Modeling Methods Development for Routine Data based Screening Evaluation: Decision Making for Organized Abdominal Aortic Aneurysm Screening

Abstract

Screening technologies are under discussion in many health care systems of industrialized countries. Besides cancer screening a growing list of other health problems are getting in focus.This work presents a dynamic simulation based decision support for the evaluation of organized screening interventions concerning patients with abdominal aortic aneurysms (AAA).The interdisciplinary subject required the collaboration of experts in different fields, which were medical doctors, Health Technology Assessment (HTA) experts and modelers. The here presented modular model structure was constructed in such a flexible way that it allows adaptation on screening research questions for similar diseases. Another focus of the work was integration of risk factors and how this boundaries and restrictions influence the choice of modeling methods to use, fitting the real world structure using a parameterize able implementation. This is especially because of the steadily increasing knowledge about treatment or improved treatment of AAA which could cause the necessity of a periodic evaluation.By inclusion of several patient specific properties, the model does not only provide comparison of current state which are incidental findings as well as unorganized screening with organized screening of definied age groups, but also the elaboration of alterations of population characteristics, for incidence changing in smoking behavior, and its consequences on AAA cases. The development of the modular model structure was started during the IFEDH cooperation project, and is actually refined in DEXHELPP, where special focus is on the population module.