Ontology highlight
ABSTRACT: Objective
The use of risk prediction models grows as electronic medical records become widely available. Here, we develop and validate a model to identify individuals at increased risk for colorectal cancer (CRC) by analyzing blood counts, age, and sex, then determine the model's value when used to supplement conventional screening.Materials and methods
Primary care data were collected from a cohort of 606?403 Israelis (of whom 3135 were diagnosed with CRC) and a case control UK dataset of 5061 CRC cases and 25?613 controls. The model was developed on 80% of the Israeli dataset and validated using the remaining Israeli and UK datasets. Performance was evaluated according to the area under the curve, specificity, and odds ratio at several working points.Results
Using blood counts obtained 3-6 months before diagnosis, the area under the curve for detecting CRC was 0.82?±?0.01 for the Israeli validation set. The specificity was 88?±?2% in the Israeli validation set and 94?±?1% in the UK dataset. Detecting 50% of CRC cases, the odds ratio was 26?±?5 and 40?±?6, respectively, for a false-positive rate of 0.5%. Specificity for 50% detection was 87?±?2% a year before diagnosis and 85?±?2% for localized cancers. When used in addition to the fecal occult blood test, our model enabled more than a 2-fold increase in CRC detection.Discussion
Comparable results in 2 unrelated populations suggest that the model should generally apply to the detection of CRC in other groups. The model's performance is superior to current iron deficiency anemia management guidelines, and may help physicians to identify individuals requiring additional clinical evaluation.Conclusions
Our model may help to detect CRC earlier in clinical practice.
SUBMITTER: Kinar Y
PROVIDER: S-EPMC4997037 | biostudies-literature | 2016 Sep
REPOSITORIES: biostudies-literature
Kinar Yaron Y Kalkstein Nir N Akiva Pinchas P Levin Bernard B Half Elizabeth E EE Goldshtein Inbal I Chodick Gabriel G Shalev Varda V
Journal of the American Medical Informatics Association : JAMIA 20160215 5
<h4>Objective</h4>The use of risk prediction models grows as electronic medical records become widely available. Here, we develop and validate a model to identify individuals at increased risk for colorectal cancer (CRC) by analyzing blood counts, age, and sex, then determine the model's value when used to supplement conventional screening.<h4>Materials and methods</h4>Primary care data were collected from a cohort of 606 403 Israelis (of whom 3135 were diagnosed with CRC) and a case control UK ...[more]