STATISTICAL ISSUES IN THE EARLY DETECTION OF DISEASE

描述：该项目的主要目标是调查和开发 与早期发现慢性病有关的统计模型和程序 疾病 本研究的出发点是： 检测癌症-尤其是乳腺癌。 研究分为 三个主要领域：（一）规划临床试验，以评估 早期发现疾病的好处;（二）参数估计 （敏感性、临床前逗留时间分布） （iii）在审讯期间及在最后一次排定的讯问之后;及 开发和推广定量方法，以帮助公共卫生规划人员 规划早期检测方案，使更多的人受益。 早期规划大型公共卫生项目的主要问题 疾病的检测是：在什么年龄应该个人开始， 参加考试的次数、考试间隔时间和考试次数。 将制定评估任何拟议的公共卫生计划的方法。 应用这些模型的经济和健康影响是 潜力巨大。 规划早期检测临床试验的主要问题是 这些试验的特殊特征的优点;例如，考试次数， 检查之间的间隔，疾病发病率随年龄的变化，以及 每个科目的历史与以前的考试有关。 实验设计 出现的问题，如在某些疾病领域的对照组（无检查）， 可行 参数估计中的主要问题涉及具有多个 检测方式，可能导致不同的临床前逗留 时间分布，确定敏感性和逗留时间 分布取决于年龄、依从性和调查（如果不同） 检测模式是独立的。

DESCRIPTION: The major goals of this project are to investigate and develop statistical models and procedures related to the early detection chronic diseases. The research is motivated from current problems in the early detection of cancer --- especially breast cancer. The research is divided into three major areas: (i) planning clinical trials to evaluate the benefits of early detection of disease; (ii) estimation of parameters (sensitivities, pre-clinical sojourn time distributions) during the course of a trial as well as after the last scheduled examination; and (iii) develop and extend quantitative methods to aid public health planners in the planning of early detection programs to benefit larger populations. The major issues in planning large public health programs for the early detection of disease are: at which ages should individuals begin to participate, the time between examinations and the number of examinations. Methods will be developed for evaluating any proposed public health program. The economic and health implications of applying these models are potentially large. The major issues in planning early detection clinical trials are to take advantage of the special features of these trials; e.g., number of exams, spacing between exams, the changing incidence of disease with age, and the history of each subject with regard to earlier exams. Experimental design problems arise as in some disease area control groups (no exams) may not be feasible. The major issues in parameter estimation relate to having more than one detection modality, possibly resulting in different pre-clinical sojourn time distributions, ascertaining if sensitivity and sojourn time distributions are age dependent, compliance, and investigating if different detection modalities are independent.