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    The Vancouver lung cancer risk prediction model: Assessment by using a subset of the national lung screening trial cohort

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    Author
    White, C.S.
    Dharaiya, E.
    Campbell, E.
    Date
    2017
    Journal
    Radiology
    Publisher
    Radiological Society of North America Inc.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1148/radiol.2016152627
    Abstract
    Purpose: To assess the likelihood of malignancy among a subset of nodules in the National Lung Screening Trial (NLST) by using a risk calculator based on nodule and patient characteristics. Materials and Methods: All authors received approval for use of NLST data. An institutional review board exemption and a waiver for informed consent were granted to the author with an academic appointment. Nodule characteristics and patient attributes with regard to benign and malignant nodules in the NLST were applied to a nodule risk calculator from a group in Vancouver, Canada. Patient populations and their nodule characteristics were compared between the NLST and Vancouver cohorts. Multiple thresholds were tested to distinguish benign nodules from malignant nodules. An optimized threshold value was used to determine positive and negative predictive values, and a full logistic regression model was applied to the NLST data set. Results: Sufficient data were available for 4431 nodules (4315 benign nodules and 116 malignant nodules) from the NLST data set. The NLST and Vancouver data sets differed in that the former included fewer nodules per study, fewer nonsolid nodules, and more nodule spiculation and emphysema. A composite risk score threshold of 10% was determined to be optimal, demonstrating sensitivity, specificity, positive predictive value, and negative predictive value of 85.3%, 93.9%, 27.4%, and 99.6%, respectively. The receiver operating characteristic curve for the full regression model applied to the NLST database demonstrated an area under the receiver operating characteristic curve of 0.963 (95% confidence interval: 0.945, 0.974). Conclusion: Application of an NLST data subset to the Vancouver risk calculator yielded a high discriminant value, which supports the use of a risk calculator method as a valuable approach to distinguish between benign and malignant nodules.
    Keyword
    pulmonary nodules
    Vancouver risk calculator
    Lungs--Cancer
    Lungs--Tumors
    Tomography, X-Ray Computed--methods
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85017133188&doi=10.1148%2fradiol.2016152627&partnerID=40&md5=15c2d7289060e3d25557648c5d250895; http://hdl.handle.net/10713/11261
    ae974a485f413a2113503eed53cd6c53
    10.1148/radiol.2016152627
    Scopus Count
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    UMB Open Access Articles 2017

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