Collaborative Research: Mathematical Modeling of Dynamic Breast Cancer Screening

合作研究：动态乳腺癌筛查的数学模型

• 批准号: 0423090
• 负责人: Julie Ivy
• 金额: $ 6.12万
• 依托单位: Regents of the University of Michigan - Ann Arbor
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2006-08-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=0423090&HistoricalAwards=false
• 关键词: Collaborative; Research; Mathematical; Modeling; Dynamic

This grant provides funding for the development of a mathematical model to examine whether different mammogram screening intervals should be used pre-menopause and post-menopause. Analysis of this model will provide insight into the following questions: how worthwhile is it, in terms of mortality risk, to use different mammogram intervals in the pre- and post-menopausal phases? Should screening be more frequent pre- or post-menopause? How does screening start-age/stop-age affect mortality risk? These questions are particularly interesting given the dynamic nature of breast cancer incidence, breast cancer aggression, and mammogram-efficacy between the pre- and post-menopausal phases. Using a partially observed Markov decision process model, different screening policies will be evaluated, and informative tradeoff curves that plot some measure of "policy effort" versus mortality risk will be constructed. Attention will be restricted to two types of policies: "routine" policies that prescribe the same screening interval over the life of the patient, and "two-phase" policies that prescribe one interval pre-menopause and a different interval post-menopause. The results of this research will potentially benefit society through patient-empowerment and improved public policy. The tradeoff curves will allow women to tailor their own mammogram screening choices based on individual risk preference, economic status, insurance coverage, incidence propensity, etc.. The tradeoff curves will present the quantitative relationship between screening policy and mortality risk in a format that is both understandable and useful for "non-scientists." If successful, the outcomes of the proposed research may also impact American Cancer Society policy recommendations for breast cancer screening.

这笔赠款为开发数学模型提供资金，以检查绝经前和绝经后是否应使用不同的乳房X光检查间隔。对该模型的分析将深入了解以下问题：就死亡风险而言，在绝经前和绝经后阶段使用不同的乳房X光检查间隔是否值得？绝经前或绝经后应该更频繁地进行筛查吗？ 筛查起始年龄/终止年龄如何影响死亡风险？考虑到乳腺癌发病率、乳腺癌侵袭性以及绝经前和绝经后阶段之间的乳房 X 光检查效果的动态性质，这些问题特别有趣。使用部分观察的马尔可夫决策过程模型，将评估不同的筛查政策，并构建绘制“政策努力”与死亡率风险的某种衡量标准的信息权衡曲线。 注意力将仅限于两种类型的政策：规定患者一生中相同筛查间隔的“常规”政策，以及规定绝经前一个间隔和绝经后不同间隔的“两阶段”政策。 这项研究的结果将通过患者赋权和改善公共政策潜在地造福社会。 权衡曲线将允许女性根据个人风险偏好、经济状况、保险范围、发病倾向等定制自己的乳房X光检查选择。权衡曲线将以以下格式呈现筛查政策和死亡风险之间的定量关系：对于“非科学家”来说既可以理解又有用。 如果成功，拟议研究的结果也可能影响美国癌症协会对乳腺癌筛查的政策建议。