Modeling the Long-term Comparative Effectiveness of CRC Screening

项目概要（见说明）我们提出的项目的总体目标，成功：研究结直肠癌：筛查策略的有效性，是发展证据，告知个性化的筛查建议，保持大部分或所有的强化筛查的好处，最大限度地减少风险和成本，并尊重患者的喜好。基于集团健康研究所（GHRI），SuCCESS项目将利用集团健康（GH）（华盛顿州的一个综合医疗保健提供系统）提供的大量丰富的电子数据源，收集有关风险因素、筛查模式、诊断程序、病理学、治疗和GH登记者癌症结局的信息。SuCCESS项目将使用GH数据来描述结直肠癌（CRC）筛查的实践，包括行为和有效性，并将在此信息的基础上研究个性化筛查方案的潜力。我们提出了与这一总体目标相关的3个相关项目。项目1，“实践中结直肠癌筛查的比较有效性”，将提供有关如何进行筛查的信息，有关患者对筛查方式的决定，以及不同筛查方案的比较有效性。项目二：“个性化结直肠癌筛查和监测”将重点关注根据筛查历史和其他个体风险因素确定有效的个性化筛查方案。项目3，“模拟结直肠筛查的长期比较有效性”，将使用疾病模拟模型，根据项目1和项目2的结果预测不同筛查和监测方案对botii总体和CRC死亡率的长期有效性，并将开发一个可自由分布的CRC队列模型。我们建议的研究机构将为个性化的直肠癌筛查提供重要的基础，并将产生对多学科观众有用的结果，包括临床医生，患者，政策制定者，研究人员和专业医疗组织

PROJECT SUMIVIARY (See Instructions) The overarching goal of our proposed project, SuCCESS: Studying Colorectal Cancer: Effectiveness of Screening Strategies, is to develop evidence to inform personalized screening recommendations that maintain most or all of the benefits of intensive screening, minimize risks and costs, and respect patient preferences. Based within Group Health Research Institute (GHRI), the SuCCESS project will draw on wide array of rich electronic data sources available at Group Health (GH), an integrated health care delivery system in Washington State, to gather information about risk factors, screening patterns, diagnostic procedures, pathology, treatment, and cancer outcomes among GH enrollees. The SuCCESS project will use GH data to describe colorectal cancer (CRC) screening as practiced, including behaviors and effectiveness, and will build on this information to examine the potential for personalized screening regimens. We propose 3 linked projects related to this overall goal. Project 1, "Comparative effectiveness of colorectal cancer screening as practiced," will provide information about how screening is practiced, about patient decisions regarding screening modalities, and about the comparative effectiveness of different screenin regimens as practiced. Project 2: "Personalizing colorectal cancer screening and surveillance," will focus on identifying effective personalized screening regimens based on screening history and other individual risk factors. Project 3, "Modeling long-term comparative effectiveness of colorectal screening," will use disease simulation models to predict the long-term effectiveness of different screening and surveillance regimens on botii overall and CRC mortality based on results from Project 1 and Project 2, and will develop a cohort model for CRC that will be freely distributed. Our proposed body of research will provide an important foundation for personalized clorectal cancer screening, and will produce results that are useful to a multidisciplinary audience, including clinicians, patients, policy makers, researchers, and professional medical organizations