Shariat Shahrokh F, Karakiewicz Pierre I, Margulis Vitaly, Kattan Michael W
Department of Urology, University of Texas Southwestern Medical Centre, Dallas, Texas 75390-9110, USA.
Curr Opin Urol. 2008 May;18(3):279-96. doi: 10.1097/MOU.0b013e3282f9b3e5.
We created an inventory of current predictive tools available for prostate cancer. This review may serve as an initial step toward a comprehensive reference guide for physicians to locate published nomograms that apply to the clinical decision in question. Using MEDLINE a literature search was performed on prostate cancer predictive tools from January 1966 to November 2007. We describe the patient populations to which they apply and the outcomes predicted, and record their individual characteristics.
The literature search generated 111 published prediction tools that may be applied to patients in various clinical stages of disease. Of the 111 prediction tools, only 69 had undergone validation. We present an inventory of models with input variables, prediction form, number of patients used to develop the prediction tools, the outcome being predicted, prediction tool-specific features, predictive accuracy, and whether validation was performed.
Decision rules, such as nomograms, provide evidence-based and at the same time individualized predictions of the outcome of interest. Such predictions have been repeatedly shown to be more accurate than those of clinicians, regardless of their level of expertise. Accurate risk estimates are also required for clinical trial design, to ensure homogeneous high-risk patient groups for whom new cancer therapeutics will be investigated.
我们编制了一份现有的前列腺癌预测工具清单。本综述可作为迈向全面参考指南的第一步,供医生查找适用于相关临床决策的已发表列线图。利用MEDLINE对1966年1月至2007年11月间的前列腺癌预测工具进行了文献检索。我们描述了它们所适用的患者群体以及所预测的结果,并记录了它们各自的特征。
文献检索产生了111种已发表的预测工具,可应用于处于疾病不同临床阶段的患者。在这111种预测工具中,只有69种经过了验证。我们列出了一份模型清单,包括输入变量、预测形式、用于开发预测工具的患者数量、所预测的结果、预测工具的特定特征、预测准确性以及是否进行了验证。
决策规则,如列线图,可提供基于证据且同时针对感兴趣结果的个性化预测。反复证明,此类预测比临床医生的预测更准确,无论其专业水平如何。临床试验设计也需要准确的风险估计,以确保为研究新癌症治疗方法而确定的高风险患者群体具有同质性。