的程序.
科学领域:
- 癌症学
- 公共卫生
- 医疗信息学
背景情况:
- 由于没有确定的群体和平衡风险和益处的查方案,因此无法及早发现口腔癌.
- 现有的查方法在识别可能受益于早期干预的个体方面缺乏准确性.
研究的目的:
- 为评估口腔癌查策略开发和验证一个微模拟模型 (SCORE).
- 评估风险分层活检转诊对查效率和患者结果的影响.
主要方法:
- 构建了口腔癌和风险暴露模拟 (SCORE) 微模拟模型,包括吸烟,酒精暴露和病变特征.
- 模拟口腔潜在恶性疾病 (OPMD) 的进展和评估查策略,并没有基于风险的活检决策规则.
- 校准模型与国家癌症登记数据并比较预期寿命,癌症发病率和死亡率等结果.
主要成果:
- 与没有查相比,所有评估的查策略都将口腔癌的发病率和死亡率降低了至少20-26%.
- 风险分层活检转诊提高了诊断效率,每次可治疗诊断需要8次活检.
- 在高危男性中,使用或不使用活检规则的查在减少癌症死亡和发病率方面显示出相似的好处.
- 在非高危人群中应用活检规则将活检减少38%,同时保持癌症负担的降低.
结论:
- SCORE模型为优化口腔癌查方案和确定目标人群提供了虚拟试验.
- 风险分层查策略,特别是生物检查决策规则,提高诊断效率,尽量减少不必要的程序.
- SCORE可以加速对新查技术和预防口腔癌的临床建议的评估.
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