Evidence map›Paper›PMID 30937590›Full record

Observational studyEuropean radiology2019

Post-imaging pulmonary nodule mathematical prediction models: are they clinically relevant?

Johanna Uthoff, Nicholas Koehn, Jared Larson, Samantha K N Dilger, Emily Hammond, Ann Schwartz, Brian Mullan, Rolando Sanchez, Richard M Hoffman, Jessica C Sieren and 1 more

Open access · greenAbstract readComparative StudyObservational Study
In one paragraph

Observational study in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 24% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Validation of the BRODERS classifier (BenignThe European respiratory journal · 2021
    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

11 authors at 1 institution in 1 country.

Johanna UthoffDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.
Nicholas KoehnDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.
Jared LarsonDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.
Samantha K N DilgerDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.
Emily HammondDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.
Ann SchwartzKarmanos Cancer Institute, Wayne State University, 4100 John R St, Detroit, MI, 48201, USA.
Brian MullanDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.
Rolando SanchezDepartment of Internal Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
Richard M HoffmanDepartment of Internal Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
Jessica C SierenDepartment of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA. jessica-sieren@uiowa.edu.
COPDGene Investigators
University of Iowa · US

Funding

Viral VectorP30CA086862 · NCI · UNIVERSITY OF IOWA · PI Douglas Robert Spitz · 2000 to 2026
$70.0M
Tumor Biology and Microenvironment (Program 1)P30CA022453 · NCI · WAYNE STATE UNIVERSITY · PI PAUL M STEMMER · 1985 to 2026
$68.4M
Genetic Epidemiology of COPDU01HL089897 · NHLBI · NATIONAL JEWISH HEALTH · PI CRAPO, JAMES D · 2007 to 2021
$56.9M
Pulmonary Toxicology Facility CoreP30ES005605 · NIEHS · UNIVERSITY OF IOWA · PI Brandi Janssen · 1990 to 2026
$40.5M
Metabolomic signatures of empysema and COPD progression in the COPDGene cohortR01HL089897 · NHLBI · NATIONAL JEWISH HEALTH · PI CRAPO, JAMES D · 2012 to 2016
$31.1M
Genetic Epidemiology of COPDU01HL089856 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SILVERMAN, EDWIN K · 2007 to 2021
$20.7M
(2 of 2) Genetic Epidemiology of COPDR01HL089856 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SILVERMAN, EDWIN K · 2012 to 2016
$18.9M
Inflammation Pathways and COPD in the Development of Lung CancerR01CA141769 · NCI · WAYNE STATE UNIVERSITY · PI SCHWARTZ, ANN G. · 2011 to 2016
$8.7M
Ultra-low Dose, High Speed, High Resolution, Multispectral, Multi-Source MDCT ScaS10OD018526 · OD · UNIVERSITY OF IOWA · PI HOFFMAN, ERIC ALFRED · 2015 to 2015
$2.0M
American Cancer Society IGR-77-004-34NCI NIH HHS P30 CA022453NCI NIH HHS R01 CA141769NHLBI NIH HHS R01 HL089856NHLBI NIH HHS R01 HL089897NHLBI NIH HHS U01 HL089856NHLBI NIH HHS U01HL089856NHLBI NIH HHS U01 HL089897NHLBI NIH HHS U01-HL089897NIEHS NIH HHS P30 ES005605NIH HHS HHSN261201300011INIH HHS P30CA022453NIH HHS R01CA141769NIH HHS S10 OD018526
6 · The paper itself

Abstract

objectivesPost-imaging mathematical prediction models (MPMs) provide guidance for the management of solid pulmonary nodules by providing a lung cancer risk score from demographic and radiologists-indicated imaging characteristics. We hypothesized calibrating the MPM risk score threshold to a local study cohort would result in improved performance over the original recommended MPM thresholds. We compared the pre- and post-calibration performance of four MPM models and determined if improvement in MPM prediction occurs as nodules are imaged longitudinally. MATERIALS AND

methodsA common cohort of 317 individuals with computed tomography-detected, solid nodules (80 malignant, 237 benign) were used to evaluate the MPM performance. We created a web-based application for this study that allows others to easily calibrate thresholds and analyze the performance of MPMs on their local cohort. Thirty patients with repeated imaging were tested for improved performance longitudinally.

resultsUsing calibrated thresholds, Mayo Clinic and Brock University (BU) MPMs performed the best (AUC = 0.63, 0.61) compared to the Veteran's Affairs (0.51) and Peking University (0.55). Only BU had consensus with the original MPM threshold; the other calibrated thresholds improved MPM accuracy. No significant improvements in accuracy were found longitudinally between time points.

conclusionsCalibration to a common cohort can select the best-performing MPM for your institution. Without calibration, BU has the most stable performance in solid nodules ≥ 8 mm but has only moderate potential to refine subjects into appropriate workup. Application of MPM is recommended only at initial evaluation as no increase in accuracy was achieved over time. KEY POINTS: • Post-imaging lung cancer risk mathematical predication models (MPMs) perform poorly on local populations without calibration. • An application is provided to facilitate calibration to new study cohorts: the Mayo Clinic model, the U.S. Department of Veteran's Affairs model, the Brock University model, and the Peking University model. • No significant improvement in risk prediction occurred in nodules with repeated imaging sessions, indicating the potential value of risk prediction application is limited to the initial evaluation.

Indexed as

Models, TheoreticalAdultAgedAged, 80 and overCohort StudiesFemaleHumansLungLung NeoplasmsMaleMiddle AgedPrecancerous ConditionsSolitary Pulmonary NoduleTomography, X-Ray ComputedArea under the curveLogistic modelsLung neoplasmsRisk assessmentTomography, x-ray computed

Identifiers

PMID30937590
PMCPMC6717521
OpenAlexW2935423782

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.