Evidence map›Paper›PMID 34991528›Full record

ArticleBMC pulmonary medicine2022

Percepta Genomic Sequencing Classifier and decision-making in patients with high-risk lung nodules: a decision impact study.

Sonali Sethi, Scott Oh, Alexander Chen, Christina Bellinger, Lori Lofaro, Marla Johnson, Jing Huang, Sangeeta Maruti Bhorade, William Bulman, Giulia C Kennedy

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pulmonary medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 26% 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

6 citing papers in PubMed, 6 citations in OpenAlex.

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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

10 authors at 5 institutions in 1 country.

Sonali SethiDivision of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Mail Code A90, Cleveland, OH, 44195, USA. sethis@ccf.org.
Scott OhDivision of Pulmonary, Critical Care and Sleep Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Alexander ChenDivision of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Christina BellingerPulmonary, Critical Care, Allergy and Immunologic Disease, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Lori LofaroVeracyte, Inc., South San Francisco, CA, USA.
Marla JohnsonVeracyte, Inc., South San Francisco, CA, USA.
Jing HuangVeracyte, Inc., South San Francisco, CA, USA.
Sangeeta Maruti BhoradeVeracyte, Inc., South San Francisco, CA, USA.
William BulmanVeracyte, Inc., South San Francisco, CA, USA.
Giulia C KennedyVeracyte, Inc., South San Francisco, CA, USA.
Veracyte (United States) · USCleveland Clinic · USUniversity of California, Los Angeles · USWake Forest University · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncidental and screening-identified lung nodules are common, and a bronchoscopic evaluation is frequently nondiagnostic. The Percepta Genomic Sequencing Classifier (GSC) is a genomic classifier developed in current and former smokers which can be used for further risk stratification in these patients. Percepta GSC has the capability of up-classifying patients with a pre-bronchoscopy risk that is high (> 60%) to "very high risk" with a positive predictive value of 91.5%. This prospective, randomized decision impact survey was designed to test the hypothesis that an up-classification of risk of malignancy from high to very high will increase the rate of referral for surgical or ablative therapy without additional intervening procedures while increasing physician confidence.

methodsData were collected from 37 cases from the Percepta GSC validation cohort in which the pre-bronchoscopy risk of malignancy was high (> 60%), the bronchoscopy was nondiagnostic, and the patient was up-classified to very high risk by Percepta GSC. The cases were randomly presented to U.S pulmonologists in three formats: a pre-post cohort where each case is presented initially without and then with a GSG result, and two independent cohorts where each case is presented either with or without with a GSC result. Physicians were surveyed with respect to subsequent management steps and confidence in that decision.

resultsOne hundred and one survey takers provided a total of 1341 evaluations of the 37 patient cases across the three different cohorts. The rate of recommendation for surgical resection was significantly higher in the independent cohort with a GSC result compared to the independent cohort without a GSC result (45% vs. 17%, p < 0.001) In the pre-post cross-over cohort, the rate increased from 17 to 56% (p < 0.001) following the review of the GSC result. A GSC up-classification from high to very high risk of malignancy increased Pulmonologists' confidence in decision-making following a nondiagnostic bronchoscopy.

conclusionsUse of the Percepta GSC classifier will allow more patients with early lung cancer to proceed more rapidly to potentially curative therapy while decreasing unnecessary intervening diagnostic procedures following a nondiagnostic bronchoscopy.

Indexed as

GenomicsAgedAged, 80 and overBronchoscopyClinical Decision-MakingCohort StudiesFemaleHumansLung NeoplasmsMaleMiddle AgedProspective StudiesPulmonologistsSmokingSurveys and QuestionnairesUnited StatesBronchoscopyLung cancerLung lesionPhysician confidenceRisk assessment

Identifiers

PMID34991528
PMCPMC8740045
OpenAlexW4220681692

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.