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通过比较建模了解膀癌查限制:最大临床发病率降低 (MCLIR) 方法.

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    根据三个模型,膀癌查的有效性受到短暂可检测的临床前阶段的限制. 研究结果表明,要专注于针对风险的重复查策略,以更好地检测膀癌.

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    科学领域:

    • 在瘤学瘤学.
    • 流行病学 流行病学
    • 卫生经济学 卫生经济学

    背景情况:

    • 膀癌带来了重大的临床和经济挑战.
    • 查有效性的关键自然史参数,如临床前储量大小和停留时间,很难观察.
    • 癌症干预和监测建模网络 (CISNET) 使用标准化压力测试来比较微模拟模型并了解干预影响.

    研究的目的:

    • 为了比较使用CISNET最大临床发病率减少 (MCLIR) 和现实临床发病率减少 (RCLIR) 框架的三个独立开发的膀癌微型模拟模型.
    • 评估一次性查干预措施对减少膀癌发病率的影响.
    • 了解模型差异如何影响查有效性的预测.

    主要方法:

    • 将CISNET MCLIR/RCLIR协议应用于对美国流行病学目标进行校准的三个模型 (COBRAS,Kystis,SCOUT).
    • 在没有查,完美查 (MCLIR) 和现实查 (RCLIR-1和RCLIR-2) 场景下模拟了1950年美国出生队伍.
    • 分析了特定年龄的临床发病率,发病率-减少曲线和累积减少.

    主要成果:

    • 平均临床前停留时间在不同模型中有所不同 (2.1至3.3年).
    • 在MCLIR下,白人男性65岁时的峰值发病率降低幅度从20%到32%,持久性各不相同.
    • 现实查 (RCLIR) 的结果是较小的减少,大多数残留发病率是由于新的病变出现.

    结论:

    • 三种膀癌微型模拟模型表明,可检测的临床前阶段很短,限制了一次性查的有效性.
    • 模型预测的差异与隐含逗留时间和可检测的水库大小的变化有关.
    • 结果支持评估风险向和重复查,并确定改善膀癌自然史推断的优先事项.