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Sensitivity analyses demonstrate that varying key uncertain inputs such as the distribution of sojourn time substantially changes overdiagnosis estimates.
Assuming exponential distribution of sojourn time, we estimated the sensitivity and the MST by the maximum likelihood method of Walter and Day (Walter and Day, 1983).
Distribution of sojourn times (the last two stages of the latent period are used as early infectious period with an average duration of D L = 0.5 days).
Firstly, varying the distribution of sojourn time yielded mean estimates of the proportion of overdiagnosis that ranged from 0.0%to3.9%9% for invasive cancer and from 12.4% to 51.7% for carcinomas in situ (table 2).
As we mentioned in the methods section, an improvement in mammography sensitivity may affect the distribution of the stages at diagnosis and the distribution of sojourn time in a pre-clinical state.
It is, however, necessary to understand the distribution of sojourn times in the targeted age group when formulating screening policy (Duffy et al, 1995), and so future work accounting for different age groups, analysing the cost-effectiveness and looking into women's quality-adjusted life years for various screening strategies, would be valuable.
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Considering the mean sojourn time estimate of 3.7 years for breast cancer cases and an exponential distribution of the sojourn time, the probability that a screen detected case would have remained asymptomatic up to the end of the study period was calculated.
In this case, we would like to observe how the distribution of condition sojourn time changes the reliability indices even though two distribution functions have the same expected condition sojourn time.
The prior distribution of the sojourn density will be initialized as flat or be estimated from another related data source by calling the function sojournAnno.
The landmark meta-analysis from the International Agency for Research on Cancer (IARC) provided no details regarding the age dependence of the results, but stated that "age did not affect either the sensitivity of cytological screening or the distribution of the sojourn time of the disease.
On the basis of BC incidence from Catalan cancer registries and a distribution of the sojourn time or duration in the pre-clinical state, those authors used a generalized linear model with a Poisson distribution and a polynomial parameterization for the variables of age and cohort for the estimation of BC incidence when no data was available [ 25].
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