.png){kind=icon}
返回
An Evolutionary Algorithm to Personalize Stool-Based Colorectal Cancer Screening
.png){kind=icon}
OA
AI
DOI：10.3389/fphys.2021.718276.png)
.png){kind=icon}
.png){kind=icon}
分享.png){kind=icon}
收藏
摘要
En 中文
BackgroundFecal immunochemical testing (FIT) is an established method for colorectal cancer (CRC) screening. Measured FIT-concentrations are associated with both present and future risk of CRC, and may be used for personalized screening. However, evaluation of personalized screening is computationally challenging. In this study, a broadly applicable algorithm is presented to efficiently optimize personalized screening policies that prescribe screening intervals and FIT-cutoffs, based on age and FIT-history. MethodsWe present a mathematical framework for personalized screening policies and a bi-objective evolutionary algorithm that identifies policies with minimal costs and maximal health benefits. The algorithm is combined with an established microsimulation model (MISCAN-Colon), to accurately estimate the costs and benefits of generated policies, without restrictive Markov assumptions. The performance of the algorithm is demonstrated in three experiments. ResultsIn Experiment 1, a relatively small benchmark problem, the optimal policies were known. The algorithm approached the maximum feasible benefits with a relative difference of 0.007%. Experiment 2 optimized both intervals and cutoffs, Experiment 3 optimized cutoffs only. Optimal policies in both experiments are unknown. Compared to policies recently evaluated for the USPSTF, personalized screening increased health benefits up to 14 and 4.3%, for Experiments 2 and 3, respectively, without adding costs. Generated policies have several features concordant with current screening recommendations. DiscussionThe method presented in this paper is flexible and capable of optimizing personalized screening policies evaluated with computationally-intensive but established simulation models. It can be used to inform screening policies for CRC or other diseases. For CRC, more debate is needed on what features a policy needs to exhibit to make it suitable for implementation in practice.
Keyword:
colorectal cancer
personalized screening
fecal immunochemical test
screening interval
cutoff
microsimulation models
evolutionary algorithm
FIT-history
AI总结
对已上传原文的论文进行重点信息的提取，主要内容包括：简要概述、研究摘要、背景介绍、关键亮点、图文解析、展望与总结。
期刊
IF:
3.4
论文数:
2.0W
被引数:
6.2W
机构
引用论文
分享收藏Optimizing Colorectal Cancer Screening by Race and Sex: Microsimulation Analysis II to Inform the American Cancer Society Colorectal Cancer Screening Guideline.png)
CANCEROAAI
CANCERIF5.1
OAAI分享收藏Melting centrifugally spun ultrafine poly butylene adipate-co-terephthalate (PBAT) fiber and hydrophilic modificationRSC AdvancesOAAI
RSC AdvancesIF0
OAAI分享收藏What If I Don't Treat My PSA-Detected Prostate Cancer? Answers from Three Natural History ModelsOAAI
OAAI分享收藏Colorectal Cancer Screening: An Updated Modeling Study for the US Preventive Services Task Force
OAAI
OAAI分享收藏
查看更多内容