Evidence map›Paper›PMID 30552254›Full record

ArticleBMJ open2018

Predicting 7-year mortality for use with evidence-based guidelines for Prostate-Specific Antigen (PSA) testing: findings from a large prospective study of 123 697 Australian men.

Grace Joshy, Emily Banks, Anthony Lowe, Rory Wolfe, Leonie Tickle, Bruce Armstrong, Mark Clements

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Grace JoshyNational Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.ORCID 0000-0002-0718-6368
Emily BanksNational Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
Anthony LoweMenzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
Rory WolfeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Leonie TickleDepartment of Applied Finance and Actuarial Studies, Macquarie University, Sydney, New South Wales, Australia.
Bruce ArmstrongSchool of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia.
Mark ClementsDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop and validate a prediction model for short-term mortality in Australian men aged ≥45years, using age and self-reported health variables, for use when implementing the Australian Clinical Practice Guidelines for Prostate-Specific Antigen (PSA) Testing and Early Management of Test-Detected Prostate Cancer. Implementation of one of the Guideline recommendations requires an estimate of 7-year mortality.

designProspective cohort study using questionnaire data linked to mortality data.

settingMen aged ≥45years randomly sampled from the general population of New South Wales, Australia, participating in the 45 and Up Study.

participants123 697 men who completed the baseline postal questionnaire (distributed from 1 January 2006 to 31 December 2008) and gave informed consent for follow-up through linkage of their data to population health databases. PRIMARY OUTCOME MEASURES: The primary outcome was all-cause mortality.

results12 160 died during follow-up (median=5.9 years). Following age-adjustment, self-reported health was the strongest predictor of all-cause mortality (C-index: 0.827; 95% CI 0.824 to 0.831). Three prediction models for all-cause mortality were validated, with predictors: Model-1: age group and self-rated health; Model-2: variables common to the 45 and Up Study and the Australian Health Survey and subselected using stepwise regression and Model-3: all variables selected using stepwise regression. Final predictions calibrated well with observed all-cause mortality rates. The 90th percentile for the 7-year mortality risks ranged from 1.92% to 83.94% for ages 45-85 years.

conclusionsWe developed prediction scores for short-term mortality using age and self-reported health measures and validated the scores against national mortality rates. Along with age, simple measures such as self-rated health, which can be easily obtained without physical examination, were strong predictors of all-cause mortality in the 45 and Up Study. Seven-year mortality risk estimates from Model-3 suggest that the impact of the mortality risk prediction tool on men's decision making would be small in the recommended age (50-69 years) for PSA testing, but it may discourage testing at older ages.

Indexed as

Early Detection of CancerEvidence-Based MedicineGuideline AdherenceAgedAged, 80 and overCause of DeathCohort StudiesDisability EvaluationEarly DiagnosisEarly Medical InterventionHumansKallikreinsMaleMiddle AgedNew South WalesPredictive Value of TestsKallikreinsKLK3 protein, humanProstate-Specific Antigen45 and up studyAustralian mencalibrationcox modellife expectancymortality predictionself-rated healthvalidation

Identifiers

PMID30552254
PMCPMC6303562

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.