Biostatistics and Data Management

该计划的主题是为具有不同乳腺癌风险水平的女性确定有效的乳腺癌筛查策略，以最大限度地增加筛查好处，同时将潜在的危害降至最低。该计划的目标遵循以下前提，即乳腺癌筛查将是最有效的，前提是：指南基于与筛查测试的有效性和危害相关的准确风险估计；根据风险水平向妇女和医生通报筛查测试的表现；基于风险的筛查实践是公平的；高质量的比较有效性研究结果被传播到社区实践中。方案目标将通过三个互补的研究项目和三个共享资源核心来实现。项目1，社区实践中的风险评估：开发更好的模型，将改进对不同年龄和种族/民族的妇女中乳腺癌和乳腺癌亚型的预测，并评估预测的风险是否可以用于优化筛查结果。项目2，社区实践中乳腺癌筛查成像策略的有效性比较，将根据年龄、种族/民族、乳房密度和总体乳腺癌风险来表征先进成像技术和筛查策略的表现。项目3，乳房成像技术的社区利用，将评估不同人群中基于风险的筛查，并确定在获得和使用新技术方面的差异。行政核心将支持后勤需求，并促进通信和数据共享。生物统计和数据管理核心将协调数据收集、管理和分析，并将开发统计方法。比较有效性核心中心将使用模拟模型来评估不同筛查做法对人口健康的长期影响。该计划代表了改善筛查的综合努力，总体目标是避免乳腺癌死亡，同时将危害降至最低。

The program theme is to identify effective breast cancer screening strategies for women with diverse levels of breast cancer risk to maximize screening benefits while minimizing potential harms. Program aims follow the premise that breast cancer screening will be most effective when: guidelines are based on accurate risk estimates that are tied to the effectiveness and harms of screening tests; women and physicians are informed about screening test performance based on risk level; risk-based screening practices are equitable; and high-quality comparative effectiveness research results are disseminated into community practice. Program goals will be met through three complementary research projects and three shared resource cores. Project 1, Risk Assessment in Community Practice: Developing Better Models, will improve prediction of breast cancer and breast cancer subtypes among women of varying ages and race/ethnicity and evaluate whether predicted risk can be used to optimize screening outcomes. Project 2, Comparative Effectiveness of Imaging Strategies for Breast Cancer Screening in Community Practice, will characterize the performance of advanced imaging technologies and screening strategies according to age, race/ethnicity, breast density, and overall breast cancer risk. Project 3, Community-based Utilization of Breast Imaging Technologies, will assess risk-based screening in diverse populations and identify disparities in access and use of new technologies. The Administrative Core will support logistical requirements and facilitate communication and data sharing. The Biostatistics and Data Management Core will coordinate data collection, management, and analysis and will develop statistical methods. The Comparative Effectiveness Core will use simulation modeling to estimate long-term implications of different screening practices on population health. The program represents an integrated effort to improve screening with the overall aim of averting deaths from breast cancer while minimizing harms.