Comparative effectiveness of colorectal cancer screening

项目SUMIVIARY(参见说明)我们提出的项目Success：研究结直肠癌：筛查策略的有效性的主要目标是开发证据，为个性化筛查建议提供信息，这些建议保持了强化筛查的大部分或全部好处，最大限度地减少了风险和成本，并尊重患者的偏好。Success项目以团体健康研究所(GHRI)为基础，将利用华盛顿州综合医疗保健系统团体健康(GH)提供的大量丰富的电子数据源，收集有关GH参与者的风险因素、筛查模式、诊断程序、病理、治疗和癌症结果的信息。Success项目将使用生长激素数据来描述实践中的结直肠癌(CRC)筛查，包括行为和有效性，并将基于这些信息来检查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“实施的结直肠癌筛查的比较有效性”将提供关于如何进行筛查的信息，关于患者关于筛查方式的决定，以及关于不同筛查方案的比较有效性的信息。项目2：“结直肠癌个人化筛查和监测”，将侧重于根据筛查历史和其他个人风险因素确定有效的个体化筛查方案。项目3“结直肠筛查的长期比较有效性建模”将根据项目1和项目2的结果，使用疾病模拟模型来预测不同筛查和监测方案对结直肠癌总体和结直肠癌死亡率的长期有效性，并将开发一个免费分布的结直肠癌队列模型。我们建议的研究主体将为个性化的直肠癌筛查提供重要的基础，并将产生对多学科受众有用的结果，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