Evidence map›Paper›PMID 41272613›Full record

ArticleBMC urology2025

Digital rectal exam vs. electronic "digitized" prostate exam.

Tabea Borde, Nicole A Varble, Alexander Kenigsberg, Lindsey A Hazen, Laetitia Saccenti, Peter A Pinto, Baris Turkbey, Bradford J Wood

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Tabea BordeCenter for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.ORCID http://orcid.org/0000-0003-3019-5470
Nicole A VarbleCenter for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA. nicole.varble@nih.gov.
Alexander KenigsbergUrologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
Lindsey A HazenCenter for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.
Laetitia SaccentiCenter for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.
Peter A PintoUrologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
Baris TurkbeyMolecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
Bradford J WoodCenter for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe current era of multiparametric prostate MRI (mpMRI) and ultrasound (US)/ MRI fusion has improved early detection of clinically significant prostate cancer (csPCa) while decreasing the number of unnecessary biopsies. Hence, this study aims to define the diagnostic value of pre-biopsy digital rectal examination (DRE) for screening and detection of csPCa, when there is access to mpMRI and prostate-specific antigen (PSA).

methodsThis retrospective, single-center study involved 3379 consecutive patients biopsied between 2012 and 2023 using both MRI/US-targeted fusion and systematic approaches. Biopsies were indicated because of elevated PSA levels and/or presence of cancer suspicious lesions on MRI. All patients underwent DRE and mpMRI prior to biopsy. csPCa was defined as Gleason grade group ≥2. Diagnostic performance of DRE for csPCa was compared to PSA and PSA density (PSAD) using receiver operating characteristic curves.

resultsTwo thousand one hundred eighty-eight (65%) patients were diagnosed with PCa and 1498 (44%) patients with csPCa. DRE was positive in 410/3379 (12%) patients. 261/410 (64%) DRE positive patients had confirmed csPCa, of which 160/261 (61%) were located in immediate proximity to the rectum. mpMRI was positive for focal lesion(s) in 1494/1498 (100%) csPCa patients. For csPCa detection, DRE had a sensitivity of 0.17, specificity of 0.92, a positive predictive value of 0.63 and a negative predictive value of 0.59. Compared to DRE (AUC 0.55 [CI95% 0.54, 0.56]), PSA (AUC 0.63 [CI95% 0.61, 0.64]) and PSAD (AUC 0.73 [CI95% 0.71, 0.74]) showed better csPCa prediction performance (both p < 0.001).

conclusionsPre-biopsy DRE was found to add little to no diagnostic value for the routine diagnostic workflow in a constrained setting when PSA and mpMRI are initial screening tools for patients with suspected csPCa.

Indexed as

Digital Rectal ExaminationProstatic NeoplasmsAgedHumansMaleMiddle AgedProstate-Specific AntigenRetrospective StudiesProstate-Specific AntigenDigital rectal examinationImage-Guided biopsyMagnetic resonance imagingProstateProstate-Specific antigenProstatic cancer

Identifiers

PMID41272613
PMCPMC12771905

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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.