Provided by: simrisc_15.00.00-1_amd64 
NAME
simrisc - This program performs simulations in the context of breast and lung cancer
SYNOPSIS
simrisc [options] analyses
The analyses argument is the name of the file specifying the analyses to perform. See
section ANALYSES for details.
DESCRIPTION
Simrisc was originally designed around 2010 by Marcel Greuter at the University Medical
Center Groningen, and thereafter modified in 2015 by Chris de Jonge.
Changes introduced in version 15.00.00
o In addition to breast cancer simulations simrisc can also perform lung cancer
simulations for either men or women. By default breast cancer simulations are
performed.
o The configuration file was reorganized and extended with parameters used when
performing lung cancer simulations: specifications for CT scans; additional Tumor
Beir7, Growth, Incidence, and Survival parameters, and a new section S3 containing
the age-range specific probabilities of encountering metastases.
o Simrisc offers the new option --cancer specifying the type of simulation.
When performing lung cancer simulations only the CT modality can be specified. When
performing breast cancer simulations the CT modality cannot be specified, but as with
previous versions: any combination of the Mammo, Tomo and MRI modalities can be specified.
OPTIONS
Short options are provided between parentheses, immediately following their long option
equivalents. Several parameters specify the path-names of files produced by simrisc. If a
path-name starts with a tilde character (~) then the tilde is replaced by the user’s home
directory. An initial + is replaced by the program’s base directory (see option base).
When an analysis uses multiple iterations then `$’ characters in filename specifications
are replaced by the analysis’ interation index.
All single-letter options referring to filesystem entries (directories, filenames) are
capitalized, all other single-letter options are lowercase.
o --base=basedir (-B)
the base directory where the output files will be written. By default ./. If
basedir doesn’t exist it is created by the program. If the directory cannot be
created and exception is thrown, terminating the program. The basedir
specifications may specify relative or absolute directory locations;
o --cancer=type (-c)
The simulation type (type) can be specified as breast to perform breast cancer
simulations. Breast cancer simulations are performed by default when the --cancer
option is not specified. Alternatively, to perform lung cancer simulations type
must be specified as either male or female to perform simulations for,
respectively, male or female cases.
Be advised that the default configuration file specifies Screening Mammo rounds,
which must either be changed to CT in locally used configuration files or in
analysis: sections (see section ANALYSES below);
o --config=path (-C)
the location of the configuration file. By default ~/.config/simrisc’ is used;
o --data=path (-D)
path name of the file to contain the data of the cases generated by the simulation
(default: ’<base>/data-$.txt’). If a data file should not be written specify !
(mnemonic: the logical not operator, i.e., --data !). See section OUTPUT for a
description of the generated data;
o --death-age=age (-a)
run one simulation using a specific natural death-age. This option also requires
the specification of tumor-age, and is mutually exclusive with the case option;
o --help (-h)
shows help information and terminates;
o --last-case=nCases (-l)
perform simulations until nCases cases have been analyzed and only write the data
for the final case to the data file. The rounds and sensitivity files contain the
summarized results of all nCases analyzed cases;
o --one-analysis (-o)
the program’s arguments specify the parameters of a single analysis, rather than
the name of an analyses-specification file. The program’s arguments are optional
and are used to alter the parameter values as defined in the config file or to
define label specifications. See section ANALYSES for details;
o --parameters=path (-P)
path name of the file showing the actually used parameter specifications. By
default no parameter file is written. If the --base (-B) option was specified then
path is written in the base directory if path does not contain a slash (/) (use
./path to write the parameters file in the current directory if --base was
specified);
o --rounds=path (-R)
path name of the file to containing the summary info of the simulation rounds
(default: ’<base>/rounds-$.txt’). If a rounds file should not be written specify !
(i.e., --rounds !). See section OUTPUT for a description of the generated summary
info;
o --spread=path (-s)
path name of the file containing the configured and actually used parameter values
when spread: true is specified (default: ’<base>/spread-$.txt’). If this file
should not be written specify ! (mnemonic: the logical not operator, i.e., --spread
!). If a parameter doesn’t use spreading then the ’using’ part is omitted. See
section OUTPUT for a sample of its content;
o --sensitivity=path (-S)
path name of the file to containing the summary info of the simulation’s
sensitivity data (default: ’<base>/sensitivity.txt’). If a sensitivity file should
not be written specify ! (i.e., --sensitivity !). See section OUTPUT for a
description of the produced sensitivity summary;
o --tumor-age=age (-t)
run one simulation using a specific tumor self-detect age. This option also
requires the specification of death-age, and is mutually exclusive with the case
option;
o --verbose (-V)
provides additional information while running;
o --version (-v)
shows simrisc’s version information and terminates;
ANALYSES
Unless the --one-analysis option is used the program’s first and only required argument is
the name of a file providing the details of the analyses to perform. These files are
called analysis files. These files must be a standard ascii text files. I.e., they can
only contain 7-bit ascii printable and white-space characters. Identifiers used in
analysis files and in configuration files are interpreted case sensitively.
Configuration specifications starting with uppercase letters (like Scenario: and Costs:)
specify (sub)sections and don’t contain additional specifications. Specifications starting
with lowercase letters (like ageGroup:) are followed by actual parameter values. For a
complete overview refer to the simriscparams(7) man-page.
Analysis files may define multiple analyses. Each analysis specification must begin with a
line containing
Analysis:
At each Analysis: specification the program’s initial configuration is reset.
Options specified on the command-line cannot be specified in Analysis: sections and remain
active while simrisc is running. The default option values are reset at each separate
Analysis: unless an option has been specified on the command-line, in which case those
option values are used throughout the simrisc run.
Following Analysis: lines the characteristics of the analysis are specified which can be
specified for each Analysis: specification, in the following order:
o a label: line: label: lines, when used, must immediately follow Analysis: lines.
The text following label: is written at the top of the output files;
o option lines: specifying simrisc options (not specified on the command line) which
are then used for that analysis. When program options are specified their long
option names must be used. E.g.:
base: /tmp/
last-case: 20
o parameter specifications: modify (some) parameter specifications defined in
configuration files. When parameters of configuration file sections (cf.
simriscparams(7)) are not specified then the parameters specified in the
configuration file are used.
All specifications in Analysis: sections are optional. An Analysis: section merely
containing the line Analysis: defines an analysis using the explicitly specified
command-line options or the default program options and using the parameter specifications
provided in the configuration file.
Empty lines, initial and trailing white-space, and all characters on lines starting at the
hash-mark (#) are ignored and may be used anywhere in analysis files.
Lines not conforming to the above description result in error messages, causing simrisc to
end.
Filename specified in Analysis: sections may start with a tilde character (~) which is
replaced by the user’s home directory, or they may start with an initial + character,
which is replaced by the program’s base directory (see option base). When an analysis
performs multiple iterations then `$’ characters in filename specifications are replaced
by the analysis’ interation index.
Multiple analysis sections should not specify identically named output files, as the
output files are (re)written for each separate analysis.
Analysis sections are commonly used to alter the default specifications of the
configuration file. E.g., the default number of iterations equals 1. By specifying
Scenario:
iterations: 3
the analysis performs 3 iterations.
Parameters are either read from the configuration file or they are redefined in Analysis:
sections. E.g., in de provided configuration file screening rounds use two-year intervals
between the ages of 50 and 74. To use screening rounds using 5-year intervals, between
ages 50 and 65, then an Analysis: specification could be, e.g.,
Screening:
round: 50 Mammo MRI
round: 55 Mammo MRI
round: 60 Mammo MRI
round: 65 Mammo MRI
When the --one-analysis option is used parameters are modified by providing
comma-separated parameter specifications as program command-line arguments. E.g., to
perform one analysis, writing the data file to /tmp/data, simulating 1000 cases, and using
20 as seed for the random number generator the command
simrisc -D /tmp/data -o Scenario:, cases: 1000, seed: 20
can be used. Note that when using the one-analysis option parameter section names must
precede parameter specifications. E.g., since the parameters cases and seed are defined in
the `Scenario’ section (cf. simriscparams(7)) they must be preceded by the Scenario:
specification.
When an Analysis: specification modifies parameters, then subsequent Analysis: sections
start from the unmodified option and parameter specifications.
Here is an example of an analysis file specifying two analyses:
Analysis:
base: 1
cancer: male
parameters: +params.txt
Scenario:
cases: 10
Screening:
round: 50 CT
round: 55 CT
Analysis:
base: 2
config: ~/src/simrisc/stdconfig/lung
parameters: +params.txt
cancer: breast
Scenario:
cases: 20
spread: true
Screening:
round: 50 Mammo MRI
round: 55 Mammo MRI
round: 60 Mammo MRI
round: 65 Mammo MRI
OUTPUT
The first lines of the generated files contain time stamps showing the date and time when
the files were written and the used SimRisc version. Here is an example, following the RFC
2822 format for the timestamp:
Mon, 14 Nov 2022 15:30:26 +0100 (SimRisc V. 15.00.00)
If label: lines are used then the time stamp is followed by the label specifications,
which is then followed by an empty line. After this header the file’s specific data are
shown.
The data in all files (except for the file listing the actually used parameters (option
--parameters (P))) are written using the standard comma-separated format (cf. RFC 4180).
The initial lines contain table headings and column labels documenting the meanings of the
various columns. Likewise there is a final line ending the tables.
Data of simulated cases
For each simulated case the values of the following variables are written to file (one
line of comma-separated values per simulated case):
o case: the (0-based) case-index;
o cause of death: either Natural or Tumor;
o death age: the case’s age of death;
o natural death age: the case’s natural age of death (if no tumor occurs);
o death status: a numeric index specifying how and at what stage the case died:
1: natural death in the pre-screening phase,
2: natural death in the screening phase,
3: natural death in the post-screening phase,
4: tumor caused death in the pre-screening phase,
5: tumor caused death in the screening phase,
6: tumor caused death in the post-screening phase;
o tumor present: Yes if the simulation resulted in a tumor, No if no tumor occurred;
o tumor detected: Yes if the tumor was detected, No if not;
o interval tumor: Yes if the tumor was an interval tumor, No if not;
o tumor diameter: the tumor’s diameter in mm when it was detected. 0.00 is shown if
no tumor occurred. In the exceptional case where the simulation produced a tumor
whose diameter exceeded 1000 mm the value 1001 is shown.
o tumor doubling days: the time (in days) it takes for the tumor to double its size;
o tumor preclinical period: the age at which the tumor is potentially detectible by
screening;
o tumor onset age: the age at which the tumor first occurred;
o tumor self-detect age: the age at which the tumor was self-detected. This age is
the result of the simulation, and may exceed the case’s actual death age (if so,
the case’s data report that no tumor is present);
o tumor death age: the age at which the tumor caused or would have caused he case’s
death. The simulation process uses ages ranging from 0 through 100. If the age at
which the tumor causes the case’s death exceeds 100, then 100.00 is reported;
o costs: the case’s screening and (if appliccable) treatment costs;
o self-detection indicator: 1 if the tumor was self-detected, 0 if not (also if
there’s no tumor);
o detection round: 0-based round index at which the tumor was detected (or 1) if the
tumor was self-detected, 0 if not (also if there’s no tumor).
o screening rounds: this column contains show which screening rounds were attended by
the simulated cases, and if so whether false negative or false positive diagnoses
were made. The following digits are used:
o 0: the case did not attend this screening round;
o 1: the case did attend this screening round;
o 2: the case did attend this screening round, resulting in a false negative
diagnosis;
o 3: the case did attend this screening round, resulting in a false positive
diagnosis. There are as many digits as screening rounds. The leftmost digit refers
to the first screening round, the rightmost digit to the last screening round.
E.g., using 12 screening rounds the following indicators could be obtained:
0011311110000
Using screening round indices (which are also used to refer to rounds in the
rounds-$.txt files), this case did not attent screening rounds 0, 1, 9, 10, 11 and
12, and at 4 a false positive diagnosis was obtained. Note that the screening round
indices start at 0: the first screening round is indicated by index 0.
Actually used spread-values
When spread: true is specified then by default the actually used and orgiginal parameter
values are written to the file spread-$.txt, where $ is replaced by the loop’s iteration
index. Here is a sample from the content of such a file, showing the values of the Tumor:
DoublingTime: agegroups parameters:
Tumor:
DoublingTime
ageGroup: 1 - 50 configured: 4.38, using: 3.41972
ageGroup: 50 - 70 configured: 5.06, using: 4.83591
ageGroup: 70 - * configured: 5.24, using: 5.30492
o ~/.config/simrisc: the default location of the program’s configuration file;
o the simrisc distribution archive contains the default configuration file as
simrisc-VERSION/stdconfig/simrisc, where VERSION is replaced by simrisc’s actual
release version;
o when installing simrisc using Linux distribution archives (e.g., .deb files) the
default configuration file is commonly available as
/usr/shared/doc/simrisc/simrisc.gz
SEE ALSO
simriscparams(7)
COPYRIGHT
This is free software, distributed under the terms of the GNU General Public License
(GPL).
AUTHOR
Frank B. Brokken (f.b.brokken@rug.nl),