Ionuţ Bebu
The George Washington University, Washington DC, USA

Periodic evaluations are required in the clinical management of chronic diseases in order to identify opportunities for early treatment that can avert further progression and complications. For example, in nephropathy, patients with type 1 diabetes are screened annually for the onset of microalbuminuria, an early sign of chronic kidney disease. However, as our understanding of the etiology of diseases improves, there is the opportunity to design personalized schedules for future visits based on the estimated risk of progression, instead of a fixed schedule for the entire population. Herein we describe a framework for constructing such personalized screening schedules. A screening interval to the next visit is selected to optimize some function such as limiting the probability that the event will occur (e.g. $< 0.05$) prior to the next visit, or limiting the time that progression might go undetected before the next visit. The methods are illustrated using screening for retinopathy and nephropathy in the DCCT/EDIC study.