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Evaluating the PCPT risk calculator in ten international biopsy cohorts : Results from the Prostate Biopsy Collaborative Group

Ankerst, Donna P. ; Boeck, Andreas ; Freedland, Stephen J. ; Thompson, Ian M. ; Cronin, Angel M. ; Roobol, Monique J. ; Hugosson, Jonas ; Jones, J. Stephen ; Kattan, Michael W. and Klein, Eric A. , et al. (2012) In World Journal of Urology 30(2). p.181-187
Abstract

Objectives: To evaluate the discrimination, calibration, and net benefit performance of the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) across five European randomized study of screening for prostate cancer (ERSPC), 1 United Kingdom, 1 Austrian, and 3 US biopsy cohorts. Methods: PCPTRC risks were calculated for 25,733 biopsies using prostate-specific antigen (PSA), digital rectal examination, family history, history of prior biopsy, and imputation for missing covariates. Predictions were evaluated using the areas underneath the receiver operating characteristic curves (AUC), discrimination slopes, chi-square tests of goodness of fit, and net benefit decision curves. Results: AUCs of the PCPTRC ranged from a low of 56% in... (More)

Objectives: To evaluate the discrimination, calibration, and net benefit performance of the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) across five European randomized study of screening for prostate cancer (ERSPC), 1 United Kingdom, 1 Austrian, and 3 US biopsy cohorts. Methods: PCPTRC risks were calculated for 25,733 biopsies using prostate-specific antigen (PSA), digital rectal examination, family history, history of prior biopsy, and imputation for missing covariates. Predictions were evaluated using the areas underneath the receiver operating characteristic curves (AUC), discrimination slopes, chi-square tests of goodness of fit, and net benefit decision curves. Results: AUCs of the PCPTRC ranged from a low of 56% in the ERSPC Goeteborg Rounds 2-6 cohort to a high of 72% in the ERSPC Goeteborg Round 1 cohort and were statistically significantly higher than that of PSA in 6 out of the 10 cohorts. The PCPTRC was well calibrated in the SABOR, Tyrol, and Durham cohorts. There was limited to no net benefit to using the PCPTRC for biopsy referral compared to biopsying all or no men in all five ERSPC cohorts and benefit within a limited range of risk thresholds in all other cohorts. Conclusions: External validation of the PCPTRC across ten cohorts revealed varying degree of success highly dependent on the cohort, most likely due to different criteria for and work-up before biopsy. Future validation studies of new calculators for prostate cancer should acknowledge the potential impact of the specific cohort studied when reporting successful versus failed validation.

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publishing date
type
Contribution to journal
publication status
published
keywords
Calibration, Net benefit, Receiver operating characteristic curve, Risk, prostate cancer
in
World Journal of Urology
volume
30
issue
2
pages
181 - 187
publisher
Springer
external identifiers
  • pmid:22210512
  • scopus:84859441040
ISSN
0724-4983
DOI
10.1007/s00345-011-0818-5
language
English
LU publication?
no
id
91dc7b79-b066-4c36-9e25-9b582cf275be
date added to LUP
2022-12-06 15:26:26
date last changed
2024-04-18 16:02:35
@article{91dc7b79-b066-4c36-9e25-9b582cf275be,
  abstract     = {{<p>Objectives: To evaluate the discrimination, calibration, and net benefit performance of the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) across five European randomized study of screening for prostate cancer (ERSPC), 1 United Kingdom, 1 Austrian, and 3 US biopsy cohorts. Methods: PCPTRC risks were calculated for 25,733 biopsies using prostate-specific antigen (PSA), digital rectal examination, family history, history of prior biopsy, and imputation for missing covariates. Predictions were evaluated using the areas underneath the receiver operating characteristic curves (AUC), discrimination slopes, chi-square tests of goodness of fit, and net benefit decision curves. Results: AUCs of the PCPTRC ranged from a low of 56% in the ERSPC Goeteborg Rounds 2-6 cohort to a high of 72% in the ERSPC Goeteborg Round 1 cohort and were statistically significantly higher than that of PSA in 6 out of the 10 cohorts. The PCPTRC was well calibrated in the SABOR, Tyrol, and Durham cohorts. There was limited to no net benefit to using the PCPTRC for biopsy referral compared to biopsying all or no men in all five ERSPC cohorts and benefit within a limited range of risk thresholds in all other cohorts. Conclusions: External validation of the PCPTRC across ten cohorts revealed varying degree of success highly dependent on the cohort, most likely due to different criteria for and work-up before biopsy. Future validation studies of new calculators for prostate cancer should acknowledge the potential impact of the specific cohort studied when reporting successful versus failed validation.</p>}},
  author       = {{Ankerst, Donna P. and Boeck, Andreas and Freedland, Stephen J. and Thompson, Ian M. and Cronin, Angel M. and Roobol, Monique J. and Hugosson, Jonas and Jones, J. Stephen and Kattan, Michael W. and Klein, Eric A. and Hamdy, Freddie and Neal, David and Donovan, Jenny and Parekh, Dipen J. and Klocker, Helmut and Horninger, Wolfgang and Benchikh, Amine and Salama, Gilles and Villers, Arnauld and Moreira, Daniel M. and Schröder, Fritz H. and Lilja, Hans and Vickers, Andrew J.}},
  issn         = {{0724-4983}},
  keywords     = {{Calibration; Net benefit; Receiver operating characteristic curve; Risk, prostate cancer}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{181--187}},
  publisher    = {{Springer}},
  series       = {{World Journal of Urology}},
  title        = {{Evaluating the PCPT risk calculator in ten international biopsy cohorts : Results from the Prostate Biopsy Collaborative Group}},
  url          = {{http://dx.doi.org/10.1007/s00345-011-0818-5}},
  doi          = {{10.1007/s00345-011-0818-5}},
  volume       = {{30}},
  year         = {{2012}},
}