title: Modelling the Future: System Dynamics in the Cutaneous Malignant Melanoma Care Pathway.
abstract: Incidence rates for cutaneous malignant melanoma are increasing worldwide. Estimates of the future number of melanoma cases are important for strategic planning of the care pathway. The aim of this study was to use system dynamics modelling to evaluate the long-term effects of changes in incidence, population growth and preventive interventions. Historical data on invasive melanoma cases in Western Sweden from 1990 to 2006 were obtained. Using computer simulation software, a model estimating the accumulated number of melanoma cases for 2014 to 2023 was developed. Five future scenarios were designed: stable incidence, business-as-usual, 25% reduced patient's delay, 50% reduced doctor's delay, and a combination of the last two, called improved overall secondary prevention. After 10 years, improved overall secondary prevention would have resulted in a 42% decrease in melanomas > 4 mm and a 10% increase in melanomas ≤ 1 mm, compared with business-as-usual. System dynamics is a valuable tool, which can help policymakers choose the preventive interventions with the greatest impact.
authors: Department of Dermatology and Venereology, Sahlgrenska Academy, SE-413 45 Gothenburg, Sweden. magdalena.claeson@vgregion.se.
authors: Magdalena
authors: M
authors: Claeson
authors: Stefan
authors: S
authors: Hallberg
authors: Paul
authors: P
authors: Holmström
authors: Ann-Marie
authors: AM
authors: Wennberg
authors: Helena
authors: H
authors: Gonzalez
authors: John
authors: J
authors: Paoli
mesh_terms: D003198:Computer Simulation; D019091:Critical Pathways / Q000639:trends*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care; D011157:Population Dynamics; D011314:Preventive Health Services; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D061665:Time-to-Treatment; D014850:Waiting Lists