A5046601895- Global Cancer Incidence and Screening
- Colorectal Cancer Screening and Detection
- Cancer Risks and Factors
- Breast Cancer Treatment Studies
- AI in cancer detection
- BRCA gene mutations in cancer
- Health Systems, Economic Evaluations, Quality of Life
- Clostridium difficile and Clostridium perfringens research
- Digital Radiography and Breast Imaging
- Economic and Financial Impacts of Cancer
- Infection Control in Healthcare
- Organ Transplantation Techniques and Outcomes
- Nosocomial Infections in ICU
- Liver Disease Diagnosis and Treatment
- Healthcare Operations and Scheduling Optimization
- Radiomics and Machine Learning in Medical Imaging
- Liver Disease and Transplantation
- Cancer Genomics and Diagnostics
- COVID-19 epidemiological studies
- Maternal and fetal healthcare
- Statistical Methods in Clinical Trials
- Pregnancy and preeclampsia studies
- Gastric Cancer Management and Outcomes
- Gene expression and cancer classification
- Thyroid Cancer Diagnosis and Treatment
University of Wisconsin–Madison
2016-2025
University of Wisconsin Carbone Cancer Center
2013-2024
University of Wisconsin Health
2021
Madison Area Technical College
2017-2019
University of Wisconsin System
2019
Harvard Pilgrim Health Care
2012-2018
Harvard University
2012-2018
Dartmouth Institute for Health Policy and Clinical Practice
2014-2018
Sunnybrook Health Science Centre
2018
Health Sciences Centre
2018
State-transition modeling (STM) is an intuitive, flexible, and transparent approach of computer-based decision-analytic modeling, including both Markov model cohort simulation as well individual-based (first-order Monte Carlo) microsimulation. Conceptualizing a decision problem in terms set (health) states transitions among these states, STM one the most widespread techniques clinical analysis, health technology assessment, health-economic evaluation. STMs have been used many different...
<h3>Importance</h3> Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. <h3>Objective</h3> To evaluate the contributions associated with treatment based estrogen-receptor (ER) human epidermal growth factor receptor 2 (<i>ERBB2</i>, formerly<i>HER2</i>or<i>HER2/neu</i>). <h3>Design, Setting,...
Background: Controversy persists about optimal mammography screening strategies. Objective: To evaluate outcomes, taking into account advances in and treatment of breast cancer. Design: Collaboration 6 simulation models using national data on incidence, digital performance, effects, other-cause mortality. Setting: United States. Patients: Average-risk U.S. female population subgroups with varying risk, density, or comorbidity. Intervention: Eight strategies differing by age at which starts...
Many states have laws requiring mammography facilities to tell women with dense breasts and negative results on screening discuss supplemental tests their providers. The most readily available method is ultrasonography, but little known about its effectiveness.To evaluate the benefits, harms, cost-effectiveness of ultrasonography for breasts.Comparative modeling 3 validated simulation models.Surveillance, Epidemiology, End Results Program; Breast Cancer Surveillance Consortium; medical...
The coronavirus disease 2019 (COVID-19) pandemic has disrupted breast cancer control through short-term declines in screening and delays diagnosis treatments. We projected the impact of COVID-19 on future mortality between 2020 2030.Three established Cancer Intervention Surveillance Modeling Network models modeled reductions mammography use, symptomatic diagnosis, reduced use chemotherapy for women with early-stage first 6 months return to prepandemic patterns after that time. Sensitivity...
Breast cancer mortality in the US declined between 1975 and 2019. The association of changes metastatic breast treatment with improved is unclear.
The effects of breast cancer incidence changes and advances in screening treatment on outcomes different strategies are not well known.
We provide a tutorial on the construction and evaluation of Markov decision processes (MDPs), which are powerful analytical tools used for sequential making under uncertainty that have been widely in many industrial manufacturing applications but underutilized medical (MDM). demonstrate use an MDP to solve clinical treatment problem uncertainty. generalize standard models process is embedded model multiple decisions made over time. Furthermore, they significant advantages analysis. compare...
Living donors are a significant and increasing source of livers for transplantation, mainly because the insufficient supply cadaveric organs. We consider problem optimally timing living-donor liver transplant to maximize patient's total reward, such as quality-adjusted life expectancy. formulate Markov decision process (MDP) model in which state is described by patient health. derive structural properties MDP model, including set intuitive conditions that ensure existence control-limit...
Breast cancer is the most common nonskin and second leading cause of death in U.S. women. Although mammography effective modality for breast screening, it has several potential risks, including high false-positive rates. Therefore, balance benefits which depend on personal characteristics, critical designing a screening schedule. In contrast to prior research existing guidelines that consider population-based recommendations, we propose personalized policy based history risk characteristics...
Computer models in medical diagnosis are being developed to help physicians differentiate between healthy patients and with disease. These can aid successful decision making by allowing calculation of disease likelihood on the basis known patient characteristics clinical test results. Two most frequently used computer risk estimation logistic regression an artificial neural network. A study was conducted review compare these two models, elucidate advantages disadvantages each, provide...
The only available therapy for patients with end-stage liver disease is organ transplantation. In the United States, are placed on a waiting list and offered livers based location time, as well current past health. Although there shortage of cadaveric livers, 45% all offers declined by first transplant surgeon and/or patient to whom they offered. We consider decision problem faced these patients: Should an given quality be accepted or declined? formulate Markov process model in which state...
Molecular characterization of breast cancer allows subtype-directed interventions. Estrogen receptor (ER) is the longest-established molecular marker.We used six established population models with ER-specific input parameters on age-specific incidence, disease natural history, mammography characteristics, and treatment effects to quantify impact screening adjuvant therapy age-adjusted US mortality by ER status from 1975 2000. Outcomes included stage-shifts absolute relative reductions in...
Compared with film, digital mammography has superior sensitivity but lower specificity for women aged 40 to 49 years and dense breasts. Digital replaced film in virtually all US facilities, overall population health cost from use of this technology are unclear. Using five independent models, we compared screening strategies starting at age or 50 applied annually, biennially, based on density biennial ages 74 no screening. Common data elements included cancer incidence test performance, both...
Abstract BACKGROUND: Discriminating malignant breast lesions from benign ones and accurately predicting the risk of cancer for individual patients are crucial to successful clinical decisions. In past, several artificial neural network (ANN) models have been developed cancer‐risk prediction. All studies reported discrimination performance, but not one has assessed calibration, which is an equivalently important measure accurate this study, authors evaluated whether trained on a large...
Purpose To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with screening alone, among women dense breasts. Materials Methods An established, discrete-event breast cancer simulation model was used to estimate comparative clinical cost-effectiveness both versus alone U.S. aged 50–74 years breasts from a federal payer perspective lifetime horizon. Input values were estimated for test performance, costs, health state utilities National...
Background: Timing of initiation screening for breast cancer is controversial in the United States. Objective: To determine threshold relative risk (RR) at which harm–benefit ratio women aged 40 to 49 years equals that biennial 50 74 years. Design: Comparative modeling study. Data Sources: Surveillance, Epidemiology, and End Results program, Breast Cancer Surveillance Consortium, medical literature. Target Population: A contemporary cohort eligible routine screening. Time Horizon: Lifetime....
Background: Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored may provide greater benefits. Objective: To estimate outcomes various intervals after age years based on breast density and risk cancer. Design: Collaborative simulation modeling using national incidence, density, performance data. Setting: United States. Patients: Women or older with combinations of relative (RR) 1.0, 1.3, 2.0, 4.0. Intervention: Annual, biennial, triennial...
Vaccination programs aim to control the COVID-19 pandemic. However, relative impacts of vaccine coverage, effectiveness, and capacity in context nonpharmaceutical interventions such as mask use physical distancing on spread SARS-CoV-2 are unclear. Our objective was examine impact vaccination using our previously developed agent-based simulation model.We applied model replicate COVID-19-related events 1) Dane County, Wisconsin; 2) Milwaukee metropolitan area, 3) New York City (NYC). We...
Across the United States, various social distancing measures were implemented to control spread of coronavirus disease 2019 (COVID-19). However, effectiveness such for specific regions with varying population demographic characteristics and different levels adherence is uncertain.
Screening mammography and magnetic resonance imaging (MRI) are recommended for women with ATM, CHEK2, PALB2 pathogenic variants. However, there few data to guide screening regimens these women.To estimate the benefits harms of breast cancer strategies using MRI at various start ages variants.This comparative modeling analysis used 2 established microsimulation models from Cancer Intervention Surveillance Modeling Network (CISNET) evaluate different strategies. Age-specific risks were...
Background. The optimal allocation of scarce donor livers is a contentious health care issue requiring careful analysis. objective this article was to design biologically based discrete-event simulation test proposed changes in policies. Methods. authors used data from multiple sources simulate end-stage liver disease and the complex system. To validate model, they compared output with historical data. Results. Simulation outcomes were within 1% 2% actual results for measures such as new...
Breast cancer is the most common non-skin affecting women in United States, where every year more than 20 million mammograms are performed. biopsy commonly performed on suspicious findings to confirm presence of cancer. Currently, 700,000 biopsies annually U.S.; 55%-85% these ultimately found be benign breast lesions, resulting unnecessary treatments, patient anxiety, and expenditures. This paper addresses decision problem faced by radiologists: When should a woman sent for based her...