Using Metamodeling to Identify the Optimal Strategy for Colorectal Cancer Screening.
Using Metamodeling to Identify the Optimal Strategy for Colorectal Cancer Screening.
复制标题
使用元建模确定结直肠癌筛查的最佳策略。
DOI：
10.1016/j.jval.2020.08.2099
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
M. Greuter
中科院分区：
文献类型：
--
作者：
H. Koffijberg;K. Degeling;M. IJzerman;V. Coupé;M. Greuter
ObjectivesMetamodeling可以解决决策分析建模研究中的计算挑战，评估许多策略。本文说明了metamodeling评估结直肠癌筛查策略的价值，同时占结肠镜检查能力constrains.MethodsIn传统的方法，最佳的筛选策略，确定从有限的子集的策略评估与验证腺瘤和锯齿状通路结直肠癌模型。在元建模方法中，将元模型拟合到这个有限的子集以评估所有可能合理的策略并确定最佳的总体筛选策略。方法进行了比较的基础上获得的生命年的最佳筛选策略相比，没有筛选。元模型的运行时间和准确性assessed.ResultsThe元建模方法评估>40 000战略在1分钟内具有高精度后，1自适应采样步骤（平均绝对误差：0.0002生命年），使用300个样本（代时间：8天）。研究结果表明，健康结果可以得到改善，而不需要额外的结肠镜检查能力。使用传统方法获得类似的见解可能需要至少1000个样本（生成时间：28天）。建议的好处，在年龄<40岁的筛查需要充分验证的基础腺瘤和锯齿状通路结直肠癌模型之前，使政策recommendations.ConclusionsMetamodeling允许快速评估的一个巨大的一组策略，这可能会导致识别更有利的战略相比，传统的方法。然而，元模型验证和识别超出原始决策分析模型的支持外推的结果的解释是至关重要的。元建模确定的筛查策略支持正在进行的关于降低结直肠癌筛查起始年龄的讨论。
ObjectivesMetamodeling can address computational challenges within decision-analytic modeling studies evaluating many strategies. This article illustrates the value of metamodeling for evaluating colorectal cancer screening strategies while accounting for colonoscopy capacity constraints.MethodsIn a traditional approach, the best screening strategy was identified from a limited subset of strategies evaluated with the validated Adenoma and Serrated pathway to Colorectal CAncer model. In a metamodeling approach, metamodels were fitted to this limited subset to evaluate all potentially plausible strategies and determine the best overall screening strategy. Approaches were compared based on the best screening strategy in life-years gained compared with no screening. Metamodel runtime and accuracy was assessed.ResultsThe metamodeling approach evaluated >40 000 strategies in <1 minute with high accuracy after 1 adaptive sampling step (mean absolute error: 0.0002 life-years) using 300 samples in total (generation time: 8 days). Findings indicated that health outcomes could be improved without requiring additional colonoscopy capacity. Obtaining similar insights using the traditional approach could require at least 1000 samples (generation time: 28 days). Suggested benefits from screening at ages <40 years require adequate validation of the underlying Adenoma and Serrated pathway to Colorectal CAncer model before making policy recommendations.ConclusionsMetamodeling allows rapid assessment of a vast set of strategies, which may lead to identification of more favorable strategies compared to a traditional approach. Nevertheless, metamodel validation and identifying extrapolation beyond the support of the original decision-analytic model are critical to the interpretation of results. The screening strategies identified with metamodeling support ongoing discussions on decreasing the starting age of colorectal cancer screening.
影响因子：
158.5
作者：
Shaukat, Aasma;Mongin, Steven J.;Church, Timothy R.
通讯作者：
Church, Timothy R.