1. CCE 4: Bridging Clinical Expertise Using Predictive Computational Cancer Models CRC screening and follow-up – Semi-mechanistic model of CRC development Patient-specific predictions – Age – Gender – Symptoms – Previous test results Procedure conditions >3,000 complete longitudinal patient histories Progress: Built the model & tuned to data Lieberman et al. Five-year colon surveillance after screening colonoscopy. Gastroenterology, 133: 1077-1085, 2007. Baseline finding5.5yrs from baseline Number of adenomas Advanced adenomaCancer Lieberman Data ModelLieberman Data Model 0 (n=298) 2.4%3.9%0.3%0.4% 1 or 2 (n=617) 6.5%4.7%1.1%0.6% 3 or 4 (n=145)15.9%13.6%1.4%1.1%

2. CRC risks for an individual patient (tool on cceHUB)

3. Research Questions / Model Uses Effect of colonoscopy preparation quality on… – Clinic burden – Patient costs CRC risks Cost-effectiveness of colonoscopy follow-up guidelines – Risks, costs, and mortality by Age, gender, and test history – Design colonoscopy follow-up “rules” (Incorporate other screening tests)