Limits...
Practical problems with clinical guidelines for breast cancer prevention based on remaining lifetime risk.

Quante AS, Whittemore AS, Shriver T, Hopper JL, Strauch K, Terry MB - J. Natl. Cancer Inst. (2015)

Bottom Line: Model sensitivities at thresholds for a 20% false-positive rate were also similar, with 41.8% using IBIS and 38.0% using BOADICEA.RLR-based guidelines for high-risk women are limited by discordance between commonly used risk models.Guidelines based on short-term risks would be more useful, as models are generally developed and validated under a short fixed time horizon (≤10 years).

View Article: PubMed Central - PubMed

Affiliation: : Joseph L. Mailman School of Public Health, Columbia University, New York, NY (ASQ, TS, MBT); Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany (ASQ, KS); Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany (ASQ, KS); Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ASW); Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Carlton, Victoria, Australia (JLH); Department of Epidemiology and Institute of Health and Environment, School of Public Health, Seoul National University, Seoul, Korea (JLH); Herbert Irving Comprehensive Cancer Center, Columbia Medical Center, New York, NY (MBT).

Show MeSH

Related in: MedlinePlus

Discrimination of International Breast Cancer Intervention Study (IBIS) and Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) models. The black line shows the receiver operating characteristic (ROC) curves from IBIS, and the red line shows the receiver operating characteristic (ROC) curve from BOADICEA.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4554256&req=5

Figure 3: Discrimination of International Breast Cancer Intervention Study (IBIS) and Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) models. The black line shows the receiver operating characteristic (ROC) curves from IBIS, and the red line shows the receiver operating characteristic (ROC) curve from BOADICEA.

Mentions: We compared the models’ receiver operating characteristic (ROC) curves and case risk percentiles (CRPs), omitting subjects who were last observed free of breast cancer before 10 years. Figure 3 shows similar discrimination by the two models, with area under the ROC (AUC) of 0.67 (95% CI = 0.61 to 0.73) for IBIS and 0.68 (95% CI = 0.62 to 0.74) for BOADICEA. IBIS AUC was little affected when nongenetic covariates were deleted from the model, with an AUC of 0.66 (95% CI = 0.61 to 0.72) (data not shown).


Practical problems with clinical guidelines for breast cancer prevention based on remaining lifetime risk.

Quante AS, Whittemore AS, Shriver T, Hopper JL, Strauch K, Terry MB - J. Natl. Cancer Inst. (2015)

Discrimination of International Breast Cancer Intervention Study (IBIS) and Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) models. The black line shows the receiver operating characteristic (ROC) curves from IBIS, and the red line shows the receiver operating characteristic (ROC) curve from BOADICEA.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554256&req=5

Figure 3: Discrimination of International Breast Cancer Intervention Study (IBIS) and Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) models. The black line shows the receiver operating characteristic (ROC) curves from IBIS, and the red line shows the receiver operating characteristic (ROC) curve from BOADICEA.
Mentions: We compared the models’ receiver operating characteristic (ROC) curves and case risk percentiles (CRPs), omitting subjects who were last observed free of breast cancer before 10 years. Figure 3 shows similar discrimination by the two models, with area under the ROC (AUC) of 0.67 (95% CI = 0.61 to 0.73) for IBIS and 0.68 (95% CI = 0.62 to 0.74) for BOADICEA. IBIS AUC was little affected when nongenetic covariates were deleted from the model, with an AUC of 0.66 (95% CI = 0.61 to 0.72) (data not shown).

Bottom Line: Model sensitivities at thresholds for a 20% false-positive rate were also similar, with 41.8% using IBIS and 38.0% using BOADICEA.RLR-based guidelines for high-risk women are limited by discordance between commonly used risk models.Guidelines based on short-term risks would be more useful, as models are generally developed and validated under a short fixed time horizon (≤10 years).

View Article: PubMed Central - PubMed

Affiliation: : Joseph L. Mailman School of Public Health, Columbia University, New York, NY (ASQ, TS, MBT); Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany (ASQ, KS); Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany (ASQ, KS); Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ASW); Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Carlton, Victoria, Australia (JLH); Department of Epidemiology and Institute of Health and Environment, School of Public Health, Seoul National University, Seoul, Korea (JLH); Herbert Irving Comprehensive Cancer Center, Columbia Medical Center, New York, NY (MBT).

Show MeSH
Related in: MedlinePlus