Evaluating the PCPT risk calculator in ten international biopsy cohorts

Results from the Prostate Biopsy Collaborative Group

Donna P. Ankerst, Andreas Boeck, Stephen J. Freedland, Ian M. Thompson, Angel M. Cronin, Monique J. Roobol, Jonas Hugosson, J. Stephen Jones, Michael W. Kattan, Eric A. Klein, Freddie Hamdy, David Neal, Jenny Donovan, Dipen J Parekh, Helmut Klocker, Wolfgang Horninger, Amine Benchikh, Gilles Salama, Arnauld Villers, Daniel M. Moreira & 3 others Fritz H. Schröder, Hans Lilja, Andrew J. Vickers

Research output: Contribution to journalArticle

45 Citations (Scopus)

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 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.

Original languageEnglish
Pages (from-to)181-187
Number of pages7
JournalWorld Journal of Urology
Volume30
Issue number2
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

Fingerprint

Prostate
Prostatic Neoplasms
Biopsy
Prostate-Specific Antigen
Area Under Curve
Digital Rectal Examination
Validation Studies
Chi-Square Distribution
ROC Curve
Calibration
Referral and Consultation

Keywords

  • Calibration
  • Net benefit
  • Receiver operating characteristic curve
  • Risk, prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

Ankerst, D. P., Boeck, A., Freedland, S. J., Thompson, I. M., Cronin, A. M., Roobol, M. J., ... Vickers, A. J. (2012). Evaluating the PCPT risk calculator in ten international biopsy cohorts: Results from the Prostate Biopsy Collaborative Group. World Journal of Urology, 30(2), 181-187. https://doi.org/10.1007/s00345-011-0818-5

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.; Klein, Eric A.; Hamdy, Freddie; Neal, David; Donovan, Jenny; Parekh, Dipen J; Klocker, Helmut; Horninger, Wolfgang; Benchikh, Amine; Salama, Gilles; Villers, Arnauld; Moreira, Daniel M.; Schröder, Fritz H.; Lilja, Hans; Vickers, Andrew J.

In: World Journal of Urology, Vol. 30, No. 2, 01.04.2012, p. 181-187.

Research output: Contribution to journalArticle

Ankerst, DP, Boeck, A, Freedland, SJ, Thompson, IM, Cronin, AM, Roobol, MJ, Hugosson, J, Jones, JS, Kattan, MW, Klein, EA, Hamdy, F, Neal, D, Donovan, J, Parekh, DJ, Klocker, H, Horninger, W, Benchikh, A, Salama, G, Villers, A, Moreira, DM, Schröder, FH, Lilja, H & Vickers, AJ 2012, 'Evaluating the PCPT risk calculator in ten international biopsy cohorts: Results from the Prostate Biopsy Collaborative Group', World Journal of Urology, vol. 30, no. 2, pp. 181-187. https://doi.org/10.1007/s00345-011-0818-5
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. ; Klein, Eric A. ; Hamdy, Freddie ; Neal, David ; Donovan, Jenny ; Parekh, Dipen J ; Klocker, Helmut ; Horninger, Wolfgang ; Benchikh, Amine ; Salama, Gilles ; Villers, Arnauld ; Moreira, Daniel M. ; Schröder, Fritz H. ; Lilja, Hans ; Vickers, Andrew J. / Evaluating the PCPT risk calculator in ten international biopsy cohorts : Results from the Prostate Biopsy Collaborative Group. In: World Journal of Urology. 2012 ; Vol. 30, No. 2. pp. 181-187.
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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 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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AU - Ankerst, Donna P.

AU - Boeck, Andreas

AU - Freedland, Stephen J.

AU - Thompson, Ian M.

AU - Cronin, Angel M.

AU - Roobol, Monique J.

AU - Hugosson, Jonas

AU - Jones, J. Stephen

AU - Kattan, Michael W.

AU - Klein, Eric A.

AU - Hamdy, Freddie

AU - Neal, David

AU - Donovan, Jenny

AU - Parekh, Dipen J

AU - Klocker, Helmut

AU - Horninger, Wolfgang

AU - Benchikh, Amine

AU - Salama, Gilles

AU - Villers, Arnauld

AU - Moreira, Daniel M.

AU - Schröder, Fritz H.

AU - Lilja, Hans

AU - Vickers, Andrew J.

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N2 - 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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KW - Calibration

KW - Net benefit

KW - Receiver operating characteristic curve

KW - Risk, prostate cancer

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