自我报告的前列腺癌进展状态是准确的：一项验证研究。
Self-reported Prostate Cancer Progression Status Is Accurate: A Validation Study.
机构信息
From the PCORI Washington, DC.
University of Washington School of Medicine Seattle, WA.
出版信息
Epidemiology. 2020 May;31(3):441-447. doi: 10.1097/EDE.0000000000001170.
BACKGROUND
Studies of prostate cancer progression are important for discovering risk factors that may increase the risk of prostate cancer-specific death; however, little is known about the validity of self-reported prostate cancer progression.
METHODS
We conducted a validation study of self-reported prostate cancer progression in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial and in a prostate cancer cohort enrolled in a Fred Hutchinson Cancer Research Center (FHCRC)-based study. We calculated measures of validity for self-reported progression, including sensitivity, specificity, positive predictive value, and negative predictive value using medical records as the gold standard.
RESULTS
Our results suggest that ascertaining prostate cancer progression-related events (i.e., prostate-specific antigen elevation, recurrence, metastasis, and use of secondary treatment) through self-report may be a viable option for identifying men whose disease has progressed after diagnosis or initial therapy, particularly when multiple questions related to progression are included in the assessment (aggregate cluster of questions: sensitivity = 0.76 [PLCO]; 0.93 [FHCRC], specificity = 0.80 [PLCO]; 0.97 [FHCRC]). With an aggregate positive predictive value of 0.50 (PLCO), however, our PLCO results suggest that additional medical record verification of self-reported progression events may be necessary to rule out false positives. Most individuals reporting no evidence of progression-related events, however, were true negatives (aggregate negative predictive value = 0.92 [PLCO]; 0.98 [FHCRC]). Thus, there may be limited utility to investing resources in chart review to confirm self-reported nonevents.
CONCLUSION
Ascertaining prostate cancer progression through self-report provides an efficient and valid approach to enhancing existing cancer cohorts with updated data on progression status. See video abstract at, http://links.lww.com/EDE/B658.
背景
研究前列腺癌的进展对于发现可能增加前列腺癌特异性死亡风险的因素非常重要；然而，人们对自我报告的前列腺癌进展的有效性知之甚少。
方法
我们对前列腺、肺、结直肠和卵巢（PLCO）癌症筛查试验中的自我报告的前列腺癌进展和弗雷德·哈钦森癌症研究中心（FHCRC）基于研究中招募的前列腺癌队列进行了验证研究。我们使用病历作为金标准，计算了自我报告的进展相关事件（即前列腺特异性抗原升高、复发、转移和使用二线治疗）的有效性衡量指标，包括敏感性、特异性、阳性预测值和阴性预测值。
结果
我们的研究结果表明，通过自我报告确定与前列腺癌进展相关的事件（即前列腺特异性抗原升高、复发、转移和使用二线治疗）可能是识别疾病在诊断或初始治疗后进展的男性的可行选择，特别是当评估中包含多个与进展相关的问题时（综合问题簇：PLCO 中的敏感性 = 0.76；FHCRC 中的敏感性 = 0.93，PLCO 中的特异性 = 0.80；FHCRC 中的特异性 = 0.97）。然而，我们的 PLCO 结果显示，阳性预测值为 0.50，这表明可能需要对自我报告的进展事件进行额外的病历验证，以排除假阳性。然而，大多数报告没有进展相关事件证据的个体确实是阴性（综合阴性预测值 = 0.92 [PLCO]；0.98 [FHCRC]）。因此，投入资源进行病历审查以确认自我报告的无事件可能没有多大用处。
结论
通过自我报告确定前列腺癌的进展提供了一种高效且有效的方法，可以使用更新的进展状态数据增强现有的癌症队列。
Zotero 插件