Home

CPAC CRMM User Guide

Contents

1. Status Ready to run Run 3 Risk factors a Smeking a Radon 3 Cancer parameters 7 8366 BSGE O7F 7 836E 07 olorectal Cancer 7 236E 07 Approach te generating colorectal cancer mticidence cases a Natural History Approach a Sensitivity and specificity of screening tests Clinic Survival benefit from screening beyond stage shift Ch Colon cancer inokfence rates clinical detection fi Caen cance stage Etrurien aw Experts only Click the Information button beside the parameter title The information note for this parameter shows that the data is derived from 2004 2006 Canadian data so we can be confident that our new published rates are more relevant to our province for this research project Parameter Colon cancer incidence rates clinical detection Al Note H Risk factors 4 Smoking a Redon DESCRIPTION Observed ratas are denved from thras years of data 2004 2006 Observed rates are requared by the semulaton model in order to denve calibrated rates to take into account nisk factors if any if mo calibrabon is required 2 Cancer parameters 3 Colorectal Cancer 5i Sereaniniy wa set the calibrated rates to be the observed rates The calibrated rates are used 3 Incidence risk equation ta generate incidence cases in the simulation see Colon cancer 3 Experts only cakbrated incidence rates Approach to generating colorectal cancer Per 4 Natural History Approach
2. For an example of how you would use the Excel Workbooks to adjust a cost parameter see the tutorial Create a Scenario for a New Drug with a Cancer Management Workbook cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 69 UNDERSTANDING DATA SOURCES AND REFERENCES Workbooks The Microsoft Excel workbooks are essential to understanding the design of the model The workbooks capture design assumptions references where available and computations of input parameters particularly costs Choose the workbooks associated with the model you are currently working with The values in the workbooks for a version of the model will match those in the CRMM Base case parameters for that model How to Find and click the XLS workbook for the cancer or model of interest The model will download when you click watch out for browser download warnings and ok them if they appear Find the workbook and open it with Microsoft Excel TIP f you modify a Workbook use SAVE AS before you modify so that if required you can track and change back to the original settings in the workbook The workbooks are self documented the first sheet provides instructions on how to use the sheets to match to the parameters and there are notes and references throughout the workbooks to ease your exploration and usage YOU WANT TO UNDERSTAND THE DEFINING CHARACTERISTICS OF A PARTICULAR MODEL PARTICULARLY RELEVANT IF YOU HAVE BEEN USING A PREVIOUS VERSIO
3. Value has changed to 10 years In this comparison view of the two scenarios the parameter values for the two scenarios show that the Cured value has been changed to from 0 to 10 in the CRMM 1 2 Base case scenario Note that the information for the comparison view is for the 1 0 reference scenario rather than for version 1 2 According the Information note for this parameter in Model release version 1 2 the cured duration was previously hard coded to 5 years and this Cured dimension of 0 was not used In Model 1 2 the Cured dimension was implemented and set to 10 years The new value was chosen based on a re analysis of survival data from the literature Something important to understand the information notes and the other parameters in the left panel are for the Base case scenario of the reference model in the comparison They do not show all the comparisons You will only see the comparison view if you select the parameter or table from the Compare Entire Scenarios page However to ensure that this comparison remains within the Base Case scenario for Model 1 0 you could save the view by selecting Save view as from the File menu Select the Compare entire scenarios link from the View menu to return to the Compare page cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 35 ANALYZING AND COMPARING ACROSS SCENARIOS LF conect your thoughts You have Compared the Base case scenarios from different versions o
4. Pull the horizontal scroll bar over so that you can see the changes they ll be highlighted in yellow Click Save beside the Status message or select Save scenario changes from the File menu cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 41 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS LF colec your thoughts So far you have Created a new scenario from the Base case scenario which cleared the existing output projections Changed input parameters to reflect your provincial status quo by pasting from Excel you can also double click in an individual cell to edit one cell at a time Saved the changes To learn more about editing parameters including how to customize your browser to reduce the number of warning messages you might see see the later section Details Editing Parameters For this tutorial there s one more parameter editing feature to learn before we run this scenario Pull the horizontal scroll over so that you can see the column for age 85 Notice that ages 85 all the way to 100 hold the same value of 0 0048316252 Double click to edit the cell for age 85 to set it to the new value of 0 0059114455 Yes you could have done this in Excel but we wanted you to try this useful feature 10 0 00483162520 00483162520 i 800 00353512940 0038385 12940 0352512020 7 340 00479940920 00479940920 0047994090 cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 42 GENERATING N
5. DIMENSIONS z ary App Prowince 56x and age group 5 year St Clin Wnrinenes we oa l _ E Click back or use Return to previous view to return to the value view cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 39 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS In order to change the Incidence rates we will copy the existing rates from the parameters into Excel make the required changes and then copy them back Select the parameter Colon cancer incidence rates clinical detection Notice that we are only seeing one gender at a time because they have different rates For the purposes of tutorial brevity imagine that our new data is only for males Select Male from the Sex filter above the table Experiment with selecting an entire dimension or entire row so that in the future you can copy and paste an entire selection from Excel or fill a selected range with a single value Click on the Age dimension name tile in the top left corner of the grid Every cell will be selected Click on Newfoundland and Labrador the row title to select the entire row of data Sex Female 127079480 00174825170 00174825170 0017482510 00174825170 00174 14495 1940 00172714890 00172714890 00172714840 00172714890 00172 Newfoundland and Labrador 727386 0 00222986510 00222986510 00222986510 002229865 0 00222 Select Copy from the Edit menu Note Always use the Edit menu in CRMM for copy and paste ra
6. 66 MAGN CX E E EE EE EE T E inane senantenaates 71 cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 4 his SEN ABOUT THIS USER GUIDE The questions below will help you understand the objectives of this User Guide 1 What can I do with the Cancer Risk Management Model platform The Guide will provide you with a framework of the Cancer Risk Management Model CRMM platform how the different parts of the model fit together which parts can be changed and which parts cannot be changed Understanding the framework will make it possible to plan your research questions within the power and capabilities of the system 2 How do I use the system to answer my research questions This Guide provides a set of hands on tutorials that will introduce you to all of the important features in the CRMM platform The tutorials start with a more general approach and become more detailed as they progress through comparing scenarios and creating new scenarios The final tutorial walks you through building up aggregate costing in an integrated Excel workbook for a new drug intervention scenario We recommend working your way through all of the tutorials 3 Where can I get more details on how to use a particular part of the CRMM platform Several Details sections in this Guide complement the Help system built in to the platform The Details sections are intended to clarify special issues that may arise as you conduct your research The Help
7. Click the Output Tables tab to see the output tables for this scenario Expand Colorectal cancer tables Select Colorectal cancer screening outcomes by provinceand year Notice that the Number screened measure now shows millions of screening tests in each year in contrast to the same output table in the Base case scenario which showed no screening tests Let s assume that this table is what you need A likely next step would be to export it to an Excel file you can use on your desktop Click Export data from the File menu Use the default file type of XML for Excel and click OK Warning If you are using Internet Explorer 8 you will have to start the download again after approving it in the yellow security bar at the top of the window E g Click Export then Ok click Download file in security bar then go click Export and OK again Save the file with a meaningful name the system will give it the name Download xlm ein 2011 12 biennial 3 Cancer tables Cancer cases by province sex and year a Colorectal cancer tables Colorectal cancer cases by province sox and t Ir ER Colorectal cancer rates by province sex and y Colorectal cancer direct health care cost of sc i Colorectal cancer cases by province sex and z Colorectal cancer rates by province 54x and a Colorectal cancer direct health care costs of Sh Colorectal cancer lifetime direct healthcare cos Colorectal cancer direct health care costs by a Co
8. CANCER RISK MANAGEMENT MODEL User Guide v1 0 Publication Date August 2011 CANADIAN PARTNERSHIP M PARTENARIAT CANADIEN Meee RECORD OF UPDATES UPDATE VERSION PUBLICATION DATE 1 0 August 2011 INQUIRIES Inquiries and correspondence about the Cancer Risk Management Model can be directed to CANADIAN PARTNERSHIP AGAINST CANCER 1 University Avenue Suite 300 Toronto ON M5J 2P1 Telephone 416 915 9222 Toll free 1 877 360 1665 Fax 416 915 9224 Email riskmgmt cancerview ca Website partnershipagainstcancer ca cancerview ca cancerriskmanagement ABOUT THE CANADIAN PARTNERSHIP AGAINST CANCER The Cancer Risk Management Model is an initiative of the Canadian Partnership Against Cancer an organization funded by the federal government to accelerate action on cancer control for all Canadians Bringing together cancer experts government representatives the Canadian Cancer Society and cancer patients survivors and their families through the Canadian Cancer Action Network to implement the first pan Canadian cancer control strategy the Partnership s vision is to be a driving force to achieve a focused approach that will help prevent cancer enhance the quality of life of those affected by cancer lessen the likelihood of dying from cancer and increase the efficiency of cancer control in Canada For more information visit partnershipagainstcancer ca cancerview ca cancerriskmanagement CRMM USER GUID
9. 13 65 68 Datailihik serorei insor rE TNTE 19 default year sssssssnssssnssnnrsrrrrsrrrrrrrerrerereerreeee 55 Dimensions n ssssssossssesseseererssrsresreseerresseeree 19 30 65 Display Options button cuasuisannnrsiiedswcesderiedcaronser 63 Excel Workbooks sissesiesvivicesiaiadisersveivisssveneseis 65 69 Expand all sasossnnenenssnssssseereessssssessrereresssssresrereene 21 Fill selected range ccceccccccsssseceeeeeeeees 37 43 56 Help Menu scucisisenncriavaaawiesaxnnnainiaveres 5 13 27 32 Highlighting exceptions ccccecccceceeceeeeeeeeeseeess 63 information button ssincsiccassanssiecvasansevccunsaneaes 15 48 cancerview ca cancerriskmanagement input parameter 8 9 10 11 15 17 23 24 33 36 37 41 48 58 64 65 66 67 Input parameter information cccessssseeeeees 65 Input Parameters tab ccceseseeeeeeees 14 22 25 Internet Explorer cccccceeees 4 7 26 56 58 59 Monte Carlo errors sccsssnsscecissascaceinssaveaswtisasncnceines 33 New Drug sirens wnseenaad saunensoas pheewneiacand 47 51 58 69 new scenario 7 9 28 37 38 42 44 45 46 47 48 49 53 55 57 60 output tables 14 19 21 22 23 24 26 27 30 34 38 48 55 60 62 63 66 70 Population of Canada 1 s0cscsssnccovsesosscascseaceasaness 61 Recommended Browser cccceseeceeeeceeeeeseeeees 3 7 Refresh seco crapedapnvceasnesporiceinndsasmcurssaap ealdnedsnundiaysesan 44 PUMA TE
10. Example Radon levels differ across the country The Radon Exposure input parameter in the Base case scenario shows that the value of the geometric mean radon exposure in Vancouver is set to 5 2 Input Parameter Selecting an input parameter displays the values in rows and columns Format Built in view of Input Parameters in a scenario How to Open a scenario click on the Input Parameter tab and then click the parameter you want to view YOU WANT TO KNOW WHY A PARAMETER IS SET TO A PARTICULAR VALUE IN THE BASE CASE SCENARIO OR WHY HOW IT DIFFERS FROM THE BASE CASE FOR ANY OTHER SCENARIO Example In the example above we see that radon exposure in Vancouver is set to 5 2 The parameter information explains that these values are expressed in terms of Bg m3 which is a unit usually used for measuring radon concentration The parameter information also reveals assumptions about the Radon data and describes how it is used in the model e g As we only have data from 17 cities from 9 provinces we assign each simulated individual to one of two places within the province either a city for which we have radon data or elsewhere Parameter Information the information page provides all of the background for the value s of the input parameter All information notes are structured in a similar format Format Built in Information view How to Click the button beside the parameter title cancerview ca cancerriskmanageme
11. Ontario Case Costing Initiative Lung cancer survival improvement from new tr 0000 Cancer Care Ontario OCO Personal communication Juravinski Can Year new treatment for lung cancer introduced Centre ICC1 Hamilton Health Sciences HHS Literature Progression CefinihonThe costs are for years 2007 2009 Before we look at the workbook check the current cost value for 2nd line chemotherapy for Small Cell Extensive lung cancer cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 48 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS Click the Back button or use the Return to previous view link Select Small cell extensive from the Stage filter menu above the parameter values ae 3 Risk factors Hon small cell stage I Han small call stage II 3 Smoking 4 Radon Non small cell stage I a Cancer parameters Nan small call stage IV Colorectal Cancer Small coll limited 3 Lung Cancer erie 4 Risk equation coefficients 4 Incidence 3 Treatment Lung cancer treatment probabilities Lung cancer treatment duration Lung Cancer treatment costs Lung cancer survival improvement from new tr Year new treatment for lung cancer introduce F 4 Progression i 4 Preference scores Months after last cancer treatment when patient is an im Find the value for Chemotherapy 2nd line Make a note of this value 1076 This is the parameter that will change for the new scenario
12. start organized screening program Age to start screening in organized program Recruitment attempts to register into screen Participation rates to organized screenin Fhase m pened to reach parhcipahon rates Rescreen parbcipaton rates to subsequent Frequency of s reening of organized shared F Sensitivity and specificity of screening te Survival benefit from screening beyond stage FF i 65 5 155 AE Ee 15 a ee Ja cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 57 Ht Cut n ster Participation rates to orgat Status Primary screening modakty jagan ad Paste Province al Ri e Sin Fill selected range ufoundland and Labrador a Radon Prince Edward island 3 Cancer parameters Nova Scotia 3 Colorectal Cancer a uiai EDITING INPUT PARAMETERS COPY AND PASTE INTO PARAMETERS FROM MICROSOFT EXCEL For some parameters it is useful to copy and paste ranges of cells to and from Excel often because you wish to perform some computation on all of them and then return them to the parameter Other parameters are set up in the workbooks in a tabular format identical to the parameter to enable easy cut and paste from workbook to parameter The New Drug Tutorial has an illustrated example of pasting a cell value from an Excel Cancer Management Workbook into a single input param
13. The costs for Drug CAZ were generated from the Lung Cancer Management Data CRMM1209 workbook For ease of computing you may download this workbook to the desktop in order to further analyze and modify cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 49 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS If you haven t already downloaded the workbook Click the All scenarios link Find the Model Documentation folder and click on Lung Cancer Management Data CRMM1049 xls You should see a download dialog asking you to either open or save Save the file on your desktop The first worksheet you see will be the Instructions It describes how to use the workbook and how to map the values back into the particular input parameters Find the instructions for the treatment costs Ee a ES A ST NT OS ee ee a ae ee ee T The Lung Management Data workbook is a companion tool Cancer Risk Management simulation model o T q Purpose fa transparency of methodology data sources and documentation of the treatment algonthm and costs and related data is b a tool to change update treatment costs forlung cancer ioral g Ea c for ease of recalculaing aggregated costs and probabilities to update the simulation gt 8 Treatment Algorithm diagram 3 This document contains a lung cancer treatment abgonthm diagram showing proportion of patients traveling through the vanous 10 tre
14. based on Canadian Cancer Registry out to 2009 The Base case acts as the starting point for all other scenarios in two ways 1 The Base case reflects a status quo scenario where the projection is based on current and historical observed data with plausible assumptions The current CRMM Base case scenario represents a status quo projection based on registry data as of 2005 and clinical practices reflecting the time period of 2007 2009 and thus provides a reference against which to test possible interventions 2 All other scenarios within the platform are variations on the Base case To create a new scenario you may update the Base case or any existing scenario by changing one or more input parameter values then running the new scenario to generate projections Structural changes to the model and tables for example adding a new input parameter or a new output table require access to the source code which cannot be done within the Cancer Risk Management Model platform Modifying source code is beyond the purpose of this Guide Users can update the simulation by creating new scenarios to examine the impacts of a particular intervention of interest Examples of interventions include screening programs drug treatment plans preventative measures and rates of risky activities like smoking Those assumptions were implemented by changing the input parameters cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 9 MUST KN
15. each of the treatments in thes algenthm and has already combined utilitres were multiple states ef owerlap 26 Semutation parameter name Lung cancer health utilities 39 30 Formore information please contact The Canadian Partnership Against Cancer 31 Ea Es 35 36 37 38 Notice that the instructions detail that the aggregated costs in the pink cells are meant to be copied into the input parameters For the purposes of this tutorial we ll assume that the price is 80 per cycle and that administration of the drug will be identical to CAV cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 50 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS Before you make changes use Save As to give the Excel file a new name so as not to mix up this tutorial example with the real workbook Click the Costs Chemo worksheet tab the sheet tabs are located along the bottom of the window Notice cell A17 currently New drug specify name Click on it once the link will bounce you down to cell A123 That s where we ll create this drug s profile Enter the name Tutorial Drug CAZ for the drug name in cell A123 Enter 80 into the Unit cost per cycle in cell B123 H Do E z Po oe ee ee er Ist lna ofa cthemo ep Liner i Stage ii are fli stage Stage ene il crepa iii theme Nac gii alone Adjuwani Adjuvani Sumiti B
16. hens gFOGT 50 2 year phase in 2011 12 biennial 22 000 000 cases amp gFOsT 50 4 year phase in 2011 14 biennial 32 000 000 cases gFORT 50 6 year phazse in 2011 16 biennial 32 000 000 cases igi 50 2 year Presen in 2011 12 biennial 32 000 000 cases bid Lin Tie co Ba es od F z Fran HUER sr ET RE figure 8 Model documentation cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 16 AN OVERVIEW OF THE CANCER RISK MANAGEMENT MODEL Each sheet in the workbook provides details to understand the inter relationships between parameters and computations to change and understand the underlying costs durations etc that are used to calculate the input parameter values for the particular version of the model To learn how to copy and paste from a Cancer Management workbook to a particular parameter see Section Copying and Pasting from Excel and the Example Copy Lung Cancer Treatment Probabilities from Workbook figure 9 Cancer management pathways in the workbook a EB a D Eala Lung Cancer 7 LE Ly LS ae yy a a ae ay ee i a dys atl 100 Specubet NSCLC OLY Dingnashe ad a i Tri sh i l po hA Surveillance Cored alter l a io posizesacton A 5 years TE TIE i i 3 F o AEREE E PA lt lt lt E peciakg i Vice iir i i da ee af lung cancer all cage Spacia
17. it uses the same method For the purposes of the tutorial we ll look at the changes to the Base case scenario between release version 1 2 and release version 1 0 of the Cancer Risk Management Model Notice the identical run sizes of the Base case scenarios in both versions of the model both were run with 32 million cases in this example It s important to ensure that run sizes are the same before you run a comparison of outcome projections like the one below If the run sizes were different differences in the outcome projections of the scenarios could be attributed to different run sizes i e Monte Carlo errors in addition to the effect from input parameter differences Start on the All Scenarios page Select Compare scenarios from the View menu FIT 80 2 year phase in 201 Set the Model to Cancer Risk Management Model 1 2 Select the Base case scenario as the Scenario Set the Reference model to Cancer Risk Management Model 1 0 Compare scenarios Modal Cancer Risk Management Model 1 2 Scenano Base case ot enario default o i Reference modal Cancer Risk Management Modal 1 om Reference scenaro Base case sc enanio default m Click OK Wait while the system works through the scenarios to find the differences cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 33 ANALYZING AND COMPARING ACROSS SCENARIOS The Co
18. menu provides access to a set of video tutorials and step by step instructions for common tasks These instructions are not duplicated in this User Guide DUS Printable version nr Contents F Overview Common tasks Miras OF me appicaian The OOTA Dect daiH Cinmen Take yo Co Geto mn Modgen Vies oped ae petari ian scenarios pace in alphabetical cer E outout bles page E iout parameters page in this section BL rene scaling png ois iran sah kangaid Changing pamimeter value ches y i imie ie Changing par ra au Changing scenarie tithe end rates Chengmg 0800 bie er l Ching reliabiity Checlesg miany I choosing a language Shensarg morgue Gompaing scenarios Companng scenarios Compan ore ecenan Concerns entire scenarios Cary seed wens F B creating a MA H figure 1 The Help menu for Common Tasks in the Cancer Risk Management Model Platform cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 5 ABOUT THIS USER GUIDE Led ising sonnanos and folders I Cancer Risk Management Model i 30 Cancer Risk Management Model i F IC Cancer Risk Management Model 1 4 Selecting items to display rang table and parameter wews F rre eTe al iE v Exporting data to Exos and other formate Creating 4 haw sanang Changing number formats Reghkghtng exosptians figure 2 The Help menu for Tutorials in the Cancer Risk Management Model platform 4 Does this Guide contai
19. province and year 1 12 biennial O 2 Cancer tables Cancer cases by province sex and year 4 Colorectal cancer tables Wit Colorectal canter cases by province sex and y Colorectal cantor rater by province cox and VI Colorectal cancer drect health care cost of sc Cowectal Cancer cases by prowince sex and l li Colorectal cancer rates by povince sex and a f Colorectal cancer drect health care costs of Colorectal cancer lifetime direct healthcare cos i Colorectal cancer drect health care costs by z Hi Colorectal cancer drect health care costs by El H l Coliectal canter cubcamas for calculation of r Colorectal cancer stage distribuben pooled 10 Colorectal cancer survival by year alber chagne pp Colorectal cancer secreaning outcomes bry pill Cohrectal cancer cubcomes by screening state i Scengng FIT 2 2 year phase in Z011 2010 ik itz 2013 oo oa 4 on 34 299 080 34 577 434 34 851 923 25 125 973 35 403 805 al ppro 5771385 571 595 TOTE amp 40 338 1 598 097 ariaa 169 833 O 1 488 558 1 558 697 1 477 220 1312 OAR TEE H z mal ir amns ammas amara 908 202 203 Ia 208 daH Notice the Total number of colonoscopies measure in the data view on the right We ll compare this table in the currently selected FIT 30 scenario across the FIT 50 and 80 participation rate scenarios which also p
20. provinces sak and 0 year Populahen by hyhest level of educational attan Tee EG ee te UV figure 5 Output tables view Clicking the Input Parameters tab displays the list of input parameters that were used to run and produce the output tables for this scenario Export to Excel Create new Scenario List a input T Smoking assumption for Future years a eh 3 currently sot a Experts only parameter is m Radon Jen highlighted in gold a Cancer parameters i _ Months after last cancer treatment when pati w Experts only View of currently a Population Health parameters Average heath ubkty et ek baa selected Input Parameters 2 Demographic parameters w Births a Mortality parameters 2 Interprovincial migration parameters Immigration a Emigration and returning parameters 3 Economic parameters i Economic growth parameters figure 6 Input parameters view cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 14 AN OVERVIEW OF THE CANCER RISK MANAGEMENT MODEL THE INFORMATION PAGE Clicking on the information button beside the title of a model scenario input parameter or output table will display an information page for that item It contains notes data sources and or definitions for the selected item 2011 72011 2011 2011 figure 7 Information button for each parameter HELP MENU The Help Menu on the CRMM platform provides directions for common tasks and a
21. set of video tutorials which show step by step examples of performing specific operations For help with specific tasks click Help then select from the index links or search for a particular term cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 15 AN OVERVIEW OF THE CANCER RISK MANAGEMENT MODEL Je ccc cece cece eee eee eee CANCER MANAGEMENT WORKBOOKS Workbooks that match the particular version of the model are provided in the Model Documentation folder within a Model folder in the All Scenarios View Clicking a workbook will launch the download process i Caries Risk Management Model 1 7 4 4 Model Documentation Colon Cancer Management Data CRM Data Dechenary CRMM v1 2 0 9 doc Lung Cancer Managemett Data CAMA Rectal Cancer Management Data OR Release Notes CRMMI 2 bald 1 2 0 9 Working sets a0 2 My scenarios a30 Public scenarios FO Base case scenario JO Colorectal cancer scenarios FIT 20 2 year phase in 2011 12 FIT 50 2 year phase in 2011 12 FIT 60 2 year phase in 2011 12 Base case scenario default 72 0 FT D folders and scenanos selected File Dewnload Do you want to open or zave this file Hame Lung Cancer Management Data CRMMIZU9 xh Type Microsoft Office Excel 97 2003 Worksheet 666KB Fiom E El Abvays ack before opening this type of file wot om cee save this fio What s the tk Pe 00 DO eases QOFOBT 30 2 year phase m 2011 T2
22. to select a scenario the list of Output Tables for the scenario is displayed in the left panel In the diagram below the currently selected table Cancer Cases by provinces sex and year highlighted in gold in the left panel is displayed in the right panel Scenario title me Output Table title d Cancer tablas Canter cases hy provinen tan ane yrr E a Colorectal cancer tables Lung EN canoer tales J Risk factor tables smoking tables Cirasa kE ail ia 11 28 97 List of output FR Radon tables ean ae ml TE produced by running 3 Econo i ia aaa Eia dre Baar tal hats ms i j S DEA and Taxes for population aged ale 73 this scenario a Econdeie cubcodes tet sak and Wer Brae ET Sores TA a pee L0G im Econcnic outcomes by sun and province for a i 253 511 208 537 214 033 aia 47 225 547 1071137 756 T 148579 17790 17 JE Lode LB DOG oo Lite expectancy tables View of currently E ETON BEEF Life expectancy of petons born m a seughe o 7 856 8 333 saw TE Lie ege belv br yaar S rU EE selected Output Tables 3 209 1298 154 781 138 582 143 208 108 053 145 780 152 Life expectancy of persone born ongle yes hy See BIj 8 i eee 0 366 a 147 S187 i ln karm Elben ker pact 7 885 2 PET i at 13i 1554 a 25 2 261 Life expectancy of persona barn m a single year i a Population tables Pogulgbon structure for a single year as pelec in Fogulaton count by province sex and year Peguiaton count by
23. 1 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS In celln17 on the new drug line enter 50 to represent the 50 proportion for this treatment Reduce the CAV percentage from 100 to 50 Notice the total cost in cell N5 for SC Extensive 2nd line has increased from 1076 to 1096 Your computation of the treatment is complete You ll copy the value of cell N5 to the parameter in the model Save your Excel workbook for future reference 2 Cost ciulations is dand Return to the CRMM view of the Lung Cancer treatment costs parameter in your browser window Click on the Drug cell for Chemotherapy 2nd line it will turn grey to show it is selected Enter the new drug cost of 1 096 in the cell En Ht Risk factors a Smoking dl Radon 3 Cancer parameters H Colorectal Cancer a3 lung Cancer i Risk equation coefficients i Incidence 3 Treatment Lung cancer treatment probotaktes Lung cancer treatment duration Lung cancer survival improvement from new tr Year new treatment for lung cancer introduce je d Progression H 4 Preference scores Click the Save link above the Parameter list or select Save scenario changes from the File menu cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 52 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS At this point the scenario is ready to run For tutorial purposes we ll just run a test Click the Run l
24. Chine 3 Colon cancer clinical incidence cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 56 EDITING INPUT PARAMETERS IMPORTING PARAMETER VALUES FROM OTHER SCENARIOS To answer a particular research question you may wish to combine input parameters from a number of scenarios After starting your new scenario from an existing scenario you can then import values from the same parameter in a different scenario of the same model or you can import values from an output table of a different model For example perhaps you have created a complex new scenario with multiple parameter changes and you wish to better understand a particular effect in the projection by isolating the parameter changes To do so you can create your new scenario from the Base case effectively resetting all parameters to the Base case set of default parameters and then import values from the same parameter in your original complex scenario in the same model How to import parameter values Create a New Scenario from an existing scenario Select the target parameter Select Import values specify the model and scenario that hold the matching parameter submit dedi Cah AC p aT LL panau marine OG sanra Cancer Risk Management Model Home change parameter value note Sign out Lave ocenario charges Run Fetma Das Change scenano tile and mote Dalete canario a Screening Year t
25. E PAGE 2 Record Of UPCate cceccccccssseeccecseeceseeeeccesseuecssseueeecesseuseceeeeeeeseeees 2 VN WSS A AAO ANOA AOE EE T 2 About this User Guide essssesenesssserersssseserrssssreresssseereessseeeressssereress 5 Administration Accounts and Registration essssseseerreserreesrrrrerrreereree 7 Request for an ACCOUNT scassactncssucaticenininnrosenixecnnsapindabasseinatiialisteemeeiestanteninies 7 Recommended Browser sssssssesesesssesssessserssersrersrrrssressrrssersserseeeseerseerseersseese 7 Must Know Concepts amp Teris c cscccssccssscceseceseeceseceseceensessseeeneeeeeceeaes 8 Cancer Risk Management Model cccccssssecceccessececceeeeececseeeeeeesseaeeceeseaees 8 What if Scenarios cccccsssccccessecceseccecescceceeeceeeeeceeseueceeseueeeeeeeceeeeneeesees 9 Cancer Management Workbooks sssscccccsssececceseecceseaseeceessaeeceessaees 11 Guided Tour An Overview of the Cancer Risk Management Model 12 The All Scenarios PAG cane vaancansoqancanuonnaaranmaissammaiaaesaairateneanennannaneieneneian 12 The Scenario Vie W air eirinn En NRE gue saeiibeiaravenuaesennle 14 The Information Page ssnsersnceiesin na ere 15 Relo MENU erranera EE E A E AEAT EE i 15 Cancer Management Workbooks csssccccccssseeceeeeseeceessaeeeceessaeeeeeseuees 16 Finding Using and Understanding Outcome Projections 6006 18 Analyzing and Comparing Across SC NariOS
26. EN nar nele J Derfor per vidlt fri Bar Reur ear vini 27 00 par codis 125 Pharmacy 4 5 5 5 19 parcyeis 5 5 126 Chem Nursing 127 Supplies Less 129 Chemistry Pane 130 Chemotherapy Suite Wisit Ehei Time TT Gutpatient wisit for oncologist partial assess h Instrcbans UHAT F HET F I Ci um Pim zi iar Nir i ild lt a y Ei i 15 51 par cyele par cycle fer Eu FE Enter all of the values into rows 123 132 for New Drug AZ a a ee RET P ve eee ee ee A O ee an vtical Un ae aS ME Stage ina Tage il ami i ind dre cheno gga Line Biome gurmani i i i of i a0 par bour pr wie DDO par Ermi pi wi nat Te Pair vie pS ear opie 3 PEro par cycle i hear Det ear course This new drug reduces the neuropathy side effects versus CAV so we ll reduce the nursing time to 30 minutes per cycle 125 Pharmacy 126 Chemo Hursing 127 Pryacan drug adenine LA mo bt i 128 CBC aa Chemistry Pane 131 Chemochermpy Sults Visit Chair Tiree 2 Gutpatent visit for sele Notice that the total cost in pink on the top row cell N5 has not changed yet because in the current sheet none of the patients are yet receiving the new drug Setting up the proportion of patients who will receive the new drug is the final step in this process cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 5
27. ER YOUR QUESTIONS ABOUT THE MODEL Look at the questions below to decide which source you ll need YOU WANT TO KNOW WHY A SCENARIO OR OUTPUT TABLE WAS CREATED Find it in Scenario or Output Table Information describes the purpose of the scenario or output table Example The scenario information for the scenario titled Never smoking in Canada explains the purpose of the scenario and the input parameter which was changed to produce the scenario This scenario is used to evaluate the net impact of smoking on lung cancer by asking what if there was never any smoking in Canada past present or future This is achieved by changing parameter called Smoking cessation options Format Built in information note This information was entered when the scenario or output table was created or the input parameter was created or changed How to Click the button beside the scenario output table title TIP When you create new output tables or scenarios use these notes in a similar fashion to document your changes The note entry area is shown with the title immediately after you click New scenario There is also an option to change the title or note any time before the scenario is run select Change scenario title and note from the File menu cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 66 UNDERSTANDING DATA SOURCES AND REFERENCES YOU WANT TO SEE THE VALUE USED FOR A PARTICULAR INPUT PARAMETER IN A SCENARIO
28. EW PROJECTIONS BY CREATING SCENARIOS Now click and drag to select the rest of the row starting from 85 up to 99 From the Edit menu select Fill selected range It will fill the selected block with the value in the top left corner or in this case the value in the left cell of the selected row All of the new values will be highlighted in yellow Approach to gunerabng colorectal cancer incidence cases 4 Natural History Approach 3 Clinical Incidence Approach i Sensitivity and specificity of screening tests Clinics ae Survival benefit from screening beyond stage shift Cire f a Colon cancer clinical incidence Er man Click Save cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 43 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS Click the Run link above the parameter list or select Run scenario from the File menu For the purposes of this tutorial leave the simulation size at the default of Test Note The Base Case was run with 32 million cases however for the purposes of the tutorial we will submit a faster smaller run with only moderate reliability see Reliability Click Submit The All Scenarios page will be displayed The new scenario is in the Working Sets folder EM Gat IOO B C r 0 folders and 0 scenarios selected 301 Cancer Risk Management Model 1 2 0 Model Documentation 3 4 Working sets Mitona Prowincial Statue I aO O My scenarios 3 Public scenarios 3 Base
29. MM USER GUIDE PAGE 20 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS Now look back to the left panel to the list of Output tables Each output table presents a set of outcome measures in a particular default view If you are looking for a particular outcome measure you would first look at the titles of these output tables to see if it is already captured in an output table To find a likely looking output table you can expand and collapse groups of tables individually by clicking the plus minus icon or overall by using the Expand or Collapse All buttons at the top Expand all the Output Table groups in the left panel with the Expand all button 3 Find the Colorectal cancer tables group Find and select the output table Colorectal cancer screening outcomes by province sex and year Dutput tables iy Ht 3 Cancer tables Cancer cases by province sax and yaar 3 Colorectal cancer tables Colorectal cancer cases by province sex and year Colorectal cancer rates by province sex and year rate per Colorectal cancer direct health care cost of screening and t Colorectal cancer cases by province sex and age group for Colorectal cancer rates by province sex and age group for Colorectal cancer direct health care costs of screening and Colorectal cancer lifetime direct healthcare costs for cases 1 Colorectal cancer direct health care costs by stage for case Colorectal cancer direct health care costs by treatme
30. N Model Information Explains what is different updated in this particular version of the model How to Click the button beside the model title on the All Scenarios page YOU WANT TO UNDERSTAND THE DEPENDENCIES IN THE MODEL MAINLY BETWEEN THE INPUT PARAMETERS AND THE ASSOCIATED OUTPUT TABLES Technical Model Documentation Describes the metadata for the model all of the elements of the model and their relationships How to Click the book button beside the model name cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 70 All Scenarios Page 0sssesseeesseessseeeeeees 3 12 Base Case Scenario ssicsssssssssedissscssecesssesesacavssnevsane 18 Cancer Management workbooks n s 6 12 13 Changing number formats u sssssesseereeeereee 63 Chart Options button sccsccnciincxsiscvcsnusestonsinentaneneniyion 63 coefficient of variation Wu u dsssesern 31 32 60 combine input parameters ssssseseeerersereree 57 Compare a single output table W ccssseeee 28 Compare entire scenarios sss 34 35 36 compare scenarios sccisccs sacerecssocncadivncaentcadcehies 27 28 Compare two scenarios sissrcssisaisdvedsceeorswcdnesaneaees 28 Comparison view siicensscestsners ciccensverosetaaxsnodadeeners 32 Copy and Paste from the Edit menu 58 copy and paste ranges of cells to Excel 58 Data Dictionary ssssscassnetesnvassnoessavessnens 12
31. NEW DRUG WITH A CANCER MANAGEMENT WORKBOOK In this example purely for the purposes of a simple tutorial we ll examine the impact of a hypothetical chemotherapy drug we ll call CAZ Imagine that CAZ is a new variant of CAV cyclo adriamycin vincristine that dramatically reduces neuropathy side effects In Model 1 2 CAV is used as 2nd line chemotherapy for Small Cell lung cancer In this tutorial What if scenario new drug CAZ will be provided to 50 of the Small Cell patients the rest will continue to receive the existing CAV formulation Assume that the new drug CAZ will cost slightly more than CAV We will start from the Base case scenario Find and expand the Cancer Risk Management Model 1 2 folder amp Public Scenarios Single click to open the Base case scenario default Click the Input parameters tab Click New scenario just above the parameter list or select New scenario from the File menu Type in the title for the new scenario as shown below Tutorial New drug CAZ for Small Cell Extensive Cut and paste the notes from below they are shown here to emphasize the importance of note creation to document a new scenario This scenario examines the impact of upgrading 2nd line treatment for Small Cell Extensive lung cancer for half of the patients to new drug CAZ Parameter changed Lung cancer treatment costs for Chemotherapy 2nd line drug Scenario Base case scenario default Pe a
32. OW CONCEPTS amp TERMS The diagram below shows a family tree view of how some of the Colorectal Cancer screening scenarios were created first from the Base case and then from each other to create sets with a range of input parameter values Below Examples of scenario creation beginning with the base case scenario This diagram shows various ways to reach six different outputs BASE CASE SCENARIO Screening Rate 30 Screening Rate 50 Phase in 2 year Phase in 2 year OUTPUT 1 OUTPUT 4 Phase in 4 year Phase in 6 year Phase in 4 year OUTPUT 2 OUTPUT 3 OUTPUT 5 EAN VA Start year 2015 m VA OUTPUT 6 cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 10 MUST KNOW CONCEPTS amp TERMS eee eee eee eee CANCER MANAGEMENT WORKBOOKS WORKBOOK amp INPUT PARAMETER INTEGRATION oo WORKBOOK calculations of costs probabilities durations and health utilities INPUT PARAMETERS workbook values are input manually OUTPUT M a Above Diagram of Scenario creation using Workbooks to determine some Input Parameters cancerview ca cancerriskmanagement Within the CRMM there are separate models that govern each cancer e g lung colon and rectal These are built in a form of algorithmic code that is not visible to the end user like the inside of a machine To help end users gain a better understanding of the cancer pathways embedd
33. Partnership Step 2 Within two business days of submitting your form you will receive an e mail from the Partnership with instructions on the final steps to complete your account request Step 3 Complete the final steps outlined in the e mail You will create a username and password allowing you to login the Cancer Risk Management Model platform CRMM USER SPACE ON CANCER VIEW CANADA CRMM User Space powered by Cancer View Canada is a collaborative space for model users to share documents post comments and ask questions related to the use of the model Useful resources such as model workbooks User Guide and list of Q amp A s will be added to the space by the CRM M development team Once the access is granted users can log in the CRM M User Space via www cancerview ca login Model Login Log in to the Cancer Risk Management Model platform via cancerview ca cancerriskmanagement Model Login or via the CRMM User Space Je eee cece cers ee serrecscsseesesseees RECOMMENDED BROWSER The recommended browsers for use are Microsoft Internet Explorer IE version 8 or 9 and Mozilla Firefox We caution that while most of the Cancer Risk Management Model CRMM platform will appear to function on Google Chrome there may be particular issues with creating a new scenario on the platform using these browsers 7 Users who use the platform on IE8 browser may be unable to download the Excel workbooks from the
34. SSU rr erne EET 53 run Scenario esssssssesesreresseresresesrereesereeresesrereesenees 46 Saving table and parameter views 66 27 63 Scenario 3 8 11 14 18 28 30 33 37 46 47 55 57 66 69 71 scenario information cccecceseeeeeeeeeeees 24 25 66 Selecting items to display sssssseseeerreeereee 63 single year sessionen eos denne 55 standard error ssseveeeeeevee versene sneen erne ener 60 62 Technical Model Documentation neccen 65 70 Test RUM ussel broerne 46 60 the Internet Explorer warning 2 4 56 CRMM USER GUIDE PAGE 71
35. Select the parameter titled Participation rates to organized screening for colorectal cancer it iat d Risk factors a Cancer parameters 3 Colorectal Cancer 3 Sereening Year to start organized screening program Age to start screening m ofganized program Recruitment attempts to repastar mio screening program Participation rates to organized screening lor colorectal cancer Phase in penod to reach participation rates years tes to subsequent screens Participation rates organized program i parameter selected ity of screening tests Natural History Apg FI gening beyond stage shift Natural History App a Colonoscopy compliance follow up complications and max age F E et ot II Ce FIT set to 50 Find the column for the participation rate for Fecal Immunochemical Testing FIT In contrast to the participation rate of zero in the Base case scenario for all colorectal screening techniques the FIT participation rate parameter is set to 0 5 or 50 in this scenario cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 25 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS 2 At this point you have confirmed that this is the scenario with the screening parameters you need Now you ll want to look at the output data projections
36. USER GUIDE PAGE 64 UNDERSTANDING DATA SOURCES AND REFERENCES Input parameter information the information provides the background for the value s of the input parameter All information notes are structured in a similar format Example The information for the Lung cancer observed incidence rates starts out like this Description Observed rates are derived from three years of data 2004 2006 Observed rates are required Dimensions Province sex and age group 5 year Source 1 Canadian Cancer Registry Statistics Canada Master File of June 05 2009 based on the International Agency for Research on Cancer IARC rules for identifying cancer cases Data Dictionary of all input parameter information This PDF document contains all of the parameter information pages pulled together into a single document Excel Workbooks the Microsoft Excel workbooks are essential to understanding the design of the model The workbooks capture design assumptions references where available and computations of input parameters particularly costs for drugs and services Technical Model Documentation Encyclopedic This document is provided for expert modelers who wish to understand the metadata for the model all of the elements of the model and their relationships cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 65 UNDERSTANDING DATA SOURCES AND REFERENCES occ cc ccc cece cece eee eee eee eee eee WHICH DOCUMENTATION WILL ANSW
37. ails link to see the details of the status cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 53 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS ipit parameter BIBT Cewe Cancel job Status Output pending tatus Output pending fi ano Running smulation 32 J Risk factors ES LED Once the run is completed the Output tables will be displayed This is the end of the directed tutorial Refer again to the Next Steps section of the previous tutorial for reminders on how to proceed through running the scenario with a run size comparable to the base case cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 54 a DETAILS EDITING INPUT PARAMETERS CHANGE THE REPORT YEAR IN SINGLE YEAR OUTPUT TABLES While most output tables report results by year for 20 years some output tables present the results for a single year On the list of output tables these include the words In a single year as selected by the user in the title e g Life expectancy of persons born in a single year as selected by user If you need to use a different year for those tables you can re run an existing scenario with a different default year or you can change the default year for any new scenarios you create The parameter to reset the default year is in the Special tabulation parameters group at the bottom of the parameter list Example To create a new scenario for the Base Case with the default year of 2012 Click New S
38. al Cancer Management Data CRMM12709 xis Release Notes CRMM1 Z build 1 2 0 9 doc O Working sets Base case scenario 30 C My scenarios for Model 1 2 aC Public scenarios HC Base case scenario Base case scenario default 32 000 000 cases a Colorectal cancer canarias FIT 30 2 year phase in 2011 12 biennial 22 000 000 cases FIT 50 2 year phase in 2011 12 biennial 32 000 000 cases FIT 60 2 year phase im 2011 12 bienraal 32 000 000 cases OF OST 30 2 year phase m 2011 12 biennial 32 000 000 cases FORT 50 2 year phase in 2011 12 biennial 32 000 000 cases gFO8T 50 4 year phase in 2011 14 brennial 32 000 000 cases gFOBT 50 6 year phase in 2011 16 biennial 32 000 000 cases gFORT 80 2 year phase in 2011 12 biennial 32 000 000 cases New chemotherapy drug p for colorectal cancer 32 000 000 cases O lung cancer scenario Constant future smoking prevalance rates 32 000 000 cases Never radon exposure 32 000 000 cases Smolang cessation 50 in 2010 32 000 000 cartes O Never smoking in Canada 32 000 000 cases Never smoking and no radon in Canada 32 000 000 cases 30 Cancer Risk Management Model 1 1 0 30 Cancer Risk Management Model 1 00 Data Dictionary figure 3 The All Scenarios Page cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 12 AN OVERVIEW OF THE CANCER RISK MANAGEMENT MODEL When you sign in you will see the following folders Mo
39. at a particular full measure it tends to rise to unacceptable levels when broken down into measures like provinces or age groups in some output tables Once you ve checked that everything seems to be in place create a new scenario by copying the test scenario and then skip directly to the Run command to run at medium or a higher custom value Scenario New drug CAZ variant of CAV for Small Cell Extensive ES eit Status Ready to run Run 4 Risk factors 4 Smoking Radon vd Cancer parameters Dv ire E PPR a a J Colorectal Cancer Enter mimber of cases max 80 000 000 d Lung Cancer Next steps Scenano will be queued on remote server Risk equation coefficients Time varies based on usage from minutes to hours 8 Incidence Status will ba updated in My scenanos folder whan completed l 3 Treatment Cancel Lung cancer troaatment probabilities T Choose simulation size Test 2 000 000 cases moderate reliability Medium 32 000 000 cases high reliability Custom cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 60 RUN SIZES amp RELIABILITY REPRESENTING THE POPULATION OF CANADA All scenarios regardless of the number of cases requested are scaled to the size of the Canadian population This ensures that outcomes are always representative of the Canadian population The reliability of the projections will vary according to the number of cases requested eee
40. between the FIT screening and the base case you could compare scenarios to see all of the differences across both inputs and outputs Learn more about comparing scenarios in the next section The output tables may not be formatted to suit you for example you want to highlight some values with color or switch columns with rows Learn more about formatting output tables in the details section Once your output tables look right or to keep a comparison view with the original table you ll need to save the view To learn more watch the video tutorial Saving table and parameter views available in the Help menu cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 27 i ANALYZING AND COMPARING i ACROSS SCENARIOS In this section we will examine how to compare scenarios within a model or across models There are a number of reasons why you might wish to compare scenarios We ll start with some examples of how and why you can conduct different types of comparisons EXAMPLES OF SCENARIO COMPARISON TASKS 1 Compare a single output table across 3 to 5 scenarios to see the changes in a set of measures Example In the Colorectal cancer scenarios there are 5 different guaiac fecal occult blood test gFOBT screening scenarios You might wish to look at the differences in a particular set of measures in an output table across all 5 of these scenarios You ll try this yourself in the tutorial below 2 Compare two scenario
41. case scenario Base case scenano default 32 000 000 cases i so from Base Cage Output pending Preparing model inputs You may be able to watch your new scenario progress through the run stages Depending on how many scenarios are running on the CRMM servers at any one time and their run sizes a run may take just a few minutes or several hours For this reason a progress indicator is not displayed Since you are sitting here though click the browser s Refresh button FEE You should see that the progress has changed Later when the run is completed the scenario will appear in the My Scenarios folder on the All Scenarios page This is the end of the directed tutorial The Next Steps section below is provided so that you read through and understand the possibilities of how you might use this new scenario A note on parameter changes For illustration purposes this tutorial only changed a few values in the observed incidence rates parameter Users are encouraged to examine all other related parameters to ensure proper value input for new scenarios cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 44 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS oo gt NEXT STEPS At this point you might wish to compare the output table of interest with the one from the Base Case scenario to examine the general trend in the costs in one versus the other Sure enough as expected since observed
42. ccccccsseecceeseseeeeeeseeenees 28 Examples of Scenario Comparison TASKS cccssseecececeeseeceeceeeceeseaeeeeeeees 28 Generating New Projections by Creating SC na riOS cccceceeeeeees 37 cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 3 CONTENTS Details Editing Input ParaMeterS cccccccssecccssscceeesececeseseeeneeeeensess 55 Change the Report Year in Single Year Output Tables ccccceseeeeeeeees 55 Turn off the Internet Explorer warning for editing parameter cells 56 Setting a Parameter Range to a Single Value cceccsssecceseeeeseceeeneeeeeeees 56 Importing Parameter Values from Other Scenarios cccccsseeeceeeeeeeeeeees 57 Copy and Paste into Parameters from Microsoft Excel 58 Exporting Values into an Excel Workbook cccccccssseceeeseeeeeeseeeeeeeeeeees 59 Details Run Sizes amp Reliability ccccccceccccssecccceseceseeececeeeecessuseceeenecs 60 Selecting Run Simulation SIZES ccc eeeeeeeeeeeecceccccescuseeeeeseeeeeeeeceeeeeeeaaas 60 Fe UIE REESE E E E A tadenmpnsparensasancupayteanaaengunanauativadeans 61 Details Changing Tables amp Parameters Display to Suit Your Needs 63 Understanding Data Sources and References cccccseeesceseeeeeeeeeees 64 What Documentation is Available ccseesccccccsssssseeecececseeeeeeecessesneeees 64 Which Documentation will Answer Your Questions about the Model
43. ce a Colorectal cancer tables a Lung cancer tables Risk factor tables a Smoking tables Radon tables a Economic tables Detailed Income and Taxes for populathon aged 15 Econom outcomes by sex and year Econome outcomes by sex and province for a sing 3 Life expectancy tables copy of current scenariojolorectal cancers Create new scenario as a copy of current scenario Title Tutorial Provinctal Status Queo Full Note create new status quo for our province for Updated incidence rates Parameter Colon cancer observed incidance rates All other parameters remain the same as in Base Case Next steps Click Save then use Edit to change parameters Save y Step 3 Run this scenario with Medium simulation size selected for high reliability Run scenario Choose simulaten size C Custom Test 2 000 000 cases moderate reliability Medium 32 000 000 cases high rebabilty Enter numpar of cages max 20 000 000 Next steps Scenano will be queued on remote server Time Vanes based on usage from minutes to hours Status will be updated in My scenarios folder when completed Once the run completes your new status quo scenario would be ready to be used as a reference in your research cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 46 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS O TUTORIAL CREATE A SCENARIO FOR A
44. cenario provide a title and notes that specify the year change and then Save Click to select the Year to report in single year tables Edit the year to the year you prefer to see in all single year output tables and Save Run the scenario with 32 million cases so that it is comparable to the existing Base Case scenario Eye Et Parameter Year to report in single year tables Status Completed New scenano 2 Risk factors Smoking 4 Radon d Cancer parameters 3 Colorectal Cancer Lung Cancer Months after last cancer treatment when patent is a Experts only a Population Health parameters Average health utility of population by age 2 Demographic parameters a Births a Mortality parameters a Interprovincial migration parameters 3 Immigration 4 Emigration and returning parameters 3 Economic parameters 3 Economic growth parameters Experts only 2 Special tabulation parameters cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 55 EDITING INPUT PARAMETERS TURN OFF THE INTERNET EXPLORER WARNING FOR EDITING PARAMETER CELLS If you are using Internet Explorer version 8 you may get tired of seeing this warning every time you edit a parameter cell To turn it off in Explorer 8 see this site http msdn microsoft com en us library bb250473 v vs 85 aspx internet Explorer Ti Do you want bo allow this webpage bo access your g ses T you allow this the webpage can access the Clipboard are
45. cerview ca cancerriskmanagement CRMM USER GUIDE PAGE 30 ANALYZING AND COMPARING ACROSS SCENARIOS We can now see the values of all three scenarios to examine the impact of the participation rates on the deaths and cost estimations Notice that it was also possible display the comparison data as Differences and Ratios As expected the projected number of colonoscopies performed each year increases for the scenarios with the higher participation rates 34 851 913 35 125 57 4 34 259 180 34 377 435 at ai 35 125 097 ind 795 00 50 577 436 9405208 35 126 001 d ol 2 316 909 A 571 051 p 9 816 909 372 285 BREDDE FE Saute ara oP leer 3 488 358 1 558 697 171 89 aaa SE FOD 285 060 q wise eee 456 371 at eno 11550697 1477221 Sasa call Swe 2 460 28 0 3 968 318 4 154 636 3 997 507 pal am oss anan ar 135 15 At this point we ll check that enough cases were run that the reliability of the simulation estimates as measured by the coefficient of variation is within the target range of below 5 Learn more about reliability in CRMM Select the Coefficient of variation from the Output menu cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 31 ANALYZING AND COMPARING ACROSS SCENARIOS Before switching to the view of another table we ll save this Comparison view so it s always available in this scenario Make sure to switch back to the Values for the Output fir
46. d output projections we saw a few minutes ago of zero people screened cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 23 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS 2 Collect your thoughts Up to this point you have selected the Base case scenario viewed some of the projections as outcome measures in output tables and examined an input parameter to better understand the output projections Click All Scenarios top right above the language selector or use the View menu to select All Scenarios Find the screening scenario titled FIT 50 2 year phase in 2010 11 biennial 30 cancer Risk Management Model 1 2 0 a Model Documentation O Working sets a O My scenarios 30 Public scenarios J30 Base case scenario Base case scenario default 32 000 000 cases 30 Colorectal cancer scenarios FIT 30 2 year phase in 2011 12 biennial 32 000 000 cases TT 50 2 year phase m 2011 12 banmal 32 000 000 cases FIT 80 2 year phase in 2011 12 biennial 32 000 000 casas 0 gFOBT 30 2 year phase in 2011 12 biennial 32 000 000 gFOBT 50 2 year phase in 2011 12 biennial 32 000 000 cases gFOBT 50 4 year phase in 2011 14 biennial 32 000 000 cases gFOBT 50 6 year phase in 2011 16 biennial 32 000 000 cases gFOBT 80 2 year phase in 2011 12 biennial 32 000 000 cases New chemotherapy drug p for colorectal cancer 32 000 000 cases oO Click the Information button at
47. decision point of each life the smoking rate input parameter is referenced by the algorithms and the courses of some lives are changed some smoke some do not The output data from all of the simulated lives can then be compared with the projections resulting from the existing smoking rate to examine the potential effects of the intervention SCENARIO CREATION SOME IMPORTANT TERMS IN THE CANCER RISK E aa MANAGEMENT MODEL eee A Scenario is a set of instructions in the form of PARAMETERS cenario is a set of instructions in the form o variable data Mm Input Parameter settings that run a specified number of synthetic lives and collect the resulting output into tables gt CRMM Q E RDSEE The Base case scenario for each model is a run of algorithm the synthetic lives with the model s default set of input parameters OUTPUT Output tables are views of the data projections MTT 1 TABLES produced by running a scenario Each output table data projections provides a view of a particular set of outcome measures cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 8 MUST KNOW CONCEPTS amp TERMS eee eee eee eee WHAT IF SCENARIOS BASE CASE SCENARIO Tr upto 2007 DATAt Canadian Cancer Registry DD E VA STATUS QUO t Staging was based on 2004 2007 data incidence was based on 2004 2006 data For model assessment the Model compared projected incidence to Canadian Cancer Statistics numbers which are
48. del Documentation folder contains downloadable versions of the Model Release Notes Cancer Management workbooks and the Data Dictionary of the input parameters information Working Sets folder will be empty but later will contain any scenarios you create that are either ready to run or are currently running My Scenarios folder will be empty but later will contain any scenarios that you create and have run You can create new folders within this folder to organize your new scenarios Public Scenarios folder contains pre run scenarios that demonstrate particular aspects of the model Notice the Help menu in the menu bar It provides detailed help on the CRMM features as well as a set of short video tutorials about common tasks Before you proceed with this guided tour it is recommended that you view the Using scenarios and folders tutorial O Tutoriais Using soananos and folders 3 Cancer Risk Management Model i 30 Cancer Risk Management Model i i s Cancer Risk Management Model 1 0 Selecting items to display Comparing scenarios Exporting data to Excel and other formats Creating 4 new snang Changing mumber formats Feghkghtng exaosptions figure 4 The tutorials in the Cancer Risk Management Model platform cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 13 AN OVERVIEW OF THE CANCER RISK MANAGEMENT MODEL eee eee eee eee eee THE SCENARIO VIEW Once you click
49. e page we ll work from this model 30 Cancer Risk Management Model 1 2 F 4 Model Documentation _ Working sets 070 O My scenarios 30 Public scenarios Select single click the Base case scenario default in Cancer Risk Management Model 1 2 cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 18 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS Clicking a scenario opens up the Output table list for the scenario with a tab to open the Input parameters In the left panel you can see a list of output tables and groups of output tables The first output table is selected The selected table Cancer cases by province sex and year is highlighted in gold in the Output table list Notice the buttons that act on this table are over on the right above the values All of the button actions are also available along with additional features in the menus File View Dimensions above the Output Tables tab The table values are displayed in the table s default view on the right in this case Chart view Click the Data link it s above the chart or select View as data from the View menu The view will now show the Cancer cases by province sex and year output table as numerical values in columns and rows 3 Cancer tables Cancer cases by province sex and yaar t Colorectal cancer tables 4 Lung cancer tables a Risk factor tables 4 Smoking tables EH Radon tables The data is arranged into dimensi
50. e standard error COEFFICIENT OF VARIATION VALUES SPECIAL CASES In some tables it is possible that the CV has a value set to lt Blank gt which indicates that the CV cannot be estimated The corresponding estimate is thus extremely unreliable and should not be used It is also possible that the CVs will contain extremely large values This is often the case for cell values that fluctuate between positive negative values but average close to zero In this case the use of CVs to indicate reliability is inappropriate cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 62 DETAILS CHANGING TABLES amp PARAMETERS DISPLAY TO SUIT YOUR NEEDS There are a number of ways in which you may need to change or format output tables or parameters Video tutorials to help you learn how to use the formatting options for both views are available under the help menu The tutorials relevant to changing views are Selecting items to display Changing number formats Highlighting exceptions agement Data d ising BORA GE ae folders Selecting items to display Saving table and parameter vires Saving table and parameter MIM agin eee em Companig tenant i gament Data C VIEWS iagement Data AML 2 build 1 24 Jal Statws Qua i12 Ready tor eady to run Creating nai scenario Highlighting excephans Changing number formats Exporting date te Excel and other formats When viewing a table or char
51. ed Risk factors If you are using Internet Explorer 8 you may need to click Download File in the warning bar at the top after the Export command and then click the Export button and Ok again See the Exporting Data Example in the first tutorial cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 59 a DETAILS RUN SIZES amp RELIABILITY SELECTING RUN SIMULATION SIZES The run size specifies the number of cases that will be generated when the scenario is run Each case represents an individual synthetic life that will be lived according to the model algorithms The greater the number of cases simulated the smaller the Monte Carlo error with an associated reduction in the variability for each outcome projection measure Thus running more cases will produce more reliable results up to a certain point in which the coefficient of variation standard error is within a range acceptable to the user All Public Scenarios were run with 32 million cases the SE on life expectancy was less than 0 04 years WHY USE THE TEST RUN The Test simulation size is suggested as a first step for building new scenarios Running a test will allow you a chance to check that the trends appear to be in the right direction and perhaps run a Compare Entire Scenarios to inspect that you ve changed all of the parameters to the settings you had planned Note that while the reliability may be moderate when looking
52. ed in the model Excel workbooks for each cancer are provided in every model release These Excel workbooks provide transparency of methodology data sources and documentation of the treatment algorithms costs and related data You can use the workbook to re calculate and examine aggregated healthcare direct costs which are high level input parameters i e treatment costs for chemotherapy in the CRMM platform For example the chemotherapy treatment cost value seen in the CRMM Base case input parameter is calculated in the workbook from aggregates that include the cost of the drug itself proportion of patients treated number of chemo nursing hours and number of visits and so on CRMM USER GUIDE PAGE 11 GUIDED TOUR AN OVERVIEW OF THE CANCER RISK MANAGEMENT MODEL In this section you ll learn about the layout of the CRMM in terms of the concepts introduced in the previous section Models Scenarios Input parameters and Output Tables and the Cancer Management workbooks THE ALL SCENARIOS PAGE This important page is displayed immediately after you sign in to the Cancer Risk Management Model It displays all of the models and their associated scenarios in sets of folders m 7 a o 30 30 Model Documentation Coton Cancer Management Data CRMM1209 xis Model Release Notes Data Dictionary CRMM v1 2 0 9 doc Mode Norkbhook Lung Cancer Management Data CRMM1209 xis i Rect
53. eee eee eee eee eee RELIABILITY To assess the reliability of the values in an output table use the Output menu to display either the Coefficient of Variation CV or the Standard Error SE These output measures represent the variation in results due to Monte Carlo error Monte Carlo error is generated by the stochastic processes in this case use of random numbers in the Cancer Risk Management Model Monte Carlo error can be reduced to an arbitrarily small amount by increasing run size to a sufficiently large size at the expense of time it will take to run the cases In practice you should examine the CV and SE for particular output values to understand if for instance year to year fluctuations are likely explained by Monte Carlo error or it there is something deeper happening within the data and algorithms The measures of variation in CRMM do not represent the variation in the input parameters often called parameter uncertainty This variability is not captured or quantified Users may wish to perform sensitivity analyses to evaluate the impact of uncertainty of key input parameters on outcomes In general results from simulation runs intended for use in policy development should have coefficients of variation of 5 or less from Statistics Canada Guide to the Modgen Visual Interface v10 1 0 The Coefficient of Variation in CRMM is displayed as a percentage as shown in the image at left below CRMM does not displa
54. esis GP 1 p i ok SER eee ge eo og og ao To Chemotherapy and line bone coo noo oTi Chemotherapy Ird line 117 Stage V mowable Prophylactic gania wracealh 118 Stage IV incurable Surveillance year 1 149 Sage lv incurable Surveillance yeas 2 120 Stage Iv incurable Surveillance rear 3 121 Sage ly curable Surveiliance year 4 122 Stage v incurabie Surveillance vem 12 Sage mnoawable Cured 12d Stage Iv incurable Gupoortve care onl 125 Stage IV incurable End of ite care 3 months be 425 Stage V curable End of ide care 2 months be 127 Stage Iv incurable End of ide care 1 month peti ee SR E E FSR RG FE KOGE OOOO oo oO Ne daa themen Seeeseeecec oe ose e005 20 565 56 6 60 6 alla Nes adpian thems and iadd cecoeooesceoeoceceosc sce ees sooo ago Adan chomolherapy nooo oo oo oo ooo ooo oo ag ooo o oo o l0 Concent chama and radio Sooo ooaooosoocoooo ooo ooo aa 6 6 oo lo Palle mdiotherapy Seseascseoosc con oes seco e5 0060 0 oe 0 Pre digniria FOOD 0O Senood soe ITa Diagent acoodascoooconcoooo oo oo oo oom oa li Rodona FFF EEVFE oe UEC UE ee EEC oeo o allt Chemotherapy SERRE RS Hea ee hoi O oS oe r x a ip lor h r al A B a Colon Cancer Managem E Stage IV 7 2 with hepatic resectable es liver mets 80 or Progressron T Relapselt xe am am mm ms mS a om eS oa og Bies Ris 8 oe ES d Je me ee e e e
55. eter cell The Provincial Status Quo tutorial has an illustrated example of the complete process of copying from a parameter into Excel editing then pasting back into the parameter Important To select the entire row or column click a row or column title and drag to select some or all rows or columns Use Copy and Paste from the Edit menu as shown below when copying from or pasting into a parameter range or output table range in CRMM The copy and paste commands may not function correctly if you attempt to use right click or to use the keyboard short cuts of control c and control v Click Paste then wait there is a slight system delay while the range of cells is validated It might seem as if your click didn t work but it probably did wait those few seconds instead of clicking again Use the recommended browser copy and paste from the Edit menu may not perform as specified on any browsers other than Internet Explorer version 8 or version 9 cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 58 EDITING INPUT PARAMETERS EXPORTING VALUES INTO AN EXCEL WORKBOOK Rather than copy an entire parameter into Excel use the Export Data button or select Export data from the File menu The advantage of Exporting is that the column and row headings will export with the values The copy command from the Edit menu is best suited to smaller selections of data since only the values are copi
56. f similar models to better understand the updated model and its implications on your work Expanded the New group to see the parameters that were added to the latest version of the model Examined an input parameter from the Values changed group to show a comparison view of the values that are used in the two versions of the model Returned to the Compare entire scenarios page to continue your exploration of the differences that the two models on the Base case scenario cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 36 KON GENERATING NEW PROJECTIONS be BY CREATING SCENARIOS The Base case scenario sets out the input parameter defaults for a particular model version To create a new scenario you will follow this process 1 Identify and select an existing scenario often the Base case which the new scenario will be based upon 2 Select New scenario and enter a title and notes The input parameters from the original scenario will be copied into the Input parameters tab for the new scenario The Output tables will be removed 3 Edit one or several input parameters you can change them individually in groups with the Fill selected range feature or by copying and pasting blocks from Excel Save your changes 4 Run the new scenario with a representative number of cases usually 32 million cases or more O TUTORIAL CREATE A NEW SCENARIO TO REFLECT PROVINCIAL DATA In this tutorial you ll learn how
57. hase in over 2 years and start in 2011 Comparing this particular set of scenarios allows us to isolate the participation rate as the measure of interest cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 29 ANALYZING AND COMPARING ACROSS SCENARIOS Click the Scenario link located directly above the data table or select Compare scenarios from the Dimensions menu In the Compare scenarios box that appears all of the scenarios containing comparable output tables are visible Check the FIT 50 and FIT 80 scenarios to include them in the comparison Click Show view Select data to display in the comparison Current and selected scenario values Differences selected minus current Rates selected divided by currant Select scenarios to compare Max 10 scenarios Unchack al Expand all Current scenario FIT 30 2 year phase in 2011 12 biennial 3 Cancer Risk Management Model 1 2 2 My scenarios C CRC model clinical incidance approach 3 Public scenarios 3 Base case scenario O Base case scenano default 3 Colorectal cancer scenarios FIT 50 2 year phase in 2011 12 biennial FIT 60 2 year phase in 2011 12 biennial C gFORT 30 2 year phase in 2011 12 biennial C gFOBT 50 2 year phase in 2011 12 biennial Cl gF OST 50 4 year phase in 2011 14 biennial Cl gFOBT 50 6 year phase im 2011 16 biennial O gFOBT 80 2 year phase in 2011 12 biennial Ci New chemotherapy drug p for colorectal cancer can
58. ie cae Pea nics ie ace EN Ro m a UFM i TaLi i P A MEE Create new scenario as a copy of current scenario Tite Mew drug CAZ variant oF CAV for Small all Extensive Note This scenana examines the impact of upgrading a Cancer tables j2nd ime treatment for Small Call Extensme lung Cancer cases by province sek and voor cancer for half of the patients to new drug CAZ 4 Colorectal cancer tables winch costs 14 more per cycle 3 Lung cancer tables It assumes half of the patients will recerye CAV Risk factor tables and half wil recene CAZ a Smoking tables Parameter changed bung cancer treatment costs 4 Radon tables for chemotherapy 2nd lime Drug 3 Economic tables Dataled Income and Tares for populahon aged 15 4 a Se Economic outcomes by sex and yeas Mext steps Click Save then use Edit to change parameters Save yo m g ae Economie pubcomas by sex and province fora sing Sre Cancel Click Save cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 47 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS After you click Save notice that the title of the new scenario is now at the top of the page and the status has changed to Ready to run The output tables tab has been removed since no output projections have yet been generated for this new scenario The change that will be required for this new drug is the proportion of patients treated and the cos
59. incidence rates were increased slightly for a few age groups the incidence rates in the output projections show a trend towards higher values in the Tutorial scenario versus the original Base case For the purposes of the tutorial we ran this as a test simulation with 2 million cases If you were to Compare Entire Scenarios with the Base Case scenario most values would be different because of the different run sizes To create a reliable status quo scenario for your province you must run it with an equivalent number of cases To create a comparable status quo you would follow the create new scenario process to create a new scenario as a copy of the test scenario with a slightly different name Since the parameters were copied from the tutorial scenario you could skip straight to running without changing any parameters A run of 32 million cases would be required to be comparable to the existing Base case scenario see Selecting Run Sizes cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 45 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS CREATING A HIGH RELIABILITY SCENARIO FROM A MODERATE TEST RUN SCENARIO AN EXAMPLE Step 1 Click New scenario when viewing the existing test run scenario Step 2 Give the new scenario a slightly different name here we added Full Don t forget to add your information notes about the scenario tnin Status Completed oov 3 Cancer tables Cancer cases by provin
60. ink above the parameter list or select Run scenario from the File menu The simulation size is set by default to Test Click Submit ie Choose simulation size Ready to run Run Test 2 000 000 cases moderate reliability 3 Risk factors Medium 32 000 000 cases high reliability i Smoking 4 Radon custom a cance iig IPE Enter nimbe of cases m x 40 000 000 3 Lung Cancer Next steps Scenario will be queued on remote server a Risk equation coefficients Time vanes based on usage from minutes to hours Incidence Status will be updated in My scenanos folder when completed AMLE Lind The All Scenarios page will be displayed Notice that the new scenario is in the Working Sets folder It will remain there until it has completed running Ha 28 e 2 M 0 folders and 0 scenarios selected 3 Cancer Risk Management Model 1 2 O a4 Model documentation Colon Cancer Management Data CRMM1209 xis Date Dictionary CRMM v1 2 0 9 doc Lung Cancer Management Data CRMM1209 xls Rectal Cancer Management Data CRMM1209 xl Release Notes CRMM1 2 buid 1 2 0 9 doc 3 Working sets J Tutonal Provincial Status Quo Full Ready to num New drug CAZ vanant of CAV for Small Call Extansive Output pending Prepanng model inputs nE El My sceneries Zearane a 0 Public scenarios 30 Base case scenario Base case scenano default 32 000 000 cases Select the New drug CAZ scenario Click the Det
61. is purely to illustrate how input parameters can be pasted from Excel For example purposes change the values under ages 61 to 65 to 0 0019 HF BF o o BG BH h s8 59 60 P 0 000819 06 000819 0 000819000197 0 0019 0 0019 0 0019 0 0019 0 001934 0 001934 0 001 B a OR i Now copy the entire Excel workbook row imagine that you ve made changes Return to your browser window where the Newfoundland and Labrador row is still selected Select Paste from the Edit menu a mahi E Halon 3 Canoe poranesbers 2 hha arte Scrvening a hedaman d Enperia hh poroach bo genecatng colbrectal cancer a Matera History Appenin 1 2 Olilcal Irene Approach Sensdlivity one specifichy af screens Gun Reeds fran binder eed d Colon cancer clinical incidence TEAT E TSO 13304 T 0 OCH P4440 Posie Pe a AE aaa a P4401 ada 240 00 1 0007 RRP ODOT ES LPG OOO TRFIHO OMIT SE LARA COURT HTAA 0 000 756180 0 000756 1600 C00 FS6 1090 00 75060 20 007 Lowi 00 0007 Me 0007146 MHO COO T MSO 0007 IMG Roe 001 Late aio COO 140 DOCH 1 10 DOOR A 314 0 000TERIOe O 0 00000 7h6 00000205640 00000 MSNA 00040005 500 001 23185540 0 0 00087177 EMOTII N BOOS 7191 09 7T1I90 Boose MRO Od j GOGAT IATA JA DOMANIOGO H CONKPIMAT GOMAN MEAD COLDATEOA S C 6 00074 128s G O00742165 4 000241 18 0 0007411880 001140545 000 U 00074110E 600074U LEE 000074116E 00074L LEED 001 140 ERE O Emi Cae Tag Te a eerie oih
62. kst Diagnosi Neck Falaka cant So ee eee i These values are used in probability sheets and parameters Breakdown of all underlying costs to compute total cost cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 17 FINDING USING AND ER UNDERSTANDING OUTCOME PROJECTIONS Within the CRMM platform each model version includes a folder of public scenarios which contain pre run scenarios for all CRMM users The tutorial below will guide you through an exploration of the inputs and outputs of scenarios O TUTORIAL FIND AND CHECK THE OUTCOME PROJECTIONS FOR THE BASE CASE SCENARIO Make sure you ve read through the Must Know section so that you understand the basic concepts and terminology Look through the Guided Tour section to get an idea of how the CRMM platform is laid out The CRMM platform starts at the All Scenarios page Under each available model you ll see a set of scenarios organized into folders Folders can be expanded to see all of the scenarios inside or collapsed by clicking the button beside them If there is no button the folder is currently empty The first thing you ll want to view in the model is the Base case scenario Understanding the projections and inputs to the Base case scenario is essential because it provides the starting point for all other scenarios Sign in so that you can view the All Scenarios page Find the Cancer Risk Management Model 1 2 folder on th
63. lorectal cancer direct health care costs by t Colorectal cancer outcomes for calculation of 1 Colorectal cancer stage distribution pooled 10 Colorectal cancer survival by year after diagno ff Colorectal cancer screening outcomes by p i Colorectal cancer outcomes by screening stati 20132 F 234 299 080 34 577 436 34 951 903 25 o 3 916 908 572 285 _ o 2 479 945 2 596 043 a 2 479 945 2 596 043 2 i o 180 327 145 037 _79 939 220 852 231 335 0 be 3 i 759 1 765 a 22 038 22 196 E Ba 251 850 268 373 179 ieil At this point you may wish to have a look at the file and open it in Excel Go ahead and then come on back cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 26 SCENARIO CREATION m INPUT PARAMETERS variable data CRMM O microsimulation algorithm kk OUTPUT TABLES data projections cc gt NEXT STEPS FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS LF collec your thoughts You have viewed the Base case and a what if scenario for a screening program Viewed some of the projections as outcome measures in output tables Examined input parameters to better understand the output projections Selected an output table with the measures you needed and exported it to your desktop Instead of examining each parameter to look at the differences
64. mpare entire scenarios page shows four groups of comparisons across input parameters and output tables VALUES CHANGED Parameters the input parameters were set to different values in these scenarios Tables the output tables contain different projections across the two scenarios NEW Shows input parameters or output tables that were added to the new model CRMM 1 2 e g did not exist in the 1 0 release version of the CRMM DELETED Shows parameters or tables that were present in CRMM 1 2 that no longer appear in CRMM 1 0 STRUCTURE CHANGED Shows parameters or tables that have different dimensions or the dimensions are moved filtered or displayed differently Let s start examining the changes by looking at the new parameters that were added in CRMM 1 2 Click the plus sign beside the New group to expand and expand the Parameters group Cancer Risk Management Model 1 2 Base case scenario default l Cancer Risk Management Model 1 0 Reference scenario Base case scenario default 4 Values changed Parameters wa Tables 4 Deleted I Structure changed cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 34 ANALYZING AND COMPARING ACROSS SCENARIOS Expand the Values Changed group Select Lung cancer treatment duration from the Parameters list Hig ok io View title shows it is a comparison view stage Non small cell stage 1 Y
65. n the references and data sources for the Model inputs and rules No these are built in to the Cancer Risk Management Model platform in the form of Information notes Model Release Notes and the Cancer Management workbooks The Guide does contain a section on how to find what you need among all the sources of documentation see Understanding Data Sources and References 5 Does this Guide help me learn about microsimulation programming of the Cancer Risk Management Model Cancer Risk Management Model is computed using a computer language called Modgen developed by Statistics Canada This Guide is not intended to address Modgen programming or altering the structure of the underlying models Instead the focus is on using the models published within the web based Cancer Risk Management Model platform You can use the link below to learn more about Modgen if you decide to explore programming further http www statcan gc ca microsimulation modgen modgen eng htm cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 6 E ADMINISTRATION ACCOUNTS AND REGISTRATION REQUEST FOR AN ACCOUNT Information about the Cancer Risk Management Model can be found at www cancerview ca cancerriskmanagement Follow the steps below to request a user account Step 1 Complete and submit a User Account Request Form The information on the form will be reviewed and verified by the Canadian Partnership Against Cancer the
66. ncidence i Treabnveni 3 Colon cancer Colon cancer treatment duration Colon cancer traatment costs Colon ancer ieni prolin F Colon cancer summed improvement from ni Hi Yaar new treatment for colon cancer mira Jhe Proportion of Stage IV colon cancer pater ior 7 ir Stage for trestment 4 Stage IV incurable TEEMING Base cade scenarng default To Treatment state hemo aed radio To Chemotherapy ist ine To Chemetheraiy 2nd ime To Chemotbersery Jrd long 7 o o i ENAN eles ae i i Li J 1 Li F il 6 aja a aa it Bia oa of o i a i cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 68 UNDERSTANDING DATA SOURCES AND REFERENCES To Treatment state Stage N curae Pre ciagnosia GP Stage IV incurable Fre ciagnoes s GP 05 Sage Iv incurable Diagnoses specalisti 105 Stage i incurable Neoadjuvant chamctherap no il Stage V mowable Neo adpivant chemo and ra 108 Stage IV inawable Surgery 109 Stage IV incwable adiuvant chemotmerag TIG Sage Iv incurable Radiotherapy 714 Stage Y morale Chemotherapy Ti Stage IV amable Concurrent cher anc radi TII Sage V curable Chemotierapy tat line 114 age lY incurable Chemotherapy nd line age incurable Chemciherapy 3rd line iH Sage fv incurable Palliative radkotnerapy E 3 io Temene RR Frege GP g Fredagar GF Ml Fre agn
67. nt CRMM USER GUIDE PAGE 67 UNDERSTANDING DATA SOURCES AND REFERENCES RATHER THAN LOOK AT PARAMETER INFORMATION NOTES ONE BY ONE YOU WANT TO LOOK ACROSS AN ENTIRE SET OF INFORMATION NOTES AND FOLLOW THE LINKED CONNECTIONS OR YOU WANT TO READ THE PARAMETER INFORMATION ABOUT A PARAMETER WHILE YOU LOOK AT THE PARAMETER VALUES Data Dictionary All of the Parameter Information pages for a model s Base case scenario are collected into a single searchable document Format PDF document How to Use All Scenarios to return to the main view open the model s Workbooks folder and click the dictionary TIP 70 reduce browser load save the document to your computer via your browser You can then open and use the document through Adobe Reader YOU WANT TO SEE ALL OF THE COSTS COMPUTATIONS AND ASSUMPTIONS USED TO CREATE THE VALUE FOR A PARAMETER AND POTENTIALLY CHANGE A VALUE IN THE COMPUTATION IN ORDER TO CHANGE A PARAMETER TO RUN A SCENARIO OR YOU WANT TO UNDERSTAND THE FLOW OF A PARTICULAR CANCER THROUGH THE PROBABILITIES FOR EACH STEP AND STAGE Example While you can see that the probability associated with use of 1st 2nd and 3rd line chemotherapy for Stage IV incurable colon cancer in the Colon cancer treatment probabilities parameter in the screen image at left below you may better understand these values by viewing it in the flow diagram shown in the workbook 3 Cancer parameters a Colorectal Cancer 3 Screening i I
68. nt typi Colorectal cancer outcomes for calculation of ICER for cases E year Colorectal cancer stage distribution pooled 10 years startin Colorectal cancer survival by year after diagnosis pooled 10 Colorectal cancer screening outcomes by province and Colorectal cancer outcomes by screening status i 4 Lung cancer tables Hint If the title is cut off by the panel hover your cursor over the title to see the entire title A small yellow box will appear as shown above displaying the entire title cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 21 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS Notice the Measure in the 2nd row of the table above is Number screened number of tests it s easy to spot because the row shows zero 0 across all of the years In this particular example of colorectal cancer screening it refers to the era before any organized screening program was implemented in Canada At this point you may want to go see the input values that were used to create this scenario to get a better understand of the connection between the input parameters and the output tables There are two tabs below the main menu one for viewing Output tables and one for the Input parameters Click the Input Parameters tab above the list of tables to view the input parameter values that were used to create this base case scenario 4 T Eit Pan case carro Arr
69. ons in rows columns or as filters A dimension is a category of data like Province or Year Clicking the dimension name provides a list of the members of the dimension to display Click the word Measure the dimension title for the rows in the table a Cancer tables Cancer cases by province sex and year 3 Colorectal cancer tables 3 Lung cancer tables a Risk factor tables Smoking tables 3 Radon tables Economic tables Detaled Income and Taxes for population aged 15 4 Economie outcomes by sex and y ar Economic outcomes by sex and province for a smal E Ling cancer incidence cases Oaleult ealected mambe C Ling cancer deaths C Lung cancer prevalance EJ Colorectal cancer incidence cases O Colorectal cancer deaths O Colorectal cancer prevalence al ale seer invites LE You can see that not all of the possible members of Measure are selected Click in the selection box beside Lung cancer deaths to display these values in the table view Click the Show View button to apply these selections to the data view cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 19 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS The Lung cancer deaths member is now displayed in the table data view This is a temporary view you would need to save it from the File menu if you wanted to view it again later otherwise it will revert to the default view Notice that this view of out
70. platform When encountering this issue users can obtain the workbooks via the collaborative space as part of their access to the Cancer Risk Management Model cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 7 his SEN MUST KNOW CONCEPTS amp TERMS CANCER RISK MANAGEMENT MODEL Cancer Risk Management Model is a population based dynamic microsimulation model Microsimulation is a mathematical modeling technique in which individual cases are simulated one at a time from birth to death The information from all the simulated lives is then combined to produce aggregate measures of health outcomes for the population or for particular subpopulations e g by province age or sex The primary value to researchers and policy makers is those projections can measure the effects of proposed interventions before they are implemented in a population In the Cancer Risk Management Model CRMM each simulated case represents a life The life cases are based on known and projected demographic data and have a set of decision points governing how each case will proceed In CRMM you can simulate a representative albeit synthetic sample of the population in a what if scenario by running a set number of life cases For example a scenario could be run in which an intervention reduces the smoking rate by 10 As this scenario is run all of the simulated lives play out according to the model s algorithms and inputs At the teen smoking
71. put table was set up to have the Province and Sex dimensions displayed as filter above the chart or data For both filters All is selected This tells us the values displayed are aggregated for all members of Province and Sex Selecting a filter member will show only the values for that member Click the blue triangle in the Province of Residence block to filter this view of the output table for Cancer cases by province sex and year Choose your province from the filter menu re E a 5 Py y PEE Pees Base Las scenario defa d i i i A ters Se a Ma ot tare d a Cancer tables ae rT A aS w BESTE Lr mens Sa Nee year paee E IF T ataa and Latreder Lung cancer tables if z re Prince Edward Island 3 Risk factor tables ER ee PAS FEE NER al rer incit es 21 547 22 New Brunswick Nora Socotra 3 Economic tables ride Quebec Detailed Income and Taxes for population aged 15 Economc outcomes by sex and year Economic outcomes by sex and province for a sinc 3 Life expectancy tables aiima imna Life axpectancy of persons born in a single year as p Life expectancy by year of birth Life expectancy of persons born in a single year as Life expectancy of persons born in a single year as Yukon 3 Population tables North West Terntones and Mun Population structure for a single year as selected D All BD UNE Or a D CS ID PLE tigin Manitoba Erish Columbia cancerview ca cancerriskmanagement CR
72. r population aged 15 j nr Be ey ae vee aes Sea ae Oe al Economic outcomes by sex and year Next steps Click Save then use Edit to change parameters Save your Economic outcomes by sex and province for a sing Cancel 3 Life expectancy tables Create new scenario as a copy of current scenario Title Tutonal Provincial Status Quo from Base Case Notei create new status quo for our province Updated incidence rates to reflect example tutonal data Parameter Colon cancer observed incidence rates gt All other parameters remain the same as in Base Case Click Save After you click Save notice that the title of the new scenario is now at the top of the page and the status has changed to Ready to run Note The output tables tab has been removed since no output projections have yet been generated for this new scenario After the new scenario is run the Output Tables tab will be displayed with the new projections cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 38 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS You should always look at the parameter information for the parameter you expect to change It will provide details about how the value of the parameter is computed and measured Expand the parameter groups for Colorectal cancer then Incidence then Colon cancer clinical incidence Select the parameter Co on Cancer observed incidence rates
73. reed infontiation thet you ve aut or copied recenti SETTING A PARAMETER RANGE TO A SINGLE VALUE There are many parameters in which a range of the cells are set to the same value Rather than change each value individually the Fill Selected Range feature will fill a row or block of cells with the value in the top left corner of the selection To fill a range follow this sequence similar to the Fill command in Microsoft Excel Edit the source cell for the fill in the top left corner first to Select the range that you wish to fill with the source value Select Fill selected range from the Edit menu Scenario Tutorial Provincial Status Que from Base Case f j i om H a Soe h Zai b E Winds al changes aaa aa Ce Status re a ik Ts i 3 i Baden a Cancer parameters a Colorectal Cancer 12940 00353512940 00953522940 003 OO 004 7C0 409 004 700409 0 Ch a orker z cig 312 90 00358131210 00355131290 0034 i Experts only Pore C431 70 110 00431770740 i 430 DO SL 364 39 0 03 19364340 O03 ys 001405900 Mair aOR obs O71 003278607 40 0032 1860 Til 603 18530 00291513540 00291623510 GHz EELER ODT S580 0031 1S Sao 120 00753512940 003757512680 0034 fpprech to ganar a rng Colorectal cancer iene Cees a Notural History Approach 3 Clinical trckdence Approach a Sensitivity and specificity ol scrmening tests Clinics Survival benefit from screening beyond stage shift
74. s within a model to see differences resulting from two sets of parameter inputs Example You may have created an intervention scenario You can compare your new scenario to another scenario The results will show the set of outputs and inputs with differing values between the two scenarios This provides a complete picture of the changes between the two scenarios 3 Compare identical scenarios across models to see all of the differences resulting from two model versions Example You ve been working on a research question and have created new scenarios to explore the projections At this point a new version of the model is released You read through the release notes and decide to use the new model To fully understand the changes you compare a scenario in the new model version to the identical scenario in the previous model version cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 28 ANALYZING AND COMPARING ACROSS SCENARIOS TUTORIAL COMPARING AN OUTPUT TABLE ACROSS MULTIPLE SCENARIOS There are 3 public scenarios in Cancer Risk Management Model 1 2 modeling different implementations of FIT screening programs In this tutorial we will compare the number of colonoscopies performed across these different screening program scenarios Select the scenario titled F T 30 2 year phase in 2011 12 biennial Expand the Colorectal cancer tables group Select the output table titled Colorectal cancer screening outcomes by
75. st right now we re still viewing the coefficient of variation Scenario FIT 30 2 y ha Er i By ee Yi ner ji s Gore Select Save view as from the File menu TEE Select Values from the Output menu Enter the title Comparison across FIT Print setup scenarios Printable version Sign aut Copy saved view Since the saved view is derived from a specific output table the saved view is shown under the original table in the list of Output tables in the panel on the left 4 Colorectal cancer screening outcomes by province and year Comparison aoress FIT scenarios F Colorectal cancer outcomes by screening status cc gt NEXT STEPS Learn more about comparing scenarios click Help Tutorials Comparing Scenarios to watch the brief video tutorial in the Help menu Our next step would be to export use the Export data command in the File menu or the Export button this comparison view to Excel for further analysis of the outcomes across the different participation rates cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 32 ANALYZING AND COMPARING ACROSS SCENARIOS O TUTORIAL COMPARING TWO SCENARIOS ACROSS MODEL VERSIONS OR WITHIN A MODEL In this tutorial we ll compare identical scenarios across versions of a model This will also introduce you to the process for comparing two complete scenarios within a model since
76. stments A special generalized worksheet has been created that is linked directly tothe in the diagram updating a updates this 111 erorksheet which i6 called Probabdities fis in a format that can be copied dir cily inte the simulation parameter one stage af a time 321 Semudaten pavameter name Lung cancer treatment probabilities il TE Costs Subsequent worksheets cost out each of the treatment boxes shown in the diagram in detail to estimate the aggregated average cost of 16 treatment per patent receiving i The costs are broken into costs al diagnosis surgery costs radiotherapy chemotherapy survedlance and 3 supportive care only costs The aggregated costs are highlighted in pink cells these are meant to be copied into the appropriate input ala parameters ofthe simulation The aggregated costs are buit up through formulas from the unit costs and physical units in each of these 18 Tan PS ee Se ae FARER Bera Sl Pa ed whene yet th What gasis and physical unada Bre changed 3 Simulator parameter name Lung cancer treatment costs 20 oy Durations 35 Durations of treatment are captured and documented here and copied into the simulation parameter 93 orivebor parameter name Lung cancer treatment durabons ml Health utilities 25 Health utilities are estemated fromthe PHI study for indnidual cancer health states Multiple states are combined by a multipicatrve rule The S liter here have been mapped inte
77. t the Display Options button and Chart Options button shown below display the formatting available for the data or chart view Save the view see the tutorial above on Saving table and parameter views if you would like to make this your default view for the future Rows 1 1of1 cancerview ca cancerriskmanagement Data Cha Tis zac Mile Fl i a Fit to im A e g em gt Columns 1 1 of 1 ca tAr y i Bax All CRMM USER GUIDE PAGE 63 UNDERSTANDING DATA SOURCES BE AND REFERENCES WHAT DOCUMENTATION IS AVAILABLE Latest evidence from cancer research and current clinical practices in Canada were the default input values of the Model Companion documentation such as Information Note Data Dictionary and cancer type specific workbooks are put in place to assist interpretation of the input parameters TYPES OF MODEL DOCUMENTATION Excel e Data a Workbook Dictionary e INPUT PARAMETER Information b an Note Input parameter the value assigned to a particular input to the scenario Example Values for the input parameter Lung cancer observed incidence rates are assigned by province and age group You may wish to change the input parameter values for a particular age group if you have updated data that differs from the rates used in the input parameter cancerview ca cancerriskmanagement CRMM
78. the end of the scenario title Scenario FIT 50 2 year phase in 2011 12 biennial Model Cancer Risk Management Model 1 2 Version 1 2 0 9 Note This scenario evaluates new organized screening for colorectal cancer using immunochemical faecal occult blood test FIT as the primary screening modality and follow up by colonoscopy starting in 2011 and achieving a participation rate of 50 over 2 years See Colorectal cancer screening parameters All other parameters are same as in the Base case scenano default Note The default year has been set to 2011 in version CRMM 1 2 in version CRMM 1 0 the default year was 2010 This affects tables that report on the single year a5 selected by the user and it also affects scenanos that specify a start year such as screening smoking cessation The scenario information shown above was entered when the scenario was created The information describes the input parameter changes and captures the purpose of the scenario cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 24 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS After reviewing the scenario information return to All Scenarios to select and view the scenario Return to the All Scenarios page Find the Cancer Risk Management Model 1 2 and the Public Scenarios folder below Select the scenario F T 50 2 year phase in 2011 12 biennial Click the Input Parameters tab Expand Colorectal Cancer and Screening
79. ther than right click or keyboard shortcuts see Copy and Paste from Excel Don t worry about the exponential format Excel will handle it Scenario Tutorial Provincial Status Quo from Base Case O Newfoundland and Labrador Open a new Excel workbook and paste the data onto the blank sheet Note As in the example on the next page you might also wish to fill the first row with a series up to 99 because the clipboard contains only the values not the row or column headings in this case the Age headings for the columns cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 40 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS You should know that an alternative to copying the input parameter data also exists You could export the entire parameter into an Excel workbook using the Export button or selecting Export data from the File menu This would ensure that all row and column headings are available in the exported workbook For the purposes of this tutorial we ll stick to the simply copy and paste here eie A agar A M 0 000000995 PI 1 1 2 3 4 5 b f a g 2 9 956 07 9 956 07 9 95E 07 9 956 07 9 95E 07 9 956 07 9956 07 9 956 07 9 956 07 9 97 J For the purposes of this tutorial we will just change a few values before stepping through the process of pasting the data back into the parameter In reality you would likely paste your own incidence data into the correct age cells The intent of this section
80. to create a new scenario from the Base case scenario The new scenario will reflect a customized status quo scenario for your province For the purposes of this example tutorial imagine that new data has just been published on observed colorectal cancer incidence rates in Newfoundland The tutorial will walk through the process of creating a new scenario with the revised incidence data in the incidence rates input parameter cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 37 GENERATING NEW PROJECTIONS BY CREATING SCENARIOS Find the Cancer Risk Management Model 1 2 folder and the Public Scenarios folder Single click to open Base case scenario default Click the Input parameters tab Click New scenario just above the parameter list or select New scenario from the File menu Type in the title for the new scenario Tutorial Provincial Status Quo from Base Case Type or copy paste in the following notes Create new status quo for our province Updated incidence rates to reflect example tutorial data Parameter Colon cancer observed incidence rates All other parameters remain the same as in Base Case Scenario Base case scenario default m Leauge Du Ege Ent Status Completed Naw scenario a Cancer tables Cancer cases by province sex and year a Colorectal cancer tables 4 Lung cancer tables a Risk factor tables 4 Smoking tables 4 Radon tables 2 Economic tables Detaled Income and Taxes fo
81. ts This is where the workbooks come in The proportion of patients treated is a variable in the workbooks used to compute the aggregate cost per stage of the treatment This aggregate cost was then entered in the Lung cancer treatment costs input parameter Go take a look at this parameter now Expand the Lung cancer and Treatment groups Click the Lung cancer treatment costs parameter Never change a parameter without viewing the information first to see how it is computed or measured or formatted Click the information button beside the parameter title Notice in the information that it says these costs were aggregated from the Lung Cancer Management Data Excel workbook Scenario New drug CAZ variant of CAV for Small Cell Extensive i i iy l a kr ee s EH Li Pill a i 1 m kif i a i Parameter Lung cancer treatment costs Bn Ht a Risk factors Note a Smoking i Radon 2 Cancer parameters 4 Colorectal Cancer a Lung Cancer a Risk equation coefficients D AI TION iit EGE Coots mina Ino eo je Tom 7 howe EY LUS owe bot bom up Eastin ere ere he deta Of when are found nm Me Lung jfi management Data Excel workboot DIMENSIONS Incidence Stage at diagnosis major treatments major cost category a Treatment province Lung cancer treatment probabibties Lung cancer treatment duration SOURCE Lung cancer treatment costs Ontano Health Insurance Plan OHIP
82. ume meceni coking bende continue inte future 3 Risk factors i Smoking a Radon 2 Cancer parameters 4 Colorectal Cancer i Lim Ance cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 22 FINDING USING AND UNDERSTANDING OUTCOME PROJECTIONS Just like the Output tables you can see a list of Input parameters on the left and the values for the parameter selected on the right Notice that though we were previously looking at colon cancer outputs the first parameter visible is for smoking CRMM simulates lung and colon cancer in a single integrated population based framework so all parameters and output tables for all modeled cancers are present Click the plus sign beside Colorectal Cancer to expand the group Then expand the Screening group 3 Risk factors a Smoking 4 Radon 2 Cancer parameters 2 Colorectal Cancer 3 Screening Year bo start organged sereerung program Age bo stark screening im organized program Recruitment attempts to regester ite screening program Poerdicigreticn rates fea darparir sir deer larmi al varer d Phase Hn parod fo reach participation rates years ee ele i t i T ce ee pe GS ca i i i r d Select the parameter titled Participation rates to organized screening for colorectal cancer Notice the connection between this input parameter setting of O for the participation rates to organized screening and the associate
83. y dollar signs or percent signs in the cells instead look above the table to the Current Output Display for the format Standard errors are shown in the same format as the projection values cancerview ca cancerriskmanagement CRMM USER GUIDE PAGE 61 RUN SIZES amp RELIABILITY 227 231 255 S d 536 464 57 Fa 390 217 Notice that in some output tables you can filter the cases down to a small group of the original cases run For these projections coefficients will likely be far above the target range of 5 or below In the example below the view of the original cases has been reduced to the Females from the Northwest Territories and Nunavut Notice that the coefficients for this small group have risen beyond 50 rather than 5 Despite the run size of 32 million these values suggest that the projections for this small group should not be considered reliable To work with projections for sub groups in your research larger run sizes should be considered 333 53 7 32 2 28 41 3 100 0 a ee pe Ml 46 2 41 3 43 3 32 3 25 6 24 2 20 9 249 27 2 TE 365 35 4 ET ETT 27 0 25 3 22 2 16 2 26 4 23 2 STANDARD ERROR VALUES SPECIAL CASES In some tables it is possible that the standard error has a value set to lt blank gt which indicates that the standard error cannot be estimated due to a low number of sample cases for the cell Increasing simulation run sizes will reduce th

Download Pdf Manuals

Related Search

Related Contents

シャワートイレシートタイプ 機能一覧    Handbuch anzeigen    Adjustable Wall Mount Media Shelf  ACTIVE LIVE SET  Bedienungsanleitung  Mapelastic Foundation Mapelastic Foundation  Archivobjekt öffnen - Katalog der Deutschen Nationalbibliothek  

Copyright © All rights reserved. Failed to retrieve file