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@ARTICLE{Heisser:166540,
      author       = {T. Heisser$^*$ and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{E}ffects of {S}creening for {C}olorectal {C}ancer:
                      {D}evelopment, {D}ocumentation and {V}alidation of a
                      {M}ultistate {M}arkov {M}odel.},
      journal      = {International journal of cancer},
      volume       = {148},
      number       = {8},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2020-02983},
      pages        = {1973-1981},
      year         = {2021},
      note         = {2021 Apr 15;148(8):1973-1981#EA:C070#LA:C070#},
      abstract     = {Simulation models are a powerful tool to overcome gaps of
                      evidence needed to inform medical decision making. Here, we
                      present development and application of a multistate Markov
                      model to simulate effects of colorectal cancer (CRC)
                      screening, along with a thorough assessment of the model's
                      ability to reproduce real-life outcomes. Firstly, we provide
                      a comprehensive documentation of the model development,
                      structure and assumptions. Secondly, to assess the model's
                      external validity, we compared model-derived cumulative
                      incidence and prevalences of colorectal neoplasms to (1)
                      results from KolosSal, a study in German screening
                      colonoscopy participants, (2) registry-based estimates of
                      CRC incidence in Germany, and (3) outcome patterns of
                      randomized sigmoidoscopy screening studies. We found that
                      (1) more than $90\%$ of observed prevalences in the KolosSal
                      study were within the $95\%$ confidence intervals of the
                      model-predicted neoplasm prevalences; (2) the 15-year
                      cumulative CRC incidences estimated by simulations for the
                      German population deviated by 0.0-0.2 percent units in men
                      and 0.0-0.3 percent units in women when compared to
                      corresponding registry-derived estimates; and (3) the time
                      course of cumulative CRC incidence and mortality in the
                      modelled intervention group and control group closely
                      resembles the time course reported from sigmoidoscopy
                      screening trials. Summarized, our model adequately predicted
                      colorectal neoplasm prevalences and incidences in a German
                      population for up to 25 years, with estimated patterns of
                      the effect of screening colonoscopy resembling those seen in
                      registry data and real-world studies. This suggests that the
                      model may represent a valid tool to assess the comparative
                      effectiveness of CRC screening strategies. This article is
                      protected by copyright. All rights reserved.},
      keywords     = {colorectal cancer (Other) / modelling (Other) / screening
                      (Other) / validation (Other)},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33320964},
      doi          = {10.1002/ijc.33437},
      url          = {https://inrepo02.dkfz.de/record/166540},
}