USE OF A MATHEMATICAL MODEL FOR EVALUATION OF TUBERCULOSIS CASE-FINDING WITH MASS MINIATURE RADIOGRAPHY

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  • MORI Toru
    the Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association

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  • 数学モデルによる結核検診の評価
  • スウガク モデル ニヨル ケッカク ケンシン ノ ヒョウカ

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Abstract

The purpose of the study is to quantify the direct effect of the MMR under the present Japanese medical service. A mathematical model was built which can generate the number of deaths among tuberculosis patient's cohort under situations with different degrees of case-finding service, and the number of relapses and progressions from cases of less severe type to more developed one. The model is of deterministic type and consists of six states of tuberculosis population each combined with parameters. The effect of the MMR computed with the model was then compared with the risk of cancer deaths due to radiophotographic radiations and with costs involved in the MMR procedure and treatment of the detected cases. It was found that the benefit of the MMR in terms of the lives saved (man-years) was rather small especially for young adults which is almost counter-balanced by the risk. Also it was remarkable that the present day MMR detects and leads to the treatment more cases of both infectious and non-infectious types than those which would be expected if all the MMR-examinees were only left to the routine clinical practice without MMR-service. The level of the routine clinical service is very influential on the above risk/benefit balance. It was also shown by calculation that the chances of infection under the situation without any MMR would not increase so much. The MMR made discriminately for general population especially for younger generations should be abolished and appropriate alternative control measures should be introduced and be strengthened.

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