Clinicians Versus Nomogram: Predicting Future Technetium-99m Bone Scan Positivity in Patients With Rising Prostate-specific Antigen After Radical Prostatectomy for Prostate Cancer - 21/04/13
, Changhong Yu a, Andrew J. Stephenson b, Oliver Sartor c, Bertrand Tombal d
Reprint requests: Michael W. Kattan, M.D., Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, 44195.Abstract |
Objective |
To compare the ability of clinicians vs a nomogram at predicting future bone scan positivity in patients with prostate cancer.
Materials and Methods |
This investigation was conducted during an advisory board meeting in June 2011. Details of 25 androgen deprivation therapy-naive prostate cancer patients were given to 24 prostate cancer experts, including urologists and oncologists. The clinicians were asked to predict the probability that the patients would have a positive bone scan if left untreated for 1 year. These predictions and those of the Slovin nomogram were compared with the actual occurrence of metastatic disease, and the discrimination ability was quantified using the concordance index (C index).
Results |
A higher C index value was obtained with the Slovin nomogram (0.812) than with the clinicians (0.628). The nomogram outperformed all of the clinicians; individual clinician C index values varied between 0.47 and 0.75. The urologists provided superior predictions compared with the oncologists.
Conclusion |
Future bone scan positivity can be predicted more accurately using a nomogram than by expert clinicians. Nomograms should, therefore, become an integral part of the clinical decision-making process in the prostate cancer setting for patients with a rising prostate-specific antigen level after radical prostatectomy.
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| Financial Disclosure: Michael W. Kattan and Oliver Sartor are consultants for Dendreon Corporation. Andrew J. Stephenson is a consultant for Amgen and Astellas and is on the speaker bureau for Amgen. Bertrand Tombal is an advisor for Dendreon Corporation. Changhong Yu has no disclosures. None of the authors received compensation related to the development of this manuscript. |
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| Funding Support: Funding was supplied by Dendreon Corporation. |
Vol 81 - N° 5
P. 956-961 - maggio 2013 Ritorno al numero
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