Evidence map›Paper›PMID 30343626›Full record

Trial reportMedical decision making : an international journal of the Society for Medical Decision Making2018

Modeling in Colorectal Cancer Screening: Assessing External and Predictive Validity of MISCAN-Colon Microsimulation Model Using NORCCAP Trial Results.

Maaike Buskermolen, Andrea Gini, Steffie K Naber, Esther Toes-Zoutendijk, Harry J de Koning, Iris Lansdorp-Vogelaar

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Medical decision making : an international journal of the Society for Medical Decision Making, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maaike BuskermolenDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (MB, AG, AKN, ETZ, HJdK, ILV).
Andrea GiniDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (MB, AG, AKN, ETZ, HJdK, ILV).
Steffie K NaberDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (MB, AG, AKN, ETZ, HJdK, ILV).
Esther Toes-ZoutendijkDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (MB, AG, AKN, ETZ, HJdK, ILV).
Harry J de KoningDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (MB, AG, AKN, ETZ, HJdK, ILV).
Iris Lansdorp-VogelaarDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (MB, AG, AKN, ETZ, HJdK, ILV).

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
Comparative Modeling of Colorectal Cancer: Informing Health Policies and Prioritizing Future ResearchU01CA199335 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI KUNTZ, KAREN M, LANSDORP-VOGELAAR, IRIS · 2015 to 2019
$5.5M
NCI NIH HHS P30 CA008748NCI NIH HHS U01 CA199335
6 · The paper itself

Abstract

backgroundMicrosimulation models are increasingly being used to inform colorectal cancer (CRC) screening recommendations. MISCAN-Colon is an example of such a model, used to inform the Dutch CRC screening program and US Preventive Services Task Force guidelines. Assessing the validity of these models is essential to provide transparency regarding their performance. In this study, we tested the external and predictive validity of MISCAN-Colon.

methodsWe validated MISCAN-Colon using the Norwegian Colorectal Cancer Prevention (NORCCAP) trial, a randomized controlled trial that examined the effectiveness of once-only flexible sigmoidoscopy (FS) screening. We simulated the study population and design of the NORCCAP trial in MISCAN-Colon and compared 10- to 12-year model-predicted hazard ratios (HRs) for overall and distal CRC incidence and mortality to those observed. In addition, we compared the numbers of screen-detected neoplasia. Finally, we predicted the trial's future results to allow for the assessment of predictive validity.

resultsMISCAN-Colon predicted an HR for overall CRC incidence (0.85), distal CRC incidence (0.82), overall CRC mortality (0.68), and distal CRC mortality (0.62). These were within the limits of the 95% confidence intervals of the NORCCAP trial results. Similar results were observed for the number of screen-detected cancers. The model significantly underestimated the number of screen-detected adenomas. Model-predicted HRs for CRC incidence and mortality up to 15- to 17-year follow-up were 0.84 and 0.72, respectively.

conclusionAlthough the underestimation of screen-detected adenomas requires further investigation, MISCAN-Colon is able to make a valid replication of the CRC incidence and mortality reduction of an FS screening trial, which suggests that it can be considered a useful tool to support decision making on CRC screening.

Indexed as

Decision Support TechniquesModels, StatisticalAgedColorectal NeoplasmsComputer SimulationEarly Detection of CancerFemaleHumansIncidenceMaleMiddle AgedNorwayReproducibility of ResultsSigmoidoscopycancer screeningcolorectal neoplasmcomputer simulationmicrosimulation modeling

Identifiers

PMID30343626
PMCPMC6705122

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.