Evidence map›Paper›PMID 31708233›Full record

ArticleSeminars in oncology

External validation of a prognostic model for mortality among patients with non-small-cell lung cancer using the Veterans Precision Oncology Data Commons.

David Cheng, Jaime Ramos-Cejudo, David Tuck, Danne Elbers, Mary Brophy, Nhan Do, Nathanael Fillmore

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Article in Seminars in oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

David ChengVA Boston Healthcare System, Boston, MA.
Jaime Ramos-CejudoVA Boston Healthcare System, Boston, MA; NYU Langone Medical Center, New York, NY.
David TuckVA Boston Healthcare System, Boston, MA.
Danne ElbersVA Boston Healthcare System, Boston, MA; University of Vermont, Burlington, VT.
Mary BrophyVA Boston Healthcare System, Boston, MA; Boston University School of Medicine, Boston, MA.
Nhan DoVA Boston Healthcare System, Boston, MA; Boston University School of Medicine, Boston, MA.
Nathanael FillmoreVA Boston Healthcare System, Boston, MA; Harvard Medical School, Boston, MA; Dana-Farber Cancer Institute, Boston, MA. Electronic address: Nathanael.Fillmore@va.gov.

Funding

Intramural VA VA999999
6 · The paper itself

Abstract

backgroundThere is wide interest in developing prognostic models in non-small-cell lung cancer (NSCLC) due to the heterogeneity of the disease. Models developed at other healthcare institutions may not be directly applicable for patients treated at the Department of Veterans Affairs (VA). External validation of a candidate prognostic model among VA patients would be crucial before it can be implemented to aid clinical decision-making.

methodsA prognostic model for mortality developed in the Military Health System (MHS) was applied to data from the VA Precision Oncology Data Repository (VA-PODR), which is available to researchers inside and outside the VA at the Veterans Precision Oncology Data Commons (VPODC). Measures of discrimination and calibration were calculated for the MHS model. The MHS model was also refitted in VA-PODR data using the same risk factors to compare the effect of specific factors and predictive performance when the model is developed using VA data.

resultsTime-dependent AUC of the MHS prognostic model was 0.788, 0.806, 0.780, and 0.779 for predicting survival at 1, 2, 3, and 5 years following diagnosis, respectively. Significant discrepancies were found between predicted and observed rates of survival, particularly for later years. When the model is refit in VA-PODR data, it achieved cross-validated AUCs of 0.739, 0.773, 0.769, and 0.807 at the same time points, and discrepancies between predicted and observed survival were reduced.

conclusionsValidation of the MHS prognostic model in VA-PODR demonstrates that its discrimination remains strong when applied to VA patients. Nevertheless, further calibration to VA data may be needed to improve its risk estimation performance. This study highlights the utility of VA-PODR and the VPODC as a national resource for developing analytic tools that are well adapted to the Veteran population.

Indexed as

VeteransAdultAgedAged, 80 and overCarcinoma, Non-Small-Cell LungFemaleFollow-Up StudiesHumansMaleMedical OncologyMiddle AgedMortalityPrecision MedicinePrognosisReproducibility of ResultsRisk FactorsExternal validationNon–small-cell lung cancerPrognostic model

Identifiers

PMID31708233
PMCPMC11068418

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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.