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Grant Details

Grant Number: 1R01CA097337-01A2 Interpret this number
Primary Investigator: Gazelle, G
Organization: Massachusetts General Hospital
Project Title: A Lung Cancer Policy Model
Fiscal Year: 2004


Abstract

DESCRIPTION (provided by applicant): The goal of the proposed research is to develop a lung cancer model capable of guiding screening policy decisions over the next several years, before results of ongoing clinical trials are available. Through Monte Carlo simulations of large numbers of individuals in selected target populations, the model will provide estimates of the health and economic consequences of proposed screening technologies such as helical CT and chest X-ray imaging. Much of the model's value will lie in translating short-term trial results into lifetime health and economic consequences. Data from a diverse array of sources, including past and ongoing screening trials, will be integrated to derive robust parameter estimates. An underlying natural history component will simulate the generation and growth of cancers and benign lesions, with parameters derived from existing screening trial data, autopsy studies, and information on tumor growth rates. Each individual's probability of developing lesions will be determined by risk factors such as smoking history, age, and sex. Additional model components will simulate the detection and treatment of lung cancer, with outcomes calibrated to existing data from prevalence screens and tumor registries. By modeling tumor growth and detection explicitly, our approach differs from previous decision analyses of lung cancer screening. Principal goals of the research are to determine the cost-effectiveness of proposed and hypothetical screening strategies, to examine the economic and health effects of screening different target populations or of screening with improved technologies, and to make comparisons not included in ongoing trials (e.g., helical CT screening vs. no screening, or screening at different frequencies). The model will also allow identification of threshold performance characteristics, above which new screening programs would be attractive alternatives to no screening or to screening with helical CT. By identifying parameters with both large plausible ranges and important effects on results, the model can serve as a tool for use in the efficient design of future clinical trials. The model will guide imminent screening policy decisions, and, paralleling achievements of the coronary heart disease policy model, could one day evaluate treatment advances or incidence trends.



Publications

Personalizing Annual Lung Cancer Screening For Patients With Chronic Obstructive Pulmonary Disease: A Decision Analysis
Authors: Lowry K.P. , Gazelle G.S. , Gilmore M.E. , Johanson C. , Munshi V. , Choi S.E. , Tramontano A.C. , Kong C.Y. , McMahon P.M. .
Source: Cancer, 2015-05-15 00:00:00.0; 121(10), p. 1556-62.
PMID: 25652107
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Microsimulation Model Predicts Survival Benefit Of Radiofrequency Ablation And Stereotactic Body Radiotherapy Versus Radiotherapy For Treating Inoperable Stage I Non-small Cell Lung Cancer
Authors: Tramontano A.C. , Cipriano L.E. , Kong C.Y. , Shepard J.A. , Lanuti M. , Gazelle G.S. , McMahon P.M. .
Source: Ajr. American Journal Of Roentgenology, 2013 May; 200(5), p. 1020-7.
PMID: 23617484
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Chapter 9: The Mgh-hms Lung Cancer Policy Model: Tobacco Control Versus Screening
Authors: McMahon P.M. , Kong C.Y. , Johnson B.E. , Weinstein M.C. , Weeks J.C. , Tramontano A.C. , Cipriano L.E. , Bouzan C. , Gazelle G.S. .
Source: Risk Analysis : An Official Publication Of The Society For Risk Analysis, 2012 Jul; 32 Suppl 1, p. S117-24.
PMID: 22882882
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Chapter 13: Cisnet Lung Models: Comparison Of Model Assumptions And Model Structures
Authors: McMahon P.M. , Hazelton W.D. , Kimmel M. , Clarke L.D. .
Source: Risk Analysis : An Official Publication Of The Society For Risk Analysis, 2012 Jul; 32 Suppl 1, p. S166-78.
PMID: 22882887
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Impact of reduced tobacco smoking on lung cancer mortality in the United States during 1975-2000.
Authors: Moolgavkar S.H. , Holford T.R. , Levy D.T. , Kong C.Y. , Foy M. , Clarke L. , Jeon J. , Hazelton W.D. , Meza R. , Schultz F. , et al. .
Source: Journal Of The National Cancer Institute, 2012-04-04 00:00:00.0; 104(7), p. 541-8.
EPub date: 2012-04-04 00:00:00.0.
PMID: 22423009
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Using Radiation Risk Models In Cancer Screening Simulations: Important Assumptions And Effects On Outcome Projections
Authors: Kong C.Y. , Lee J.M. , McMahon P.M. , Lowry K.P. , Omer Z.B. , Eisenberg J.D. , Pandharipande P.V. , Gazelle G.S. .
Source: Radiology, 2012 Mar; 262(3), p. 977-84.
PMID: 22357897
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Cost-effectiveness Of Computed Tomography Screening For Lung Cancer In The United States
Authors: McMahon P.M. , Kong C.Y. , Bouzan C. , Weinstein M.C. , Cipriano L.E. , Tramontano A.C. , Johnson B.E. , Weeks J.C. , Gazelle G.S. .
Source: Journal Of Thoracic Oncology : Official Publication Of The International Association For The Study Of Lung Cancer, 2011 Nov; 6(11), p. 1841-8.
PMID: 21892105
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Lung Cancer Treatment Costs, Including Patient Responsibility, By Disease Stage And Treatment Modality, 1992 To 2003
Authors: Cipriano L.E. , Romanus D. , Earle C.C. , Neville B.A. , Halpern E.F. , Gazelle G.S. , McMahon P.M. .
Source: Value In Health : The Journal Of The International Society For Pharmacoeconomics And Outcomes Research, 2011 Jan; 14(1), p. 41-52.
PMID: 21211485
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Calibration Of Disease Simulation Model Using An Engineering Approach
Authors: Vanni T. , Legood R. , White R.G. .
Source: Value In Health : The Journal Of The International Society For Pharmacoeconomics And Outcomes Research, 2010 Jan-Feb; 13(1), p. 157.
PMID: 19883406
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Calibration Of Disease Simulation Model Using An Engineering Approach
Authors: Kong C.Y. , McMahon P.M. , Gazelle G.S. .
Source: Value In Health : The Journal Of The International Society For Pharmacoeconomics And Outcomes Research, 2009 Jun; 12(4), p. 521-9.
PMID: 19900254
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Calibration Methods Used In Cancer Simulation Models And Suggested Reporting Guidelines
Authors: Stout N.K. , Knudsen A.B. , Kong C.Y. , McMahon P.M. , Gazelle G.S. .
Source: Pharmacoeconomics, 2009; 27(7), p. 533-45.
PMID: 19663525
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Adopting Helical Ct Screening For Lung Cancer: Potential Health Consequences During A 15-year Period
Authors: McMahon P.M. , Kong C.Y. , Weinstein M.C. , Tramontano A.C. , Cipriano L.E. , Johnson B.E. , Weeks J.C. , Gazelle G.S. .
Source: Cancer, 2008-12-15 00:00:00.0; 113(12), p. 3440-9.
PMID: 18988293
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Estimating Long-term Effectiveness Of Lung Cancer Screening In The Mayo Ct Screening Study
Authors: McMahon P.M. , Kong C.Y. , Johnson B.E. , Weinstein M.C. , Weeks J.C. , Kuntz K.M. , Shepard J.A. , Swensen S.J. , Gazelle G.S. .
Source: Radiology, 2008 Jul; 248(1), p. 278-87.
PMID: 18458247
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