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.
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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DOI：
10.1136/gutjnl-2017-315730
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发表时间：
2019-04
期刊：
影响因子：
24.5
通讯作者：
Tzoulaki I
中科院分区：
文献类型：
--
作者：
Smith T;Muller DC;Moons KGM;Cross AJ;Johansson M;Ferrari P;Fagherazzi G;Peeters PHM;Severi G;Hüsing A;Kaaks R;Tjonneland A;Olsen A;Overvad K;Bonet C;Rodriguez-Barranco M;Huerta JM;Barricarte Gurrea A;Bradbury KE;Trichopoulou A;Bamia C;Orfanos P;Palli D;Pala V;Vineis P;Bueno-de-Mesquita B;Ohlsson B;Harlid S;Van Guelpen B;Skeie G;Weiderpass E;Jenab M;Murphy N;Riboli E;Gunter MJ;Aleksandrova KJ;Tzoulaki I
在两个基于人群的前瞻性队列中系统地识别和验证已发表的不需要侵入性检测的结直肠癌风险预测模型。通过更新已发表的系统综述确定模型，并在欧洲癌症与营养前瞻性研究（EPIC）和英国生物库中进行验证。通过区分（C-统计量）和校准（观察概率与预测概率图）评估模型预测研究入组后5年或10年内结直肠癌发生率的性能。系统性综述及其更新从8篇出版物（8篇结直肠、5篇结肠和3篇直肠）中识别出16种模型。每次模型验证的参与者人数从41 587到396 515不等，病例数从115到1 781不等。各个模型中合格和不合格的参与者基本上相当。在可评估的情况下，模型的校准非常好，并通过重新校准得到进一步改进。验证队列之间模型的C统计量基本相似，在英国生物样本库中达到的最高值为0.70（95% CI 0.68至0.72），在EPIC中为0.71（95% CI 0.67至0.74）。这些非侵入性模型中有几个在两个外部验证人群中表现出良好的校准和区分，因此可能适合用于促进基于人群的结直肠筛查计划中的风险分层。今后的工作应通过建模和影响研究来评估这一潜力，并确定能否进一步提高其性能。
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.
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影响因子：
7.2
作者：
Kim, DJ;Rockhill, B;Colditz, GA
通讯作者：
Colditz, GA
影响因子：
3.2
作者：
Riboli, E;Hunt, KJ;Saracci, R
通讯作者：
Saracci, R
影响因子：
4.8
作者：
Newson, Roger
通讯作者：
Newson, Roger
影响因子：
2.3
作者：
Colditz, GA;Atwood, KA;Hunter, DJ
通讯作者：
Hunter, DJ
影响因子：
2
作者：
Pencina, Michael J.;D'Agostino, Ralph B., Sr.;Song, Linye
通讯作者：
Song, Linye