Existing General Population Models Inaccurately Predict Lung Cancer Risk in Patients Referred for Surgical Evaluation James M. Isbell, MD, MSCI, Stephen.

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Existing General Population Models Inaccurately Predict Lung Cancer Risk in Patients Referred for Surgical Evaluation James M. Isbell, MD, MSCI, Stephen Deppen, MA, MS, Joe B. Putnam, MD, Jonathan C. Nesbitt, MD, Eric S. Lambright, MD, Aaron Dawes, BA, Pierre P. Massion, MD, Theodore Speroff, PhD, David R. Jones, MD, Eric L. Grogan, MD, MPH The Annals of Thoracic Surgery Volume 91, Issue 1, Pages 227-233 (January 2011) DOI: 10.1016/j.athoracsur.2010.08.054 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) The receiver operating characteristic (ROC) curve for the Mayo Clinic model. Area under the ROC curve (AUC) = 0.78 (95% confidence interval [CI] 0.70% to 0.85%). (B) The calibration curve plots median predicted probability of a malignant nodule by observed frequency for patients in each of the 5 quintiles of predicted probability. A point above the diagonal indicates that the model underestimates the likelihood of cancer. A point below the diagonal indicates that the model overestimates the likelihood of cancer. A point near the diagonal indicates that the model is calibrated and the estimated probability is close to the observed probability of cancer. Goodness of fit estimated by Hosmer-Lemeshow (H-L) test (p < 0.001). The p values greater than 0.05 are consistent with models that fit observed data. The Annals of Thoracic Surgery 2011 91, 227-233DOI: (10.1016/j.athoracsur.2010.08.054) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Receiver operating characteristic (ROC) curve for the solitary pulmonary nodules (SPN) model. Area under the ROC curve (AUC) = 0.80 (95% confidence interval [CI] 0.73% to 0.87%). (B) The calibration curve plots median predicted probability of a malignant nodule by observed frequency for patients in each quintile of predicted probability. Goodness of fit estimated by Hosmer-Lemeshow test (H-L test p < 0.001). The p values greater than 0.05 are consistent with models that fit observed data. The Annals of Thoracic Surgery 2011 91, 227-233DOI: (10.1016/j.athoracsur.2010.08.054) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions