Natasha K. Stout

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BACKGROUND Despite trials of mammography and widespread use, optimal screening policy is controversial. OBJECTIVE To evaluate U.S. breast cancer screening strategies. DESIGN 6 models using common data elements. DATA SOURCES National data on age-specific incidence, competing mortality, mammography characteristics, and treatment effects. TARGET(More)
The objective of this study was to develop a comprehensive natural history model of human papillomavirus (HPV) and cervical cancer using a two-step approach to model calibration. In the first step, the authors utilized primary epidemiologic data from a longitudinal study of women in Brazil and identified a plausible range for each input parameter that(More)
Breast cancer is the most common non-skin cancer and the second leading cause of cancer-death in US women. Although mammography is the most effective modality for breast cancer diagnosis, it has several potential risks, including high false positive rates, which are not very rare. Therefore, the balance of benefits and risks, which depend on personal(More)
Bayesian statistics provides effective techniques for analyzing data and translating the results to inform decision making. This paper provides an elementary tutorial overview of the WinBUGS software for performing Bayesian statistical analysis. Background information on the computational methods used by the software is provided. Two examples drawn from the(More)
OBJECTIVES Model-based cost-effectiveness analyses support decision-making. To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. METHODS We developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations(More)
BACKGROUND The availability of human papillomavirus (HPV) DNA testing and vaccination against HPV types 16 and 18 (HPV-16,18) motivates questions about the cost-effectiveness of cervical cancer prevention in the United States for unvaccinated older women and for girls eligible for vaccination. METHODS An empirically calibrated model was used to assess the(More)
Increasingly, computer simulation models are used for economic and policy evaluation in cancer prevention and control. A model's predictions of key outcomes, such as screening effectiveness, depend on the values of unobservable natural history parameters. Calibration is the process of determining the values of unobservable parameters by constraining model(More)
BACKGROUND Many guidelines recommend screening mammography every 1-2 years for women older than 40 years; more than 70% of women now participate in routine screening. No studies have examined the societal impact of screening practices over the past decade in the United States on costs and quality-adjusted life-years (QALYs). We performed a retrospective(More)
BACKGROUND New screening and vaccination technologies will provide women with more options for cervical cancer prevention. Because the risk of cervical cancer diminishes with effective routine screening, women may wish to consider additional attributes, such as the likelihood of false-positive results and diagnostic procedures for mild abnormalities likely(More)
BACKGROUND The DMIST (Digital Mammography Imaging Screening Trial) reported improved breast cancer detection with digital mammography compared with film mammography in selected population subgroups, but it did not assess the economic value of digital relative to film mammography screening. OBJECTIVE To evaluate the cost-effectiveness of digital(More)