Wu Dongfeng, Rosner Gary L, Broemeling Lyle D
Department of Mathematics and Statistics, Mississippi State University, Mississippi State, Mississippi 39762, USA.
Biometrics. 2007 Sep;63(3):873-80. doi: 10.1111/j.1541-0420.2006.00732.x.
This article develops a probability distribution for the lead time in periodic cancer screening examinations. The general aim is to allow statistical inference for a screening program's lead time, the length of time the diagnosis is advanced by screening. The program's lead time is distributed as a mixture of a point mass and a piecewise continuous distribution. Simulation studies using the HIP (Health Insurance Plan for Greater New York) study's data provide estimates of different characteristics of a screening program under different screening frequencies. The components of this mixture represent two aspects of screening's benefit, namely, a reduction in the number of interval cases and the extent by which screening advanced the age of diagnosis. We present estimates of these two measures for participants in a breast cancer screening program. We also provide the mean, mode, variance, and density curve of the program's lead time. The model can provide policy makers with important information regarding the screening period, frequency, and the endpoints that may serve as surrogates for the benefit to women who take part in a periodic screening program. Though the study focuses on breast cancer screening, it is also applicable to other kinds of chronic disease.
本文针对定期癌症筛查检查中的提前期建立了一种概率分布。总体目标是对筛查计划的提前期进行统计推断，即筛查使诊断提前的时间长度。该计划的提前期分布为一个点质量和一个分段连续分布的混合。使用纽约市健康保险计划（HIP）研究数据进行的模拟研究提供了不同筛查频率下筛查计划不同特征的估计值。这种混合的组成部分代表了筛查益处的两个方面，即减少间隔期病例数以及筛查使诊断年龄提前的程度。我们给出了乳腺癌筛查计划参与者这两项指标的估计值。我们还提供了该计划提前期的均值、众数、方差和密度曲线。该模型可以为政策制定者提供有关筛查周期、频率以及可能作为参与定期筛查计划女性受益替代指标的终点的重要信息。尽管该研究聚焦于乳腺癌筛查，但它也适用于其他类型的慢性病。
