Evidence map›Paper›PMID 24439009›Full record

ArticleUrology2014

Probability of an abnormal screening prostate-specific antigen result based on age, race, and prostate-specific antigen threshold.

Roxanne Espaldon, Katharine A Kirby, Kathy Z Fung, Richard M Hoffman, Adam A Powell, Stephen J Freedland, Louise C Walter

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Roxanne EspaldonDivision of Geriatrics, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA.
Katharine A KirbyDivision of Geriatrics, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA.
Kathy Z FungDivision of Geriatrics, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA.
Richard M HoffmanDepartment of Medicine, University of New Mexico, New Mexico VA Health Care System, Albuquerque, NM.
Adam A PowellCenter for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN.
Stephen J FreedlandDurham VA Medical Center, Durham, NC; Duke Prostate Center, Duke University, Durham, NC.
Louise C WalterDivision of Geriatrics, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA. Electronic address: Louise.Walter@ucsf.edu.
University of California, San Francisco · USDurham VA Medical Center · USMinneapolis VA Health Care System · USSan Francisco VA Medical Center · USUniversity of New Mexico · US

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2013 to 2026
$19.9M
Prostate-Specific Antigen Practices and Outcomes in the ElderlyR01CA134425 · NCI · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI WALTER, LOUISE C. · 2009 to 2013
$1.7M
Midcareer Mentoring Award for Patient-Oriented Research in AgingK24AG041180 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WALTER, LOUISE C. · 2011 to 2016
$909k
HSRD VA CDA 08-024NCI NIH HHS R01 CA134425NIA NIH HHS K24 AG041180NIA NIH HHS K24AG041180NIA NIH HHS P30 AG044281
6 · The paper itself

Abstract

objectiveTo determine the distribution of screening prostate-specific antigen (PSA) values in older men, and how different PSA thresholds affect the proportion of white, black, and Latino men who would have an abnormal screening result across advancing age groups.

methodsWe used linked national Veterans Affairs and Medicare data to determine the value of the first screening PSA test (ng/mL) of 327,284 men older than 65 years who underwent PSA screening in the Veterans Affairs health care system in 2003. We calculated the proportion of men with an abnormal PSA result based on age, race, and common PSA thresholds.

resultsAmong men older than 65 years, 8.4% had a PSA >4.0 ng/mL. The percentage of men with a PSA >4.0 ng/mL increased with age and was highest in black men (13.8%) vs white (8.0%) or Latino men (10.0%) (P <.001). Combining age and race, the probability of having a PSA >4.0 ng/mL ranged from 5.1% of Latino men aged 65-69 years to 27.4% of black men older than 85 years. Raising the PSA threshold from >4.0 ng/mL to >10.0 ng/mL reclassified the greatest percentage of black men older than 85 years (18.3% absolute change) and the lowest percentage of Latino men aged 65-69 years (4.8% absolute change) as being under the biopsy threshold (P <.001).

conclusionAge, race, and PSA threshold together affect the pretest probability of an abnormal screening PSA result. Based on screening PSA distributions, stopping screening among men whose PSA <3 ng/mL means more than 80% of white and Latino men older than 70 years would stop further screening, and increasing the biopsy threshold to >10 ng/mL has the greatest effect on reducing the number of older black men who will face biopsy decisions after screening.

Indexed as

AgedAged, 80 and overAge FactorsBlack or African AmericanCross-Sectional StudiesHispanic or LatinoHumansMaleProbabilityProstate-Specific AntigenProstatic NeoplasmsUnited StatesWhite PeopleProstate-Specific Antigen

Identifiers

PMID24439009
PMCPMC3943595
OpenAlexW2078502610

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.