PMID- 22910935
OWN - NLM
STAT- MEDLINE
DCOM- 20121019
LR  - 20220409
IS  - 1539-3704 (Electronic)
IS  - 0003-4819 (Print)
IS  - 0003-4819 (Linking)
VI  - 157
IP  - 4
DP  - 2012 Aug 21
TI  - Predictive accuracy of the Liverpool Lung Project risk model for stratifying 
      patients for computed tomography screening for lung cancer: a case-control and 
      cohort validation study.
PG  - 242-50
LID - 10.7326/0003-4819-157-4-201208210-00004 [doi]
AB  - BACKGROUND: External validation of existing lung cancer risk prediction models is 
      limited. Using such models in clinical practice to guide the referral of patients 
      for computed tomography (CT) screening for lung cancer depends on external 
      validation and evidence of predicted clinical benefit. OBJECTIVE: To evaluate the 
      discrimination of the Liverpool Lung Project (LLP) risk model and demonstrate its 
      predicted benefit for stratifying patients for CT screening by using data from 3 
      independent studies from Europe and North America. DESIGN: Case-control and 
      prospective cohort study. SETTING: Europe and North America. PATIENTS: 
      Participants in the European Early Lung Cancer (EUELC) and Harvard case-control 
      studies and the LLP population-based prospective cohort (LLPC) study. 
      MEASUREMENTS: 5-year absolute risks for lung cancer predicted by the LLP model. 
      RESULTS: The LLP risk model had good discrimination in both the Harvard (area 
      under the receiver-operating characteristic curve [AUC], 0.76 [95% CI, 0.75 to 
      0.78]) and the LLPC (AUC, 0.82 [CI, 0.80 to 0.85]) studies and modest 
      discrimination in the EUELC (AUC, 0.67 [CI, 0.64 to 0.69]) study. The decision 
      utility analysis, which incorporates the harms and benefit of using a risk model 
      to make clinical decisions, indicates that the LLP risk model performed better 
      than smoking duration or family history alone in stratifying high-risk patients 
      for lung cancer CT screening. LIMITATIONS: The model cannot assess whether 
      including other risk factors, such as lung function or genetic markers, would 
      improve accuracy. Lack of information on asbestos exposure in the LLPC limited 
      the ability to validate the complete LLP risk model. CONCLUSION: Validation of 
      the LLP risk model in 3 independent external data sets demonstrated good 
      discrimination and evidence of predicted benefits for stratifying patients for 
      lung cancer CT screening. Further studies are needed to prospectively evaluate 
      model performance and evaluate the optimal population risk thresholds for 
      initiating lung cancer screening.
FAU - Raji, Olaide Y
AU  - Raji OY
AD  - Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer 
      Research Centre, Institute of Translational Medicine, The University of 
      Liverpool, Liverpool L3 9TA, United Kingdom.
FAU - Duffy, Stephen W
AU  - Duffy SW
FAU - Agbaje, Olorunshola F
AU  - Agbaje OF
FAU - Baker, Stuart G
AU  - Baker SG
FAU - Christiani, David C
AU  - Christiani DC
FAU - Cassidy, Adrian
AU  - Cassidy A
FAU - Field, John K
AU  - Field JK
LA  - eng
GR  - P20 CA090578/CA/NCI NIH HHS/United States
GR  - R01 CA092824/CA/NCI NIH HHS/United States
GR  - CA090578/CA/NCI NIH HHS/United States
GR  - CA74386/CA/NCI NIH HHS/United States
GR  - P50 CA090578/CA/NCI NIH HHS/United States
GR  - CA092824/CA/NCI NIH HHS/United States
GR  - R01 CA074386/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
PL  - United States
TA  - Ann Intern Med
JT  - Annals of internal medicine
JID - 0372351
SB  - IM
CIN - Ann Intern Med. 2012 Aug 21;157(4):294-5. PMID: 22910942
CIN - Ann Intern Med. 2013 Apr 2;158(7):568. PMID: 23546573
CIN - Ann Intern Med. 2013 Apr 2;158(7):568-9. PMID: 23546574
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Case-Control Studies
MH  - Decision Support Techniques
MH  - *Early Detection of Cancer
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*diagnostic imaging
MH  - Male
MH  - Middle Aged
MH  - *Models, Statistical
MH  - Prospective Studies
MH  - Referral and Consultation
MH  - Risk Assessment
MH  - Risk Factors
MH  - *Tomography, X-Ray Computed
PMC - PMC3723683
MID - NIHMS476269
COIS- Potential Conflicts of Interest: Disclosures can be viewed at 
      www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1994.
EDAT- 2012/08/23 06:00
MHDA- 2012/10/20 06:00
PMCR- 2013/07/25
CRDT- 2012/08/23 06:00
PHST- 2012/08/23 06:00 [entrez]
PHST- 2012/08/23 06:00 [pubmed]
PHST- 2012/10/20 06:00 [medline]
PHST- 2013/07/25 00:00 [pmc-release]
AID - 1351360 [pii]
AID - 10.7326/0003-4819-157-4-201208210-00004 [doi]
PST - ppublish
SO  - Ann Intern Med. 2012 Aug 21;157(4):242-50. doi: 
      10.7326/0003-4819-157-4-201208210-00004.