Diagnostic accuracy of the Gail model in the Black Women's Health Study
Diagnostic accuracy of the Gail model in the Black Women's Health Study
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DOI：
10.1111/j.1524-4741.2007.00439.x
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发表时间：
2007-07-01
期刊：
影响因子：
2.1
通讯作者：
Rosenberg, Lynn
中科院分区：
文献类型：
--
作者：
Adams-Campbell, Lucile L.;Makambi, Kepher H.;Rosenberg, Lynn
Gail模型用于预测临床试验方案中不同种族/民族女性的乳腺癌风险。然而，该模型仅在美国白色女性中得到验证。采用巢式病例对照研究设计，我们评估了原始盖尔模型（GM）和黑人/非洲裔美国人（GM-B）在黑人妇女健康研究（BWHS）中的修正盖尔模型算法的诊断准确性。1995年，在加入BWHS时，通过自我报告的问卷得出风险概况。从参与者那里获得两年一次的问卷调查，以确定乳腺癌的发病病例。对725例乳腺癌病例和725例对照的研究显示，基于GM的乳腺癌5年风险在病例中为0.2%至15.4%，在对照中为0.2%至13.6%。根据GM-B，乳腺癌的5年风险范围为0.2%至8.7%的病例和0.2%至7.2%的对照。GM和GM-B模型的敏感性分别为17.9%（95%CI：15.9-19.9%）和4.1%（95%CI：3.0-5.2），标准临界值为1.7%。盖尔模型的原始版本和修改版本都低估了非洲裔美国妇女患乳腺癌的风险。更重要的是，修改后的盖尔模型（GM-B）在预测黑人乳腺癌的发展方面比原始模型（GM）做得更差。
The Gail model is used to predict the risk of breast cancer in women of diverse race/ethnic groups for clinical trial protocols. However, this model has only been validated in US white women. Using a nested case-control study design, we evaluated the diagnostic accuracy of the original Gail model (GM) and that of the revised Gail model algorithm for blacks/African-Americans (GM-B) in the Black Women's Health Study (BWHS). Risk profiles were derived via a self reported questionnaire at the time of enrollment into the BWHS in 1995. Biennial questionnaires were obtained from the participants to determine the incident cases of breast cancer. The study of 725 breast cancer cases and 725 controls revealed that the 5-year risk of breast cancer based on the GM ranged from 0.2% to 15.4% among cases and 0.2% to 13.6% among the controls. Based on the GM-B, the 5-year risk of breast cancer ranged from 0.2% to 8.7% among cases and 0.2% to 7.2% among the controls. The sensitivities of the GM and GM-B model with the standard cutoff of 1.7% were 17.9% (95% CI: 15.9-19.9%) and 4.1% (95% CI: 3.0-5.2), respectively. Both the original and the modified version of the Gail model underestimate the risk of developing breast cancer in African-American women. More importantly, the modified Gail Model (GM-B) does a worse job at predicting the development of breast cancer for blacks than the original model (GM).