Institute of Medical Information, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
BMC Med Inform Decis Mak. 2022 Jan 4;22(1):1. doi: 10.1186/s12911-021-01695-4.
Lung cancer screening and intervention might be important to help detect lung cancer early and reduce the mortality, but little was known about lung cancer intervention strategy associated with intervention effect for preventing lung cancer. We employed Deep Q-Networks (DQN) to respond to this gap. The aim was to quantitatively predict lung cancer optimal intervention strategy and assess intervention effect in aged 65 years and older (the elderly).
We screened lung cancer high risk with web-based survey data and conducted simulative intervention. DQN models were developed to predict optimal intervention strategies to prevent lung cancer in elderly men and elderly women separately. We assessed the intervention effects to evaluate the optimal intervention strategy.
Proposed DQN models quantitatively predicted and assessed lung cancer intervention. DQN models performed well in five stratified groups (elderly men, elderly women, men, women and the whole population). Stopping smoking and extending quitting smoking time were optimal intervention strategies in elderly men. Extending quitting time and reducing smoked cigarettes number were optimal intervention strategies in elderly women. In elderly men and women, the maximal reductions of lung cancer incidence were 31.81% and 24.62% separately. Lung cancer incidence trend was deduced from the year of 1984 to 2050, which predicted that the difference of lung cancer incidence between elderly men and women might be significantly decreased after thirty years quitting time.
We quantitatively predicted optimal intervention strategy and assessed lung cancer intervention effect in the elderly through DQN models. Those might improve intervention effects and reasonably prevent lung cancer.
肺癌筛查和干预可能对于早期发现肺癌和降低死亡率非常重要,但对于与干预效果相关的肺癌干预策略知之甚少。我们采用深度 Q 网络(DQN)来解决这一差距。目的是定量预测肺癌的最佳干预策略,并评估 65 岁及以上老年人的干预效果。
我们通过网络调查数据筛选肺癌高危人群,并进行模拟干预。分别为老年男性和老年女性开发了 DQN 模型,以预测预防肺癌的最佳干预策略。我们评估了干预效果,以评估最佳干预策略。
提出的 DQN 模型定量预测和评估了肺癌干预。DQN 模型在五个分层组(老年男性、老年女性、男性、女性和总人口)中表现良好。在老年男性中,戒烟和延长戒烟时间是最佳干预策略。在老年女性中,延长戒烟时间和减少吸烟数量是最佳干预策略。在老年男性和女性中,肺癌发病率的最大降幅分别为 31.81%和 24.62%。从 1984 年到 2050 年,我们推算了肺癌发病率的趋势,预测在 30 年戒烟时间后,老年男性和女性之间的肺癌发病率差异可能会显著降低。
我们通过 DQN 模型定量预测了老年人的最佳干预策略和评估了肺癌干预效果。这些可能会提高干预效果,并合理预防肺癌。