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首页> 外文期刊>Gut: Journal of the British Society of Gastroenterology >Comparison of prognostic models to predict the occurrence of colorectal cancer in asymptomatic individuals: a systematic literature review and external validation in the EPIC and UK Biobank prospective cohort studies
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Comparison of prognostic models to predict the occurrence of colorectal cancer in asymptomatic individuals: a systematic literature review and external validation in the EPIC and UK Biobank prospective cohort studies

机译:预后模型的比较预测无症状中结直肠癌的发生:史诗与英国生物安前瞻性研究中的系统文献综述与外在验证

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摘要

To systematically identify and validate published colorectal cancer risk prediction models that do not require invasive testing in two large population-based prospective cohorts.Models were identified through an update of a published systematic review and validated in the European Prospective Investigation into Cancer and Nutrition (EPIC) and the UK Biobank. The performance of the models to predict the occurrence of colorectal cancer within 5 or 10 years after study enrolment was assessed by discrimination (C-statistic) and calibration (plots of observed vs predicted probability).The systematic review and its update identified 16 models from 8 publications (8 colorectal, 5 colon and 3 rectal). The number of participants included in each model validation ranged from 41?587 to 396?515, and the number of cases ranged from 115 to 1781. Eligible and ineligible participants across the models were largely comparable. Calibration of the models, where assessable, was very good and further improved by recalibration. The C-statistics of the models were largely similar between validation cohorts with the highest values achieved being 0.70 (95% CI 0.68 to 0.72) in the UK Biobank and 0.71 (95% CI 0.67 to 0.74) in EPIC.Several of these non-invasive models exhibited good calibration and discrimination within both external validation populations and are therefore potentially suitable candidates for the facilitation of risk stratification in population-based colorectal screening programmes. Future work should both evaluate this potential, through modelling and impact studies, and ascertain if further enhancement in their performance can be obtained.
机译:为了系统地鉴定和验证出版的结肠直肠癌风险预测模型,这些癌症预测模型在两个大型人口的未来队列中不需要侵入性测试,通过更新发布的系统审查并验证欧洲预期调查癌症和营养(Epic )和英国Biobank。通过歧视(C统计)和校准(观察到的VS预测概率的校准,评估了模型在5或10年内预测入学入学后5或10年内的结肠直肠癌发生的发生。系统审查及其更新确定了16种型号8出版物(8种成分,5个结肠和3个直肠)。每个模型验证中包含的参与者的数量范围为41?587至396?515,案件数量为115至1781年。符合这些模型的资格和不合格的参与者在很大程度上是可比的。校准模型,在评估,通过重新校准非常好,进一步提高。模型的C统计数据在很大程度上与验证队列之间的验证队列相似,在英国Biobank中的最高值为0.70(95%CI 0.68至0.72),史诗中的0.71(95%CI 0.67至0.74)。这些非侵入模型在外部验证群体中表现出良好的校准和歧视,因此是潜在的候选人,用于促进基于人群的结肠直肠筛查计划的风险分层。通过建模和影响研究,将来的工作应该评估这一潜力,并确定是否可以获得进一步提高其性能的进一步提高。

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