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Timely evaluation with minimal use of additional diagnostic testing is key to minimizing anxiety and cost. In this paper, we propose a Bayesian semi\u2010Markov model that allows for flexible, semi\u2010parametric specification of the sojourn time distributions and apply our model to an investigation of the process of diagnostic evaluation with mammography, ultrasound and biopsy following an abnormal screening mammogram. We also investigate risk factors associated with the sojourn time between diagnostic tests. By utilizing semi\u2010Markov processes, we expand on prior work that described the timing of the first test received by providing additional information such as the mean time to resolution and proportion of women with unresolved mammograms after 90\u00a0days for women requiring different sequences of tests in order to reach a definitive diagnosis. Overall, we found that older women were more likely to have unresolved positive mammograms after 90\u00a0days. Differences in the timing of imaging evaluation and biopsy were generally on the order of days and thus did not represent clinically important differences in diagnostic delay. Copyright \u00a9 2016 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/sim.7055","type":"journal-article","created":{"date-parts":[[2016,7,21]],"date-time":"2016-07-21T11:26:58Z","timestamp":1469100418000},"page":"4980-4993","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Using semi\u2010Markov processes to study timeliness and tests used in the diagnostic evaluation of suspected breast cancer"],"prefix":"10.1002","volume":"35","author":[{"given":"R. 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