Probability of prostate cancer in Chinese men - Evidencio
Probability of prostate cancer in Chinese men
Prostate health index (PHI) nomogram predicting the probability of prostate cancer in Chinese men with PSA ≤10 ng/mL and normal digital rectal examination (c-index: 0.79).
Research authors: Zhu Y, Han CT, Zhang GM, Liu F, Ding Q, Xu JF, Vidal AC, Freedland SJ, Ng CF, Ye DW.
Version: 1.19
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Probability of prostate cancer:

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This nomogram provides an objective and quantifiable estimation of cancer risk and offers useful information for consultation. The decision to perform a prostate biopsy not only depends on prostate carcinoma risk, but also on multiple factors, including the patient’s life expectancy, co-morbidity, and preference.

Model performance:
On internal validation using a 200 bootstrap resampled dataset, the nomogram’s corrected AUC was 0.872. The calibration plot showed good correlation between predicted and actual probability. In a separate validation cohort consisting of 230 patients, the AUC of the nomogram was 0.786 (range, 0.678–0.894).

Clinical relevance: 
Zhu et al (2015) simulated clinical decision making by calculating the consequences of applying different criteria in the validation cohort. PSAD biopsy criteria resulted in unnecessary biopsies in 42.6% of cases and missed 28.6% of cancer cases. Using the PHI-nomogram, the authors were able to significantly reduce the number of unnecessary biopsies. For example, at the cutoff of 5%, unnecessary biopsies were reduced to 27% without missing any additional cancer cases.

Reference: Zhu Y, Han CT, Zhang GM, Liu F, Ding Q, Xu JF, Vidal AC, Freedland SJ, Ng CF, Ye DW. Development and external validation of a prostate health index-based nomogram for predicting prostate cancer. Sci Rep. 2015 16;5:15341.


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This algorithm is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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