Evidence map›Paper›PMID 32099477›Full record

ArticleClinical epidemiology2020

Application of the Adaptive Validation Substudy Design to Colorectal Cancer Recurrence.

Lindsay J Collin, Anders H Riis, Richard F MacLehose, Thomas P Ahern, Rune Erichsen, Ole Thorlacius-Ussing, Timothy L Lash

Abstract read
In one paragraph

Article in Clinical epidemiology, 2020. 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.

Lindsay J CollinDepartment of Epidemiology, Emory University, Atlanta, GA, USA.ORCID 0000-0003-0170-2592
Anders H RiisDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Richard F MacLehoseDivision of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
Thomas P AhernDepartment of Surgery, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, VT, USA.
Rune ErichsenDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.ORCID 0000-0001-9398-9185
Ole Thorlacius-UssingDepartment of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark.
Timothy L LashDepartment of Epidemiology, Emory University, Atlanta, GA, USA.

Funding

Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI HIGGINS, STEPHEN T · 2013 to 2022
$21.3M
Registering Cancer Recurrences in the Georgia Cancer RegistryR01CA234538 · NCI · EMORY UNIVERSITY · PI LASH, TIMOTHY L., WARD, KEVIN C · 2019 to 2024
$2.8M
Improving Reproducibility by Incorporating UncertaintyR01LM013049 · NLM · EMORY UNIVERSITY · PI LASH, TIMOTHY L. · 2019 to 2022
$1.1M
Biologic and Patient Variation Affecting Breast Cancer Treatment EfficacyF31CA239566 · NCI · EMORY UNIVERSITY · PI COLLIN, LINDSAY JANE · 2019 to 2020
$53k
NCI NIH HHS F31 CA239566NCI NIH HHS R01 CA234538NIGMS NIH HHS P20 GM103644NLM NIH HHS R01 LM013049
6 · The paper itself

Abstract

backgroundAmong men and women diagnosed with colorectal cancer (CRC), 20-50% will develop a cancer recurrence. Cancer recurrences are not routinely captured by most population-based registries; however, linkage across Danish registries allows for the development of predictive models to detect recurrence. Successful application of such models in population-based settings requires validation against a gold standard to ensure the accuracy of recurrence identification.

objectiveWe apply a recently developed validation study design for prospectively collected validation data to validate predicted CRC recurrences against gold standard diagnoses from medical records in an actively followed cohort of CRC patients in Denmark.

methodsWe use a Bayesian monitoring framework, traditionally used in clinical trials, to iteratively update classification parameters (positive and negative predictive values, and sensitivity and specificity) in an adaptive validation substudy design. This design allows determination of the sample size necessary to estimate the corresponding parameters and to identify when validation efforts can cease based on predefined criteria for parameter values and levels of precision.

resultsAmong 355 men and women diagnosed with CRC in Denmark and actively followed semi-annually, there were 63 recurrences diagnosed by active follow-up and 70 recurrences identified by a predictive algorithm. The adaptive validation design met stopping criteria for the classification parameters after 120 patients had their recurrence information validated. This stopping point yielded parameter estimates for the classification parameters similar to those obtained when the entire cohort was validated, with 66% less patients needed for the validation study.

conclusionIn this proof of concept application of the adaptive validation study design for outcome misclassification, we demonstrated the ability of the method to accurately determine when sufficient validation data have been collected. This method serves as a novel validation substudy design for prospectively collected data with simultaneous implementation of a validation study.

Indexed as

colorectal cancer recurrencevalidation study design

Identifiers

PMID32099477
PMCPMC7007499

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