UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Development and validation of a haematuria cancer risk score to identify patients at risk of harbouring cancer

Tan, WS; Ahmad, A; Feber, A; Mostafid, H; Cresswell, J; Fankhauser, CD; Waisbrod, S; ... DETECT I trial collaborators, ; + view all (2019) Development and validation of a haematuria cancer risk score to identify patients at risk of harbouring cancer. Journal of Internal Medicine , 285 (4) pp. 436-445. 10.1111/joim.12868. Green open access

[img]
Preview
Text
Brew-Graves_Tan_et_al-2019-Journal_of_Internal_Medicine.pdf - Published version

Download (1MB) | Preview

Abstract

BACKGROUND: A lack of consensus exists among national guidelines regarding who should be investigated for haematuria. Type of haematuria and age specific thresholds are frequently used to guide referral for investigation of haematuria. OBJECTIVES: To develop and externally validate the haematuria cancer risk score (HCRS) to improve patient selection for investigation of haematuria. METHODS: Development cohort comprise of 3,539 prospectively recruited patients recruited at 40 UK hospitals (DETECT 1; ClinicalTrials. gov: NCT02676180) and validation cohort comprise of 656 Swiss patients. All patients were aged >18 years and referred to hospital for the evaluation of visible (VH) and non-visible haematuria (NVH). Sensitivity and specificity of the HCRS in the validation cohort was derived from a cut-off identified from the discovery cohort. RESULTS: Patient age, gender, type of haematuria and smoking history were used to develop the HCRS. HCRS validation achieves good discrimination (AUC 0.835; 95% CI: 0.789-0.880) and calibration (calibration slope=1.215) with no significant overfitting (p=0.151). The HCRS detected 11.4% (n=8) more cancers which would be missed by UK National Institute for Health and Clinical Excellence guidelines. The American Urological Association guidelines would identify all cancers with a specificity of 12.6% compared to 30.5% achieved by the HCRS. All patients with upper tract cancers would have been identified. CONCLUSION: The HCRS offers good discriminatory accuracy which is superior to existing guidelines. The simplicity of the model would facilitate adoption and improve patient and physician decision making. This article is protected by copyright. All rights reserved.

Type: Article
Title: Development and validation of a haematuria cancer risk score to identify patients at risk of harbouring cancer
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/joim.12868
Publisher version: http://doi.org/10.1111/joim.12868
Language: English
Additional information: Copyright © 2018 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: bladder cancer, detection, haematuria, nomogram, predict, urinary tract cancer
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Metabolism and Experi Therapeutics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/10064669
Downloads since deposit
46Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item