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Appendix Q
CISNET—Cancer Intervention and Surveillance Eric J. (Rocky) Feuer, Ph.D.

SLIDE 1

SLIDE 1 NOTES: No notes.



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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary Appendix Q CISNET—Cancer Intervention and Surveillance Eric J. (Rocky) Feuer, Ph.D. SLIDE 1 SLIDE 1 NOTES: No notes.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 2 SLIDE 2 NOTES: The CISNET initiative has some features that are closely aligned to the purposes of this workshop but many features in addition. It is an NCI-sponsored consortium focused on the “Why?” and “What if?” questions in cancer trends. So, it goes beyond the issues of cost-effectiveness modeling to the modeling of population trends. CISNET is intended to further statistical modeling of the impact of cancer, taking into account the impact of the full range of cancer control interventions-prevention, screening and treatment—on current and future trends. We have had two rounds of funding so far. These have been four-year grants by the National Cancer Institute (NCI). They are U01 cooperative agreements, which means that the staff at NCI work in cooperation with the grantees. In 2000, we began with three cancer sites—breast, prostate and colorectal cancer-and funded 9 grants. Most of those grants were in the area of breast cancer, reflecting the state of modeling at the time. Eight more grants were funded in 2002, and lung cancer was added to the list of sites

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 3 SLIDE 3 NOTES: The modelers in CISNET represent a well respected and diverse group of cancer modelers. The MISCAN group from the Netherlands was one of the first groups in the world to do modeling of this type. Besides having a breast grant of their own, their colorectal model is being used by the funded group at Memorial Sloan Kettering, and the lung model being developed at Rand is a transplanted MISCAN person.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 4 SLIDE NOTES 4: No notes.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 5 SLIDE 5 NOTES: No notes.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 6 SLIDE 6 NOTES: This workshop grew out of one of the same issues that CISNET has had to address: the lack of comparability of inputs, outputs, structures and definitions among different models of the same cancer site. We have tried to address this problem in CISNET with tools called “Model Profiler,” and “Base Cases.” I will discuss both of these efforts.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 7 SLIDE 7 NOTES: Model Profiler is software that allows our collaborating centers to access a central CISNET interactive Web site that contains documentation on their own and other models in a consistent fashion.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 8 SLIDE 8 NOTES: Here is the structured format for entry of documentation into Model Profiler. There are a number of basic profile documents, a model overview, a model purpose, and an assumption overview. Ideally, all collaborators would enter information into each of these documents. It is possible to go deeper and enter documents that address specific assumptions or parameters. Although we are encouraging groups to use this profiler, they are free to go into as much depth as they want to.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 9 SLIDE 9 NOTES: When each group’s data is posted on the central CISNET Web site, the table of contents page looks like this.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 10 SLIDE 10 NOTES: Because each modeler answers the same set of questions, it is possible to compare the models relatively quickly. Here is an example of the Component Overview documents for a number of models.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 11 SLIDE 11 NOTES: Here is an example of an analysis on breast cancer survival, where the rows are specific models and the columns represent certain characteristics of that model. This comparative analysis is done off-line by an analyst, but it can be posted in the Model Profiler.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 12 SLIDE 12 NOTES: The final step, still to be taken, is to make the Model Profiler information available in a public site. The public site, cisnet.cancer.gov will be able to accommodate publications and documentation.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 13 SLIDE 13 NOTES: The CISNET Base Cases initiative is similar to what the modelers at this workshop have been attempting to do. The group jointly decides to address a common question. We have common population-based inputs, and the modelers maintain what I would call the deeper aspects of their models, e.g., assumption and formulation of natural histories. We produce a set of common computer runs, and the format of the outputs is specified. That provides a chance to reach a consensus on important questions and to better understand differences among the models.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 14 SLIDE 14 NOTES: No notes.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 15 SLIDE 15 NOTES: No notes.

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Economic Models of Colorectal Cancer Screening in Average-Risk Adults: Workshop Summary SLIDE 16 SLIDE 16 NOTES: No notes.