Modelling the Future: System Dynamics in the Cutaneous Malignant Melanoma Care Pathway

Abstract

Incidence rates for cutaneous malignant melanoma are increasing worldwide. Estimates of the future number of melanoma cases are important for strategic planning of the care pathway. The aim of this study was to use system dynamics modelling to evaluate the long-term effects of changes in incidence, population growth and preventive interventions. Historical data on invasive melanoma cases in Western Sweden from 1990 to 2006 were obtained. Using computer simulation software, a model estimating the accumulated number of melanoma cases for 2014 to 2023 was developed. Five future scenarios were designed: stable incidence, business-as-usual, 25% reduced patient's delay, 50% reduced doctor's delay, and a combination of the last two, called improved overall secondary prevention. After 10 years, improved overall secondary prevention would have resulted in a 42% decrease in melanomas > 4 mm and a 10% increase in melanomas ≤ 1 mm, compared with business-as-usual. System dynamics is a valuable tool, which can help policymakers choose the preventive interventions with the greatest impact.

Lethal Melanomas: A Population-based Registry Study in Western Sweden from 1990 to 2014

“…Rapid increases were observed in age-standardized melanoma incidence in Western Sweden from 1990 to 2014. Other studies have projected further future increases in melanoma incidence for Sweden, probably for at least a decade based on current trends (9,14). For example, a recent analysis predicts an on-going increase until the years 2022 to 2026, before it possibly becomes more stable, similar to how the incidence has reached a plateau in Australia (1, 5).…”

“…Sweden has a tradition of well-kept cancer registries with high coverage rates, facilitating epidemiological registry studies (12). The western parts of Sweden have, for the past decades, shown a higher incidence of melanoma than the national average, and projections show that this geographical area can anticipate greater numbers of melanoma in the future (13,14). A few studies have investigated thin melanomas in Sweden, but none have focused on Western Sweden (4,(15)(16)(17).…”

Data-Driven Treatment Pathways Mining for Early Breast Cancer Using cSPADE Algorithm and System Clustering

“…In recent years, due to the development of informatics, software engineering, mathematics and other disciplines, interdisciplinary research has begun to emerge, and treatment pathway construction methods based on process mining technology have appeared [8][9][10][11] . The development of electronic medical records (EMR) provides the possibility for the extraction and optimization of treatment paths [12][13][14] .…”

Data‐driven treatment pathways mining for early breast cancer using cSPADE algorithm and system clustering

“…Using the Kolmogorov-Smirnov test, we found no signi cant differences between the sequence distributions.Conclusions: The cSPADE algorithm combined with system clustering can achieve hierarchical and vertical mining of breast cancer treatment models. By uncovering the treatment pathways of early breast cancer patients by this method, the real-world breast cancer treatment behavior model can be evaluated, and it can provide a reference for the redesign and optimization of the treatment pathways.technology have appeared [8][9][10][11] . The development of electronic medical records (EMR) provides the possibility for the extraction and optimization of treatment paths [12][13][14] .…”

“…technology have appeared [8][9][10][11] . The development of electronic medical records (EMR) provides the possibility for the extraction and optimization of treatment paths [12][13][14] .…”