Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA
Introduction Risk calculators (RCs) are easy-to-use tools considering available clinical variables that could help to select those patients with risk of prostate cancer (PCa) who should undergo a prostate biopsy.Objective To perform a comparison for the prediction of significant PCa (SigPCa) between...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e031032.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850221103971041280 |
|---|---|
| author | Enrique Gomez Gomez Juan José Salamanca Bustos Julia Carrasco Valiente Jose Luis Fernandez Rueda Ana Blanca José Valero Rosa Ines Bravo Arrebola Javier Marquez López Juan Manuel Jimenez Vacas Maria José Requena Tapia Raul Miguel Luque |
| author_facet | Enrique Gomez Gomez Juan José Salamanca Bustos Julia Carrasco Valiente Jose Luis Fernandez Rueda Ana Blanca José Valero Rosa Ines Bravo Arrebola Javier Marquez López Juan Manuel Jimenez Vacas Maria José Requena Tapia Raul Miguel Luque |
| author_sort | Enrique Gomez Gomez |
| collection | DOAJ |
| description | Introduction Risk calculators (RCs) are easy-to-use tools considering available clinical variables that could help to select those patients with risk of prostate cancer (PCa) who should undergo a prostate biopsy.Objective To perform a comparison for the prediction of significant PCa (SigPCa) between the European Randomised Study of Screening for PCa (ERSPC) and the PCa Prevention Trial (PCPT) RCs in patients with prostate-specific antigen (PSA) between 3 and 10 ng/mL through an evaluation of the accuracy/variability between two consecutive PSA values.Setting An observational study in a major university hospital in the south of Spain.Methods and participants An observational study was performed in patients who underwent a prostate biopsy. SigPCa probabilities were calculated with the two PSA measures using ERSPC3/4+digital rectal examination and PCPT v2+free PSA RCs. The prediction of SigPCa was determined by the area under the receiver operating characteristic curve (AUC). Calibration, discrimination and decision curve analysis were studied. The variability between both RCs’ agreement was compared using Cohen’s kappa coefficient.Results 510 patients were analysed (87 diagnosed with SigPCa). The median PSA values were 5.3 and 5 ng/mL for PSA1 and PSA2, respectively. Both RCs overestimated the risk in the case of high-risk probabilities. Discriminative ability for SigPCa was similar between models with an AUC=0.73 (0.68–0.79) for ERSPC-RC versus 0.73 (0.67–0.79) for PCPT-RC. ERSPC-RC showed less variability than PCPT-RC, with a constant agreement (k=0.7–0.8) for usual range of clinical decision-making. Remarkably, a higher number of biopsies would be avoided using the ERSPC-RC, but more SigPCa would be missed along all the risk probabilities.Conclusions Both RCs performed similar in the prediction of SigPCa. However, ERSPC-RC seems to be more stable for intraindividual PSA variations. |
| format | Article |
| id | doaj-art-8f37ff77a0de4a6c8882b3e28f99ad72 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-8f37ff77a0de4a6c8882b3e28f99ad722025-08-20T02:06:49ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-031032Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSAEnrique Gomez Gomez0Juan José Salamanca Bustos1Julia Carrasco Valiente2Jose Luis Fernandez Rueda3Ana Blanca4José Valero Rosa5Ines Bravo Arrebola6Javier Marquez López7Juan Manuel Jimenez Vacas8Maria José Requena Tapia9Raul Miguel Luque102 Genitourinary Diseases, Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain1 Urology, Hospital Universitario Reina Sofia, Cordoba, Spain1 Urology, Hospital Universitario Reina Sofia, Cordoba, Spain3 Innovation and Methodology, Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain2 Genitourinary Diseases, Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain1 Urology, Hospital Universitario Reina Sofia, Cordoba, Spain1 Urology, Hospital Universitario Reina Sofia, Cordoba, Spain1 Urology, Hospital Universitario Reina Sofia, Cordoba, Spain4 Oncobesity and Metabolism, Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain1 Urology, Hospital Universitario Reina Sofia, Cordoba, Spain4 Oncobesity and Metabolism, Maimonides Institute for Biomedical Research of Cordoba, Cordoba, SpainIntroduction Risk calculators (RCs) are easy-to-use tools considering available clinical variables that could help to select those patients with risk of prostate cancer (PCa) who should undergo a prostate biopsy.Objective To perform a comparison for the prediction of significant PCa (SigPCa) between the European Randomised Study of Screening for PCa (ERSPC) and the PCa Prevention Trial (PCPT) RCs in patients with prostate-specific antigen (PSA) between 3 and 10 ng/mL through an evaluation of the accuracy/variability between two consecutive PSA values.Setting An observational study in a major university hospital in the south of Spain.Methods and participants An observational study was performed in patients who underwent a prostate biopsy. SigPCa probabilities were calculated with the two PSA measures using ERSPC3/4+digital rectal examination and PCPT v2+free PSA RCs. The prediction of SigPCa was determined by the area under the receiver operating characteristic curve (AUC). Calibration, discrimination and decision curve analysis were studied. The variability between both RCs’ agreement was compared using Cohen’s kappa coefficient.Results 510 patients were analysed (87 diagnosed with SigPCa). The median PSA values were 5.3 and 5 ng/mL for PSA1 and PSA2, respectively. Both RCs overestimated the risk in the case of high-risk probabilities. Discriminative ability for SigPCa was similar between models with an AUC=0.73 (0.68–0.79) for ERSPC-RC versus 0.73 (0.67–0.79) for PCPT-RC. ERSPC-RC showed less variability than PCPT-RC, with a constant agreement (k=0.7–0.8) for usual range of clinical decision-making. Remarkably, a higher number of biopsies would be avoided using the ERSPC-RC, but more SigPCa would be missed along all the risk probabilities.Conclusions Both RCs performed similar in the prediction of SigPCa. However, ERSPC-RC seems to be more stable for intraindividual PSA variations.https://bmjopen.bmj.com/content/9/11/e031032.full |
| spellingShingle | Enrique Gomez Gomez Juan José Salamanca Bustos Julia Carrasco Valiente Jose Luis Fernandez Rueda Ana Blanca José Valero Rosa Ines Bravo Arrebola Javier Marquez López Juan Manuel Jimenez Vacas Maria José Requena Tapia Raul Miguel Luque Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA BMJ Open |
| title | Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA |
| title_full | Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA |
| title_fullStr | Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA |
| title_full_unstemmed | Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA |
| title_short | Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA |
| title_sort | observational study comparing the accuracy variability between the erspc and the pcpt risk calculators for the prediction of significant prostate cancer in patients with psa |
| url | https://bmjopen.bmj.com/content/9/11/e031032.full |
| work_keys_str_mv | AT enriquegomezgomez observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT juanjosesalamancabustos observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT juliacarrascovaliente observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT joseluisfernandezrueda observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT anablanca observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT josevalerorosa observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT inesbravoarrebola observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT javiermarquezlopez observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT juanmanueljimenezvacas observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT mariajoserequenatapia observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa AT raulmiguelluque observationalstudycomparingtheaccuracyvariabilitybetweentheerspcandthepcptriskcalculatorsforthepredictionofsignificantprostatecancerinpatientswithpsa |