A score to estimate the likelihood of detecting advanced colorectal neoplasia at colonoscopy.
A score to estimate the likelihood of detecting advanced colorectal neoplasia at colonoscopy.
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DOI：
10.1136/gutjnl-2013-304965
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发表时间：
2014-07
期刊：
影响因子：
24.5
通讯作者：
Regula J
中科院分区：
文献类型：
--
作者：
Kaminski MF;Polkowski M;Kraszewska E;Rupinski M;Butruk E;Regula J
本研究旨在建立并验证一个模型，以估计在白种人患者中发现晚期结直肠肿瘤的可能性。我们对2007年波兰73个中心的40至66岁患者的数据库记录进行了横断面分析，这些患者参加了全国性的以结肠镜为基础的结直肠癌筛查项目。在随机选择的测试集中，我们使用多变量逻辑回归来研究临床变量与晚期肿瘤存在之间的关联，并在验证集中证实了这种关联。我们使用模型系数来建立检测晚期结直肠肿瘤的风险评分。在35 918名纳入的参与者中，有2544名（7.1%）检测到晚期结直肠肿瘤。在检验集中，logistic回归模型显示晚期结直肠癌肿瘤的独立危险因素为：年龄、性别、结直肠癌家族史、吸烟（这4个因素p<0.001）、体重指数（Body Mass Index） （p=0.033）。在验证集中，该模型被很好地校准（预期与观察到的晚期肿瘤风险之比：1.00 (95% CI 0.95至1.06)），并且具有中等的判别能力（c-统计量0.62）。我们制定了一个评分来估计在验证集中发现晚期肿瘤的可能性，从0分患者的1.32%到7-8分患者的19.12%。由简单的临床因素组成的开发和内部验证的评分成功地估计了在无症状的高加索患者中发现晚期结直肠肿瘤的可能性。一旦得到外部验证，它可能对咨询或设计初级预防研究有用。
This study aimed to develop and validate a model to estimate the likelihood of detecting advanced colorectal neoplasia in Caucasian patients. We performed a cross-sectional analysis of database records for 40-year-old to 66-year-old patients who entered a national primary colonoscopy-based screening programme for colorectal cancer in 73 centres in Poland in the year 2007. We used multivariate logistic regression to investigate the associations between clinical variables and the presence of advanced neoplasia in a randomly selected test set, and confirmed the associations in a validation set. We used model coefficients to develop a risk score for detection of advanced colorectal neoplasia. Advanced colorectal neoplasia was detected in 2544 of the 35 918 included participants (7.1%). In the test set, a logistic-regression model showed that independent risk factors for advanced colorectal neoplasia were: age, sex, family history of colorectal cancer, cigarette smoking (p<0.001 for these four factors), and Body Mass Index (p=0.033). In the validation set, the model was well calibrated (ratio of expected to observed risk of advanced neoplasia: 1.00 (95% CI 0.95 to 1.06)) and had moderate discriminatory power (c-statistic 0.62). We developed a score that estimated the likelihood of detecting advanced neoplasia in the validation set, from 1.32% for patients scoring 0, to 19.12% for patients scoring 7–8. Developed and internally validated score consisting of simple clinical factors successfully estimates the likelihood of detecting advanced colorectal neoplasia in asymptomatic Caucasian patients. Once externally validated, it may be useful for counselling or designing primary prevention studies.
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影响因子：
24.5
作者：
Logan RF;Patnick J;Nickerson C;Coleman L;Rutter MD;von Wagner C;English Bowel Cancer Screening Evaluation Committee
通讯作者：
English Bowel Cancer Screening Evaluation Committee
影响因子：
3
作者：
Klabunde, CN;Vernon, SW;Brown, ML
通讯作者：
Brown, ML
影响因子：
39.2
作者：
Hundt, Sabrina;Haug, Ulrike;Brenner, Hermann
通讯作者：
Brenner, Hermann
DOI：
10.1016/j.amjgastroenterol.2203.09.041
发表时间：
2003-12-01
影响因子：
9.8
作者：
Betés, M;Muñoz-Navas, MA;Martínez-González, MA
通讯作者：
Martínez-González, MA
影响因子：
3.7
作者：
Kolligs, Frank T.;Crispin, Alexander;Goeke, Burkhard
通讯作者：
Goeke, Burkhard