Using resource modelling to inform decision making and service planning: the case of colorectal cancer screening in Ireland

Background - Organised colorectal cancer screening is likely to be cost-effective, but cost-effectiveness results alone may not help policy makers to make decisions about programme feasibility or service providers to plan programme delivery. For these purposes, estimates of the impact on the health services of actually introducing screening in the target population would be helpful. However, these types of analyses are rarely reported. As an illustration of such an approach, we estimated annual health service resource requirements and health outcomes over the first decade of a population-based colorectal cancer screening programme in Ireland. Methods - A Markov state-transition model of colorectal neoplasia natural history was used. Three core screening scenarios were considered: (a) flexible sigmoidoscopy (FSIG) once at age 60, (b) biennial guaiac-based faecal occult blood tests (gFOBT) at 55–74 years, and (c) biennial faecal immunochemical tests (FIT) at 55–74 years. Three alternative FIT roll-out scenarios were also investigated relating to age-restricted screening (55–64 years) and staggered age-based roll-out across the 55–74 age group. Parameter estimates were derived from literature review, existing screening programmes, and expert opinion. Results were expressed in relation to the 2008 population (4.4 million people, of whom 700,800 were aged 55–74). Results - FIT-based screening would deliver the greatest health benefits, averting 164 colorectal cancer cases and 272 deaths in year 10 of the programme. Capacity would be required for 11,095-14,820 diagnostic and surveillance colonoscopies annually, compared to 381–1,053 with FSIG-based, and 967–1,300 with gFOBT-based, screening. With FIT, in year 10, these colonoscopies would result in 62 hospital admissions for abdominal bleeding, 27 bowel perforations and one death. Resource requirements for pathology, diagnostic radiology, radiotherapy and colorectal resection were highest for FIT. Estimates depended on screening uptake. Alternative FIT roll-out scenarios had lower resource requirements. Conclusions - While FIT-based screening would quite quickly generate attractive health outcomes, it has heavy resource requirements. These could impact on the feasibility of a programme based on this screening modality. Staggered age-based roll-out would allow time to increase endoscopy capacity to meet programme requirements. Resource modelling of this type complements conventional cost-effectiveness analyses and can help inform policy making and service planning

U.S. DOE's Efforts to Promote Knowledge Sharing Opportunities from R&D Efforts: Development of the U.S. Carbon Utilization and Storage Atlas and Best Practices Manuals

AbstractKnowledge sharing among various stakeholders is essential to promote the commercialization of carbon capture, utilization, and storage (CCUS) technologies. The United States Department of Energy (DOE) promotes information and knowledge sharing through various avenues, including the development and distribution of Best Practices Manuals (BPMs), the development of online tools and resources, involvement in working groups on CCUS, and other public outreach and education efforts. One of NETL's main initiatives to promote information and knowledge sharing is the development of a series of BPMs that outline uniform approaches to address a variety of CCUS-related issues and challenges. A major online resource developed by DOE is the National Carbon Sequestration Database and Geographic Information System (NATCARB), which is a geographic information system (GIS)-based tool developed to provide an interactive visual representation of CCUS potential. The series of past and future carbon storage Atlases featuring the Regional Carbon Sequestration Partnerships (RCSPs), such as the to be released United States Carbon Utilization and Storage Atlas, complements NATCARB, and contains additional information regarding commercialization opportunities for CCUS technologies from each of DOE's RCSPs. Building on past successes, NETL is expanding the NATCARB effort through the North American Carbon Atlas Partnership (NACAP) to better assess CCUS potential throughout all of North America. NETL has been actively disseminating knowledge and developing the future required workforce through training centers that are focused on training personnel for future implementation of CCUS technology