Evidence map›Paper›PMID 35027755›Full record

ArticleNature medicine2022

Artificial intelligence for diagnosis and Gleason grading of prostate cancer: the PANDA challenge.

Wouter Bulten, Kimmo Kartasalo, Po-Hsuan Cameron Chen, Peter Ström, Hans Pinckaers, Kunal Nagpal, Yuannan Cai, David F Steiner, Hester van Boven, Robert Vink and 24 more

Abstract read
In one paragraph

Article in Nature medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 227 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
227citing papers in PubMed, 3 pooled it
–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

227 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Artificial intelligence for glaucoma.The Cochrane database of systematic reviews · 2025
    Pooled it
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  17. Immune Spatial Organization Predicts Distant Metastasis Risk in Aggressive Localized Prostate Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
    Article
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167 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

34 authors.

Wouter Bulten *Department of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. wouter@wouterbulten.com.ORCID http://orcid.org/0000-0002-6129-5039
Kimmo Kartasalo *Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. kimmo.kartasalo@ki.se.ORCID http://orcid.org/0000-0002-9470-4783
Po-Hsuan Cameron Chen *Google Health, Palo Alto, CA, USA. cameronchen@google.com.ORCID http://orcid.org/0000-0002-0083-4991
Peter StrömDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Hans PinckaersDepartment of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Kunal NagpalGoogle Health, Palo Alto, CA, USA.
Yuannan CaiGoogle Health, Palo Alto, CA, USA.
David F SteinerGoogle Health, Palo Alto, CA, USA.ORCID http://orcid.org/0000-0003-1297-0023
Hester van BovenDepartment of Pathology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Robert VinkLaboratory of Pathology East Netherlands, Hengelo, The Netherlands.
Christina Hulsbergen-van de KaaLaboratory of Pathology East Netherlands, Hengelo, The Netherlands.
Jeroen van der LaakDepartment of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0001-7982-0754
Mahul B AminDepartment of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.ORCID http://orcid.org/0000-0001-5943-3634
Andrew J EvansLaboratory Medicine, Mackenzie Health, Toronto, Ontario, Canada.
Theodorus van der KwastDepartment of Pathology, Laboratory Medicine and Pathology, University Health Network and University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0001-8640-5786
Robert AllanPathology and Laboratory Medicine Service, North Florida/South Georgia Veterans Health System, Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA.
Peter A HumphreyDepartment of Pathology, Yale School of Medicine, New Haven, CT, USA.
Henrik GrönbergDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-1073-2753
Hemamali SamaratungaAquesta Uropathology and University of Queensland, Brisbane, QLD, Australia.
Brett DelahuntDepartment of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
Toyonori TsuzukiDepartment of Surgical Pathology, School of Medicine, Aichi Medical University, Nagakute, Japan.ORCID http://orcid.org/0000-0002-4855-4366
Tomi HäkkinenFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Lars EgevadDepartment of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
Maggie DemkinKaggle Inc, Mountain View, CA, USA.
Sohier DaneKaggle Inc, Mountain View, CA, USA.
Fraser TanGoogle Health, Palo Alto, CA, USA.
Masi ValkonenInstitute of Biomedicine, Cancer Research Unit and FICAN West Cancer Centre, University of Turku and Turku University Hospital, Turku, Finland.
Greg S CorradoGoogle Health, Palo Alto, CA, USA.
Lily PengGoogle Health, Palo Alto, CA, USA.
Craig H MermelGoogle Health, Palo Alto, CA, USA.ORCID http://orcid.org/0000-0002-0816-3395
Pekka RuusuvuoriFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Geert LitjensDepartment of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-1554-1291
Martin EklundDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0001-5032-5266
PANDA challenge consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Artificial intelligence (AI) has shown promise for diagnosing prostate cancer in biopsies. However, results have been limited to individual studies, lacking validation in multinational settings. Competitions have been shown to be accelerators for medical imaging innovations, but their impact is hindered by lack of reproducibility and independent validation. With this in mind, we organized the PANDA challenge-the largest histopathology competition to date, joined by 1,290 developers-to catalyze development of reproducible AI algorithms for Gleason grading using 10,616 digitized prostate biopsies. We validated that a diverse set of submitted algorithms reached pathologist-level performance on independent cross-continental cohorts, fully blinded to the algorithm developers. On United States and European external validation sets, the algorithms achieved agreements of 0.862 (quadratically weighted κ, 95% confidence interval (CI), 0.840-0.884) and 0.868 (95% CI, 0.835-0.900) with expert uropathologists. Successful generalization across different patient populations, laboratories and reference standards, achieved by a variety of algorithmic approaches, warrants evaluating AI-based Gleason grading in prospective clinical trials.

Indexed as

Neoplasm GradingAlgorithmsBiopsyCohort StudiesHumansMaleProstatic NeoplasmsReproducibility of Results

Identifiers

PMID35027755
PMCPMC8799467

What OpenQuestion holds

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Registered trials

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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.