Mark Clements

Mark Clements

Senior Lecturer | Docent
Telephone: +46852482023
Visiting address: ,
Postal address: C8 Medicinsk epidemiologi och biostatistik, C8 MEB II Clements, 171 77 Stockholm
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About me

  • I am a docent and associate professor in biostatistics. I have worked as a biostatistician in Sweden, Australia, New Zealand and the United Kingdom, including positions in academia and in government. 

    I am currently a member of the Management Group for the Swedish eScience Research Centre and co-leader for eScience Methods for Precision Health (eMPHasis) project. I am also a member of the Steering Group for the KI Epidemiology Doctoral Program.

    My research group includes a mix of biostatistics (x4), health economists (x3) and epidemiologists (x3).

    Education

    • 1991, BSc (Hons) in Mathematics and Statistics, University of Auckland
    • 2001, PhD in Biostatistics and Cancer Epidemiology, University of Sydney
    • 2021, Docent in Biostatistics, Karolinska Institutet.

    Grants

    I have received generous financial support as the principal investigator from Cancerfonden, the Swedish Research Council, Prostatacancerförbundet, ALF and KI.

    Current primary PhD supervision

    • Birzhan Akynkozhayev
    • Xiaoyang Du
    • Balram Rai

    Previous primary PhD supervision

    • Andreas Karlsson
    • Xingrong Liu
    • Shuang Hao

    I have also co-supervised 13 other PhDs.

Research

Teaching

Articles

All other publications

Grants

  • Swedish Research Council
    1 January 2026 - 31 December 2029
    Our general aim is to use evidence-based modelling and simulation to reduce the burden due to cancer through effective and cost-effective prostate cancer screening. The Swedish government is currently investigating whether to introduce organised prostate cancer testing (OPT). However, policy makers lack key evidence on the long-term effectiveness and cost-effectiveness of organised testing compared with current opportunistic testing. We will combine the available trials evidence with simulation models to predict the long-term outcomes of a range of prostate cancer testing strategies. The specific aims are to:Measure health-related quality of life and health anxiety for men undergoing prostate cancer screening and diagnostics.Extend an existing prostate cancer screening model to represent opportunistic and organised testing.Evaluate novel prostate cancer screening tests and diagnostics, including a polygenic risk score, artificial intelligence as a dual rater for prostate pathology, and risk predictions based on screening history.Predict whether OPT will increase socio-economic inequalities in prostate cancer outcomes compared with current inequalities.Predict the long-term effectiveness and cost-effectiveness of OPT compared with current testing.These aims will support the decision on whether and how to introduce organised prostate cancer testing in Sweden and other European countries.
  • Swedish Research Council
    1 December 2024 - 30 November 2028
    Sweden has numerous linkable registers which are a goldmine for research in the medical and social sciences. However, as increasingly more complex research questions are being addressed, there are challenges to correctly and efficiently analyse such data, and further methods development is needed. We aim to develop and apply methods for register-based research that are relevant for a wide range of settings. We also aim to transfer new methodology to subject-matter scientists and train the next generation of biostatistical scientists. The long-term goal is to leverage the rich information within the registers for the benefit of patients, policy-makers and society. Specifically, we will develop, evaluate and apply methods for:1. Missing data in registers2. Causal mediation analysis3. Policy-relevant complex disease models and lifetime outcomes in health economics 4. Federated analyses and synthetic data to share information.Our proposal focuses on the development of statistical methods, but each aim is motivated by real problems in medicine and social science, e.g. improving cancer screening, understanding causal mechanisms for social inequalities in cancer survival, time trends in disease incidence trends and situations when individual-level data cannot cross borders. Our team of biostatistical scientists will work in close collaboration with an extended network of Swedish and Nordic register holders, epidemiologists, clinical and social scientists, and relevant stakeholders.
  • Swedish Research Council
    1 January 2023 - 31 December 2025
  • Swedish Research Council
    1 January 2023 - 31 December 2025
  • Swedish Cancer Society
    1 January 2022
    Prostate cancer is the most common cancer among men in Sweden. Screening using a prostate-specific antigen (PSA) test may lead to fewer deaths from prostate cancer, but also to more men being diagnosed with prostate cancer that may not be life-threatening. Cervical cancer is the fourth most common cancer among women globally. The cervical cancer screening program has reduced the number of cases of cervical cancer in Sweden. In addition, school-based vaccinations are expected to further reduce the number of cancer cases. Our overall goal is to use health economic models to reduce the impact on society and the individual due to cancer through cost-effective cancer screening. For prostate cancer, new and more accurate tests are expected to reduce harm while maintaining the benefits of early detection. For cervical cancer, more accurate testing and screening-based vaccination would further reduce the incidence of cervical cancer. The fundamental question is: How should a cancer screening program be planned? We will tackle these questions by developing evidence-based simulation models that can help policy makers make policy decisions. To show how harm from prostate cancer testing can be reduced and to achieve the goal of eradicating cervical cancer through screening based on risk selection and screening-based vaccination. For Sweden, our research can be used for evaluation of ongoing pilot tests of systematic prostate cancer screening and contribute to the development of guidelines for cervical cancer screening. Policy reforms and increasing health care costs are driving the demands for efficient allocation of cancer care resources through evidence-based decision making. We propose that interdisciplinary tools and concepts be used to improve existing cancer care.
  • Swedish Research Council
    1 January 2019 - 31 December 2022
  • Cost-effectiveness in screening for limo neck and prostate cancer.
    Swedish Cancer Society
    1 January 2018
    Prostate cancer is the most common form of cancer and the leading cause of cancer mortality among men in Sweden. A recent review of the new prostate cancer tests by SBU not convincingly the National Board of Health and Welfare which concluded that sufficient evidence is lacking for the cost-effectiveness of the new test and further research is needed.   Cervical cancer is the fourth most common cancer among women globally. Cytology-based screening programs have markedly reduced the incidence and mortality of cervical cancer in industrialized countries. There is uncertainty about the question of how best to plan the screening for both younger and older women. How should we plan for cancer screening? The purpose is to use epidemiological models and simulations to reduce the burden due to cancer by means of cost-effective screening. New prostate cancer tests and MRI-guided biopsies should reduce the damage but retain the benefits of early detection. For cervical cancer, high participation in vaccination and testing for HPV by younger and older women can further reduce incidence and mortality.   We do this by using evidence-based models to answer practical research issues, including evaluating costs and assessing cost-effectiveness in both test programs. Experience from cervical cancer screening should help control the prostate cancer test so that it has a more functional organization with better tests, better compliance and reduced costs through risk-based screening. Political reforms and increased costs for health and medical care are a driving force so that demands for efficient allocation of resources within cancer care are taken on the basis of evidence-based research. Health economics, biostatistics and epidemiology together provide an interdisciplinary set of tools and concepts to be able to assess the value of the decisions taken to improve existing cancer care.
  • Swedish Research Council
    1 January 2018 - 31 December 2021
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2016 - 31 December 2018
  • Statistical and mathematical modeling of efficacy in prostate cancer screening.
    Swedish Cancer Society
    1 January 2014
    Prostate cancer is the most common form of cancer among men and one of the highest mortality forms. Although there is information indicating that screening with a prostate-specific antigen (PSA) may cause fewer deaths, it is unclear whether the benefits outweigh the disadvantages. There are other biomarkers that can be combined into a better test. A large study (Stockholm-3) is underway to assess whether these can maintain the safety of detection of advanced prostate cancer, while being able to work more specifically so that fewer men without cancer are referred to biopsy (tissue sampling). The project aims to use the results from Stockholm-3 and model the advantages and disadvantages of screening for prostate cancer. In the project, an existing model for prostate cancer will be expanded with these biomarkers and methods developed to analyze Stockholm-3 data to assess the effectiveness of the biomarkers. The model should be adjusted to reproduce cancer incidence and deaths in cancer for Stockholm. The adjusted model will then be used to assess long-term disadvantages and benefits with respect to different types of prostate cancer screening. The project is of importance to be able to determine how best (most efficiently) to screen for the emergence of prostate cancer, both in Sweden and internationally.

Employments

  • Senior Lecturer, Biostatistics, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 2012-

Degrees and Education

  • Docent, Karolinska Institutet, 2019

Supervision

  • Supervision to doctoral degree

    • Enoch Chen, Extrapolating survival with applications in health technology assessment, 2021-
    • Andreas Karlsson, Microsimulation modelling of prostate cancer screening in Sweden., 2019
    • Linda Abrahamsson, Statistical models of breast cancer tumour progression for mammography screening data, 2018

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