External validation of the Prostate Cancer Prevention Trial and the European Randomized Study of Screening for Prostate Cancer risk calculators in a Chinese cohort
Several prediction models have been developed to estimate the outcomes of prostate biopsies. Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention T...
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| Veröffentlicht in: | Asian journal of andrology 2012-09, Vol.14 (5), p.738-744 |
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| container_title | Asian journal of andrology |
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| creator | Zhu, Yao Wang, Jin-You Shen, Yi-Jun Dai, Bo Ma, Chun-Guang Xiao, Wen-Jun Lin, Guo-Wen Yao, Xu-Dong Zhang, Shi-Lin Ye, Ding-Wei |
| description | Several prediction models have been developed to estimate the outcomes of prostate biopsies. Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention Trial （PCPT） and the European Randomized Study of Screening for Prostate Cancer （ERSPC） risk calculators in a Chinese cohort. Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011. The estimated probabilities of prostate cancer and high-grade disease （Gleason 〉6） were calculated using the PCPT and ERSPC risk calculators. Overall measures, discrimination, calibration and clinical usefulness were assessed for the model evaluation. Of these patients, 28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease. Compared to the PCPT model and the prostate-specific antigen （PSA） threshold of 4 ng m1-1, the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease （the area under the curve was 0.831 and 0.852, respectively, P〈O.01 for both）. Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset. Both prediction models demonstrated miscalibration： the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities. In conclusion, the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml- z in predicting prostate cancer and high-grade disease in Chinese patients. However, the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort. |
| doi_str_mv | 10.1038/aja.2012.28 |
| format | Article |
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Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention Trial （PCPT） and the European Randomized Study of Screening for Prostate Cancer （ERSPC） risk calculators in a Chinese cohort. Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011. The estimated probabilities of prostate cancer and high-grade disease （Gleason 〉6） were calculated using the PCPT and ERSPC risk calculators. Overall measures, discrimination, calibration and clinical usefulness were assessed for the model evaluation. Of these patients, 28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease. Compared to the PCPT model and the prostate-specific antigen （PSA） threshold of 4 ng m1-1, the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease （the area under the curve was 0.831 and 0.852, respectively, P〈O.01 for both）. Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset. Both prediction models demonstrated miscalibration： the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities. In conclusion, the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml- z in predicting prostate cancer and high-grade disease in Chinese patients. However, the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort.</description><identifier>ISSN: 1008-682X</identifier><identifier>EISSN: 1745-7262</identifier><identifier>DOI: 10.1038/aja.2012.28</identifier><identifier>PMID: 22561907</identifier><language>eng</language><publisher>China: Medknow Publications & Media Pvt. Ltd</publisher><subject>Aged ; Biopsy ; China ; Cohort Studies ; Discrimination ; Ethnic Groups ; Humans ; Male ; Mass Screening ; Middle Aged ; Original ; Prediction ; Prediction models ; Prevention ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - prevention & control ; Risk Factors ; 中国 ; 前列腺癌 ; 筛查 ; 计算器 ; 队列研究 ; 随机 ; 预防试验 ; 风险</subject><ispartof>Asian journal of andrology, 2012-09, Vol.14 (5), p.738-744</ispartof><rights>Copyright Nature Publishing Group Sep 2012</rights><rights>Copyright © 2012 SIMM & SJTU 2012 SIMM & SJTU</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-424f581a8fb508925a20981086451937e0a5aa78b059b1ee06052b61461aa2a13</citedby><cites>FETCH-LOGICAL-c468t-424f581a8fb508925a20981086451937e0a5aa78b059b1ee06052b61461aa2a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/84127X/84127X.jpg</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734979/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734979/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22561907$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Yao</creatorcontrib><creatorcontrib>Wang, Jin-You</creatorcontrib><creatorcontrib>Shen, Yi-Jun</creatorcontrib><creatorcontrib>Dai, Bo</creatorcontrib><creatorcontrib>Ma, Chun-Guang</creatorcontrib><creatorcontrib>Xiao, Wen-Jun</creatorcontrib><creatorcontrib>Lin, Guo-Wen</creatorcontrib><creatorcontrib>Yao, Xu-Dong</creatorcontrib><creatorcontrib>Zhang, Shi-Lin</creatorcontrib><creatorcontrib>Ye, Ding-Wei</creatorcontrib><title>External validation of the Prostate Cancer Prevention Trial and the European Randomized Study of Screening for Prostate Cancer risk calculators in a Chinese cohort</title><title>Asian journal of andrology</title><addtitle>Asian Journal of Andrology</addtitle><description>Several prediction models have been developed to estimate the outcomes of prostate biopsies. Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention Trial （PCPT） and the European Randomized Study of Screening for Prostate Cancer （ERSPC） risk calculators in a Chinese cohort. Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011. The estimated probabilities of prostate cancer and high-grade disease （Gleason 〉6） were calculated using the PCPT and ERSPC risk calculators. Overall measures, discrimination, calibration and clinical usefulness were assessed for the model evaluation. Of these patients, 28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease. Compared to the PCPT model and the prostate-specific antigen （PSA） threshold of 4 ng m1-1, the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease （the area under the curve was 0.831 and 0.852, respectively, P〈O.01 for both）. Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset. Both prediction models demonstrated miscalibration： the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities. In conclusion, the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml- z in predicting prostate cancer and high-grade disease in Chinese patients. However, the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort.</description><subject>Aged</subject><subject>Biopsy</subject><subject>China</subject><subject>Cohort Studies</subject><subject>Discrimination</subject><subject>Ethnic Groups</subject><subject>Humans</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Prediction</subject><subject>Prediction models</subject><subject>Prevention</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - prevention & control</subject><subject>Risk Factors</subject><subject>中国</subject><subject>前列腺癌</subject><subject>筛查</subject><subject>计算器</subject><subject>队列研究</subject><subject>随机</subject><subject>预防试验</subject><subject>风险</subject><issn>1008-682X</issn><issn>1745-7262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkkuP0zAURiMEYh6wYo-M2IyEUvyKY2-QUFUe0kggZpDYRTfJTeOS2h07qRj-Dn8Ut1MqHhtWfh0f-fp-WfaE0RmjQr-EFcw4ZXzG9b3slJWyyEuu-P00p1TnSvMvJ9lZjCtKuWDGPMxOOC8UM7Q8zX4svo0YHAxkC4NtYbTeEd-RsUfyMfg4wohkDq7BkNa4RbcnroNNV8C1e3AxBb9BcORT2vFr-x1bcjVO7e3OdNUERGfdknQ-_OMMNn4lDQzNNMDoQyTWESDz3jqMSBrf-zA-yh50MER8fBjPs89vFtfzd_nlh7fv568v80YqPeaSy67QDHRXF1QbXgCnRjOqlSyYESVSKABKXdPC1AyRKlrwWjGpGAAHJs6zV3fezVSvsW1SrQGGahPsGsJt5cFWf54421dLv61EKaQpTRJcHATB30wYx2ptY4PDAA79FCtGjZBSMFn8Byo0VSYVkNDnf6ErP-1atqdKpUqtd8IXd1STfjgG7I7vZnRvq1JOql1OKr5zPv291CP7KxgJeHbQ9d4tb1L7jowUgpcpR-IngbjFcw</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Zhu, Yao</creator><creator>Wang, Jin-You</creator><creator>Shen, Yi-Jun</creator><creator>Dai, Bo</creator><creator>Ma, Chun-Guang</creator><creator>Xiao, Wen-Jun</creator><creator>Lin, Guo-Wen</creator><creator>Yao, Xu-Dong</creator><creator>Zhang, Shi-Lin</creator><creator>Ye, Ding-Wei</creator><general>Medknow Publications & Media Pvt. 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Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention Trial （PCPT） and the European Randomized Study of Screening for Prostate Cancer （ERSPC） risk calculators in a Chinese cohort. Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011. The estimated probabilities of prostate cancer and high-grade disease （Gleason 〉6） were calculated using the PCPT and ERSPC risk calculators. Overall measures, discrimination, calibration and clinical usefulness were assessed for the model evaluation. Of these patients, 28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease. Compared to the PCPT model and the prostate-specific antigen （PSA） threshold of 4 ng m1-1, the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease （the area under the curve was 0.831 and 0.852, respectively, P〈O.01 for both）. Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset. Both prediction models demonstrated miscalibration： the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities. In conclusion, the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml- z in predicting prostate cancer and high-grade disease in Chinese patients. However, the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort.</abstract><cop>China</cop><pub>Medknow Publications & Media Pvt. Ltd</pub><pmid>22561907</pmid><doi>10.1038/aja.2012.28</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biopsy China Cohort Studies Discrimination Ethnic Groups Humans Male Mass Screening Middle Aged Original Prediction Prediction models Prevention Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - diagnosis Prostatic Neoplasms - pathology Prostatic Neoplasms - prevention & control Risk Factors 中国 前列腺癌 筛查 计算器 队列研究 随机 预防试验 风险 |
| title | External validation of the Prostate Cancer Prevention Trial and the European Randomized Study of Screening for Prostate Cancer risk calculators in a Chinese cohort |
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