文章基本信息

标题：Inference of Long-Term Screening Outcomes for Individuals with Screening Histories
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作者：Dongfeng Wu ; Karen Kafadar ; Shesh N. Rai 等
期刊名称：Statistics and Public Policy
电子版ISSN：2330-443X
出版年度：2018
卷号：5
期号：1
页码：1-11
DOI：10.1080/2330443X.2018.1438939
出版社：Taylor and Francis Ltd
摘要：We develop a probability model for evaluating long-term outcomes due to regular screening that incorporates the effects of prior screening examinations. Previous models assume that individuals have no prior screening examinations at their current ages. Due to current widespread medical emphasis on screening, the consideration of screening histories is essential, particularly in assessing the benefit of future screening examinations given a certain number of previous negative screens. Screening participants are categorized into four mutually exclusive groups: symptom-free-life, no-early-detection, true-early-detection, and overdiagnosis. For each case, we develop models that incorporate a person’s current age, screening history, expected future screening frequency, screening test sensitivity, and other factors, and derive the probabilities of occurrence for the four groups. The probability of overdiagnosis among screen-detected cases is derived and estimated. The model applies to screening for any disease or condition; for concreteness, we focus on female breast cancer and use data from the study conducted by the Health Insurance Plan of Greater New York (HIP) to estimate these probabilities and corresponding credible intervals. The model can provide policy makers with important information regarding ranges of expected lives saved and percentages of true-early-detection and overdiagnosis among the screen-detected cases.
关键词：No-early-detection ; Overdiagnosis ; Sensitivity ; Sojourn time ; Symptom-free-life ; True-early-detection