Stephen A. Deppen, PhD, Jeffrey D. Blume, PhD, Melinda C

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Presentation transcript:

Predicting Lung Cancer Prior to Surgical Resection in Patients with Lung Nodules Stephen A. Deppen, PhD, Jeffrey D. Blume, PhD, Melinda C. Aldrich, PhD, MPH, Sarah A. Fletcher, BA, Pierre P. Massion, MD, Ronald C. Walker, MD, Heidi C. Chen, PhD, Theodore Speroff, PhD, Catherine A. Degesys, MD, Rhonda Pinkerman, NP, Eric S. Lambright, MD, Jonathan C. Nesbitt, MD, Joe B. Putnam, MD, Eric L. Grogan, MD, MPH Journal of Thoracic Oncology Volume 9, Issue 10, Pages 1477-1484 (October 2014) DOI: 10.1097/JTO.0000000000000287 Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Consort diagram of VUMC and Tennessee Valley Healthcare System VA cohort. VUMC, Vanderbilt University Medical Center cohort; VA, Veteran Affairs; NSCLC, non–small-cell lung cancer. Journal of Thoracic Oncology 2014 9, 1477-1484DOI: (10.1097/JTO.0000000000000287) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Comparison of AUC for the Mayo Clinic model using originally published estimates and TREAT model in the VUMC and VA cohorts. CIs for AUC are reported for each estimate model. TREAT model AUC is significantly higher compared with the Mayo Clinic model in each cohort (p < 0.001). AUC, area under the receiver operating curve; TREAT, Thoracic Research Evaluation And Treatment; VA, Veteran Affairs; VUMC, Vanderbilt University Medical Center cohort; CI, confidence interval. Journal of Thoracic Oncology 2014 9, 1477-1484DOI: (10.1097/JTO.0000000000000287) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Box plots comparing Brier score from 500 bootstrap samples of the data for each model and from each cohort. Brier score for the TREAT model exhibited better calibration of predicted probability of lung cancer when compared with the Mayo Clinic model in the VUMC cohort (TREAT = 0.12 versus Mayo Clinic = 0.17) and VA cohort (TREAT = 0.07 versus Mayo Clinic 0.18). Brier score values of 0.25 are the same as a chance and lower values of Brier score represent increased calibration of the model. As Brier score decreases from 0.25 to 0, the predicted probability of cancer increasingly equals the observed probability of cancer and the calibration is improved. TREAT, Thoracic Research Evaluation And Treatment; VUMC, Vanderbilt University Medical Center cohort; VA, Veteran Affairs. Journal of Thoracic Oncology 2014 9, 1477-1484DOI: (10.1097/JTO.0000000000000287) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions