Comparative Modeling of Colorectal Cancer: Informing Health Policies and Prioritizing Future Research

 描述（由申请人提供）：结直肠癌（CRC）是美国癌症死亡的第二大原因。我们提出的项目的长期目标是通过提供解决关键政策问题和优先考虑未来研究所需的信息来减少CRC的人口负担。为了实现这一目标，我们将使用基于人群的微观模拟模型：1）告知CRC控制范围内卫生政策中的新问题; 2）使用信息价值（VOI）框架指导CRC研究优先事项和研究设计; 3）吸引利益相关者，培训建模人员，并提高模型透明度，以确保现在和未来对CRC控制措施的高质量评价。我们的团队将填补知识的关键空白，使决策者能够采取行动。重要的知识差距包括筛查和治疗过程失败对CRC负担的影响;基于目前可用的风险分层工具，安全地降低某些患者的筛查和监测强度的可能性;基于患者水平信息的新靶向筛查方法的潜在益处（即，“精确医学”）;以及临床管理小型息肉的重要性。三个参与的建模小组有能力开展这项工作，为CRC的微观模拟建模相关问题带来了丰富的经验，专业知识和见解，并在合作和向卫生政策决策者传播我们的工作方面有着良好的记录。

 DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. The long-term goal of our proposed project is to reduce the population burden of CRC by providing the information needed to address key policy questions and prioritize future research. To accomplish this goal we will use our population- based microsimulation models to: 1) Inform emerging issues in health policy across the CRC-control spectrum; 2) Guide CRC research priorities and study design using a value of information (VOI) framework; and 3) Engage stakeholders, train modelers, and promote model transparency to ensure high-quality evaluation of CRC control measures, now and in the future. Our team will fill critical gaps in knowledge, enabling decision makers to act. Important gaps in knowledge include the impact of failures in screening and treatment processes on CRC burden; the potential to safely reduce screening and surveillance intensity among some patients based on currently available tools for risk-stratification; the potential benefit of new targeted screening approaches based on patient-level information (i.e., "precision medicine"); and the importance of clinical management of diminutive polyps. The three participating modeling groups are well-positioned to carry out this work, bringing a wealth of experience, expertise, and insight to issues related to microsimulation modeling of CRC, and have a proven track record of collaborating and disseminating our work to health policy decision makers.