Understanding the Effects of Competition for Constrained Colonoscopy Services with the Introduction of Population-level Colorectal Cancer Screening

Abstract

The study model differs from existing screening models in that it explicitly considers the colonoscopy resource implications of screening activities and the impact of constrained resources on screening effectiveness.

Operational research techniques applied throughout cancer care services: a review

“…Relatedly, Örmeci, Günes, and Kunduzcu (2016) model the operational decision of how to dynamically prioritise screening and symptomatic patients. These are both somewhat similar to the paper by Campbell et al (2017) described previously in the "Colorectal screening strategies" section, but they use different techniques and address slightly different questions. Güneş et al (2015) develop compartmental models, where each compartment contains patients in the same disease stage and the same health service stage.…”

“…Hosking, Roberts, Uzsoy, and Joseph (2013), Erenay, Alagoz, and Said (2014) and Li, Zhu, Klein, and Kong (2014) focus on colonoscopy only screening strategies, while Li, Dong, Ren, and Yin (2015), Song and Wang (2016) and Campbell, Blake, Kephart, Grunfeld, and MacIntosh (2017) consider two-step strategies that follow a noninvasive test with a colonoscopy for those patients that need it. The majority of these papers compare screening strategies (Li et al, 2014;Song & Wang, 2016) or optimise the yearly screening decision Li et al, 2015).…”

“…Li et al (2015) consider patients with a range of adherence probabilities. A different problem is tackled by Campbell et al (2017), who investigate the effect of screening the general population on colonoscopy resources available to other groups, such as surveillance and high risk (see also the paper by Güneş, Örmeci, and Kunduzcu, 2015 discussed in the next section). Hosking et al (2013) instead look at how to increase the proportion of the population screened through both supply and demand interventions.…”

“…Similar techniques are used for colorectal screening as for mammography: simulation (Campbell et al, 2017;Hosking et al, 2013;Song & Wang, 2016) and analytical . A combination of discrete event simulation and system dynamics is applied to understand the likely impacts of different interventions hoped to increase the screening level (Hosking et al, 2013).…”

Application of discrete event simulation in health care: a systematic review

“…Other screening studies reviewed incorporate two models which analyzed the effects of distinct colorectal cancer screening strategies on patient outcomes and system performance [ 21 , 22 ], with the remaining evaluating different screening practice options for tuberculosis [ 23 ], Niemann–Pick type C disease [ 24 ] and diabetic retinopathy [ 25 ].…”