Download Slide 1 - Annals of Internal Medicine

From: The Effect of Treatment Advances on the Mortality Results of Breast Cancer Screening Trials: A
Microsimulation Model
Ann Intern Med. 2016;164(4):236-243. doi:10.7326/M15-0754
Figure Legend:
Breast cancer states in the state-transition model.
Healthy women are at risk for clinical breast cancer diagnosis in the absence of screening. Patients clinically diagnosed with breast cancer may have either early- or advanced-stage disease at diagnosis, and their
survival in the absence of screening was assigned accordingly. The effect of screening is to reduce the chance of diagnosis in the advanced stage; for a fraction of advanced-stage cases, the stage at diagnosis was
reclassified as early with a commensurate change in disease-specific survival.
Date of download: 4/29/2017
Copyright © American College of Physicians. All rights reserved.
From: The Effect of Treatment Advances on the Mortality Results of Breast Cancer Screening Trials: A
Microsimulation Model
Ann Intern Med. 2016;164(4):236-243. doi:10.7326/M15-0754
Figure Legend:
10-year MRRs for trials in which treatment efficacies vary by stage and screening reduces advanced-stage incidence by 15%.
Each cell contains the within-trial MRR of screening for a trial in which a single treatment is given to all early-stage cases and another treatment is given to all advanced cases. The columns indicate the early-stage HRs,
or benefit of the early-stage treatment in the trial, and the rows indicate the HRs for the advanced-stage treatment in the trial. The top left cell indicates that with no effective early- or advanced-stage treatments, the stageshift model projects an MRR of 0.91 as the effect of screening on mortality. Trials in which advanced-stage treatment is better than early-stage treatment find a smaller effect of screening (dark green cells) than trials in
which early-stage treatment is better than advanced-stage treatment (white cells). HR = hazard ratio; MRR = mortality rate ratio.
Date of download: 4/29/2017
Copyright © American College of Physicians. All rights reserved.