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1. Risk-prediction models in postmenopausal patients with symptoms of suspected ovarian cancer in the UK (ROCkeTS): a multicentre, prospective diagnostic accuracy study

Author

Kent, Robert, Rosello, Natalia, Malhotra, Vivek, Jermy, Karen, Duncan, Tim, Ames, Victoria, Sharma, Aarti, Sinha, Anju, Tarang, Majmudar, Ciara, Mackenzie, Hebblethwaite, Neil, Exley, Kendra, Macdonald, Robert, Harmer, Marianne, Hughes, Tracey, Parker, Rob, Darwish, Ahmed, Abedin, Parveen, Balogun, Moji, Ramsay, Bruce, Moshy, Roger, Roberts, Mark, Russell, Michelle, Sayasneh, Ahmad, Abdelbar, Ahmed, Abdi, Shahram, Palmer, Julia, Gajjar, Ketankumar, Blake, Dominic, Naskretski, Adam, Ghazal, Fateh, Rai, Harinder, Keating, Patrick, Wood, Nicholas, Gnanachandran, Chellappah, Alawad, Hafez, Kaushik, Sonali, Baron, Sonali, Vita, Lavanya, Nagar, Hans, Manchanda, Ranjit, Sundar, Sudha, Agarwal, Ridhi, Davenport, Clare, Scandrett, Katie, Johnson, Susanne, Sengupta, Partha, Selvi-Vikram, Radhika, Kwong, Fong Lien, Mallett, Sue, Rick, Caroline, Kehoe, Sean, Timmerman, Dirk, Bourne, Tom, Van Calster, Ben, Stobart, Hilary, Neal, Richard D, Menon, Usha, Gentry-Maharaj, Alex, Sturdy, Lauren, Ottridge, Ryan, and Deeks, Jon

Published
2024
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3. Developing a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study

Author

Chaudry, Aasem, Sharma, Abhishek, Bennett, Adam, Ahmad, Adnan, Abroaf, Ahmed, Suliman, Ahmed Musa, Lloyd, Aimee, McKay, Alastair, Wong, Albert, Silva, Alberto, Schneider, Alexandre, MacKay, Alison, Knight, Allen, Grigorakis, Alkiviadis, Bdesha, Amar, Nagle, Amy, Cebola, Ana, Dhanasekaran, Ananda Kumar, Kondža, Andraž, Barcelos, André, Galosi, Andrea Benedetto, Ebur, Andrea, Minervini, Andrea, Russell, Andrew, Webb, Andrew, de Jalón, Ángel García, Desai, Ankit, Czech, Anna Katarzyna, Mainwaring, Anna, Adimonye, Anthony, Das, Arighno, Figueiredo, Arnaldo, Villers, Arnauld, Leminski, Artur, Chippagiri, Arvinda, Lal, Asim Ahmed, Yıldırım, Asıf, Voulgaris, Athanasios Marios, Uzan, Audrey, Oo, Aye Moh Moh, Younis, Ayman, Zelhof, Bachar, Mukhtar, Bashir, Ayres, Ben, Challacombe, Ben, Sherwood, Benedict, Ristau, Benjamin, Lai, Billy, Nellensteijn, Brechtje, Schreiter, Brielle, Trombetta, Carlo, Dowling, Catherine, Hobbs, Catherine, Benitez, Cayo Augusto Estigarribia, Lebacle, Cédric, Ho, Cherrie Wing Yin, Ng, Chi-Fai, Mount, Chloe, Lam, Chon Meng, Blick, Chris, Brown, Christian, Gallegos, Christopher, Higgs, Claire, Browne, Clíodhna, McCann, Conor, Plaza Alonso, Cristina, Beder, Daniel, Cohen, Daniel, Gordon, Daniel, Wilby, Daniel, Gordon, Danny, Hrouda, David, Lau, David Hua Wu, Karsza, Dávid, Mak, David, Martin-Way, David, Suthaharan, Denula, Patel, Dhruv, Carrion, Diego M, Nyanhongo, Donald, Bass, Edward, Mains, Edward, Chau, Edwin, Canelon Castillo, Elba, Day, Elizabeth, Desouky, Elsayed, Gaines, Emily, Papworth, Emma, Yuruk, Emrah, Kilic, Enes, Dinneen, Eoin, Palagonia, Erika, Xylinas, Evanguelos, Khawaja, Faizan, Cimarra, Fernando, Bardet, Florian, Kum, Francesca, Peters, Francesca, Kovács, Gábor, Tanasescu, Geroge, Hellawell, Giles, Tasso, Giovanni, Lam, Gitte, La Montagna, Giuseppe, Pizzuto, Giuseppe, Lenart, Gordan, MacLennan, Graeme, Özgür, Günal, Bi, Hai, Lyons, Hannah, Warren, Hannah, Ahmed, Hashim, Simpson, Helen, Burden, Helena, Gresty, Helena, Rios Pita, Hernado, Clarke, Holly, Serag, Hosam, Kynaston, Howard, Crawford-Smith, Hugh, Mostafid, Hugh, Otaola-Arca, Hugo, Koo, Hui Fen, Ibrahim, Ibrahim, Ouzaid, Idir, Puche-Sanz, Ignacio, Tomašković, Igor, Tinay, Ilker, Sahibzada, Iqbal, Thangasamy, Isaac, Cadena, Iván Revelo, Irani, Jacques, Udzik, Jakub, Brittain, James, Catto, James, Green, James, Tweedle, James, Hernando, Jamie Borrego, Leask, Jamie, Kalsi, Jas, Frankel, Jason, Toniolo, Jason, Raman, Jay D., Courcier, Jean, Kumaradeevan, Jeevan, Clark, Jennifer, Jones, Jennifer, Teoh, Jeremy Yuen-Chun, Iacovou, John, Kelly, John, Selph, John P., Aning, Jonathan, Deeks, Jon, Cobley, Jonathan, Olivier, Jonathan, Maw, Jonny, Herranz-Yagüe, José Antonio, Nolazco, Jose Ignacio, Cózar-Olmo, Jose Manuel, Bagley, Joseph, Jelski, Joseph, Norris, Joseph, Testa, Joseph, Meeks, Joshua, Hernandez, Juan, Vásquez, Juan Luis, Randhawa, Karen, Dhera, Karishma, Gronostaj, Katarzyna, Houlton, Kathleen, Lehman, Kathleen, Gillams, Kathryn, Adasonla, Kelvin, Brown, Kevin, Murtagh, Kevin, Mistry, Kiki, Davenport, Kim, Kitamura, Kosuke, Derbyshire, Laura, Clarke, Laurence, Morton, Lawrie, Martinez, Levin, Goldsmith, Louise, Paramore, Louise, Cormier, Luc, Dell'Atti, Lucio, Simmons, Lucy, Martinez-Piñeiro, Luis, Rico, Luis, Chan, Luke, Forster, Luke, Ma, Lulin, Moore, Madeline, Gallego, Maria Camacho, Freire, Maria José, Emberton, Mark, Feneley, Mark, Antón-Juanilla, Marta, Rivero, Marta Viridiana Muñoz, Pirša, Matea, Tallè, Matteo, Crockett, Matthew, Liew, Matthew, Trail, Matthew, Peters, Max, Cooper, Meghan, Kulkarni, Meghana, Ager, Michael, He, Ming, Li, Mo, Omran Breish, Mohamed, Tarin, Mohamed, Aldiwani, Mohammed, Matanhelia, Mudit, Pasha, Muhammad, Akalın, Mustafa Kaan, Abdullah, Nasreen, Hale, Nathan, Gadiyar, Neha, Kocher, Neil, Bullock, Nicholas, Campain, Nicholas, Pavan, Nicola, Al-Ibraheem, Nihad, Bhatt, Nikita, Bedi, Nishant, Shrotri, Nitin, Lobo, Niyati, Balderas, Olga, Kouli, Omar, Capoun, Otakar, Oteo Manjavacas, Pablo, Gontero, Paolo, Mariappan, Paramananthan, Marchiñena, Patricio Garcia, Erotocritou, Paul, Sweeney, Paul, Planelles, Paula, Acher, Peter, Black, Peter C., Osei-Bonsu, Peter K, Østergren, Peter, Smith, Peter, Willemse, Peter-Paul Michiel, Chlosta, Piotr L., Ul Ain, Qurrat, Barratt, Rachel, Esler, Rachel, Khalid, Raihan, Hsu, Ray, Stamirowski, Remigiusz, Mangat, Reshma, Cruz, Ricardo, Ellis, Ricky, Adams, Robert, Hessell, Robert, Oomen, Robert J.A., McConkey, Robert, Ritchie, Robert, Jarimba, Roberto, Chahal, Rohit, Andres, Rosado Mario, Hawkins, Rosalyn, David, Rotimi, Manecksha, Rustom P., Agrawal, Sachin, Hamid, Syed Sami, Deem, Samuel, Goonewardene, Sanchia, Swami, Satchi Kuchibhotla, Hori, Satoshi, Khan, Shahid, Mohammud Inder, Shakeel, Sangaralingam, Shanthi, Marathe, Shekhar, Raveenthiran, Sheliyan, Horie, Shigeo, Sengupta, Shomik, Parson, Sian, Parker, Sidney, Hawlina, Simon, Williams, Simon, Mazzoli, Simone, Grzegorz Kata, Slawomir, Pinheiro Lopes, Sofia, Ramos, Sónia, Rai, Sonpreet, Rintoul-Hoad, Sophie, O'Meara, Sorcha, Morris, Steve, Turner, Stacey, Venturini, Stefano, Almpanis, Stephanos, Joniau, Steven, Jain, Sunjay, Mallett, Susan, Nikles, Sven, Shahzad, Yan, Sylvia, Lee, Taeweon, Uçar, Taha, Drake, Tamsin, Toma, Tarq, Cabañuz Plo, Teresa, Bonnin, Thierry, Muilwijk, Tim, Wollin, Tim, Chu, Timothy Shun Man, Appanna, Timson, Brophy, Tom, Ellul, Tom, Austin, Tomas, Smrkolj, Tomaž, Rowe, Tracey, Sukhu, Troy, Patel, Trushar, Garg, Tullika, Çaşkurlu, Turhan, Bele, Uros, Haroon, Usman, Crespo-Atín, Víctor, Parejo Cortes, Victor, Capapé Poves, Victoria, Gnanapragasam, Vincent, Gauhar, Vineet, During, Vinnie, Kumar, Vivek, Fiala, Vojtech, Mahmalji, Wasim, Lam, Wayne, Fung Chin, Yew, Filtekin, Yigit, Chyn Phan, Yih, Ibrahim, Youssed, Glaser, Zachary A, Abiddin, Zainal Adwin, Qin, Zijian, Zotter, Zsuzsanna, Zainuddin, Zulkifli, Khadhouri, Sinan, Gallagher, Kevin M., MacKenzie, Kenneth R., Shah, Taimur T., Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F., Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Anbarasan, Thineskrishna, Mannas, Miles P., Marra, Giancarlo, Gómez Rivas, Juan, Marcq, Gautier, Assmus, Mark A., Claps, Francesco, Boltri, Matteo, Burnhope, Tara, Nkwam, Nkwam, Boxall, Nicholas E., Downey, Alison P., Sukhu, Troy A., Chin, Yew-Fung, Green, James S.A., Goulao, Beatriz, Nielsen, Matthew, McGrath, John S., and Kasivisvanathan, Veeru

Published
2022
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4. Variation in the observed effect of Xpert MTB/RIF testing for tuberculosis on mortality: A systematic review and analysis of trial design considerations

Author

Ochodo, Eleanor A, Kalema, Nelson, Schumacher, Samuel, Steingart, Karen, Young, Taryn, Mallett, Susan, Deeks, Jon, Cobelens, Frank, Bossuyt, Patrick M, Nicol, Mark P, and Cattamanchi, Adithya

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Emerging Infectious Diseases, Infectious Diseases, Rare Diseases, Tuberculosis, Biodefense, Clinical Trials and Supportive Activities, Infection, Good Health and Well Being, Diagnostic trials, Impact studies, Tuberculosis diagnosis, methodology, Xpert MTB/RIF, Impact, Pragmatic trials, diagnostic trials, Methodology, Systematic review, Biomedical and clinical sciences, Health sciences
Abstract

Background: Most studies evaluating the effect of Xpert MTB/RIF testing for tuberculosis (TB) concluded that it did not reduce overall mortality compared to usual care. We conducted a systematic review to assess whether key study design and execution features contributed to earlier identification of patients with TB and decreased pre-treatment loss to follow-up, thereby reducing the potential impact of Xpert MTB/RIF testing. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Scopus for literature published from 1 st January 2009 to February 2019. We included all primary intervention studies that had evaluated the effect of Xpert MTB/RIF on mortality compared to usual care in participants with presumptive pulmonary TB. We critically reviewed features of included studies across: Study setting and context, Study population, Participant recruitment and enrolment, Study procedures, and Study follow-up. Results: We included seven randomised and one non-randomised study.  All included studies demonstrated relative reductions in overall mortality in the Xpert MTB/RIF arm ranging from 6% to 40%. However, mortality reduction was reported to be statistically significant in two studies. Study features that could explain the lack of observed effect on mortality included: the higher quality of care at study sites; inclusion of patients with a higher pre-test probability of TB leading to higher than expected empirical rates; performance of additional diagnostic testing not done in usual care leading to increased TB diagnosis or empiric treatment initiation; the recruitment of participants likely to return for follow-up; and involvement of study staff in ensuring adherence with care and follow-up. Conclusion: Most studies of Xpert MTB/RIF were designed and conducted in a manner that resulted in more patients being diagnosed and treated for TB, minimising the potential difference in mortality Xpert MTB/RIF testing could have achieved compared to usual care.

Published
2019

5. Investigating harms of testing for ovarian cancer – psychological outcomes and cancer conversion rates in women with symptoms of ovarian cancer: A cohort study embedded in the multicentre ROCkeTS prospective diagnostic study.

Author

Kwong, Fong Lien, Kristunas, Caroline, Davenport, Clare, Aggarwal, Ridhi, Deeks, Jon, Mallett, Sue, Kehoe, Sean, Timmerman, Dirk, Bourne, Tom, Stobart, Hilary, Neal, Richard, Menon, Usha, Gentry‐Maharaj, Alex, Sturdy, Lauren, Ottridge, Ryan, Sundar, Sudha, Abdelbar, Ahmed, Abdi, Shahram, Abedin, Parveen, and Alawad, Hafez

Subjects
IMPACT of Event Scale, PSYCHOLOGICAL distress, SECONDARY care (Medicine), YOUNG women, POSTMENOPAUSE, OVARIAN cancer
Abstract

Objective: To investigate psychological correlates in women referred with suspected ovarian cancer via the fast‐track pathway, explore how anxiety and distress levels change at 12 months post‐testing, and report cancer conversion rates by age and referral pathway. Design: Single‐arm prospective cohort study. Setting: Multicentre. Secondary care including outpatient clinics and emergency admissions. Population: A cohort of 2596 newly presenting symptomatic women with a raised CA125 level, abnormal imaging or both. Methods: Women completed anxiety and distress questionnaires at recruitment and at 12 months for those who had not undergone surgery or a biopsy within 3 months of recruitment. Main outcome measures: Anxiety and distress levels measured using a six‐item short form of the State–Trait Anxiety Inventory (STAI‐6) and the Impact of Event Scale – Revised (IES‐r) questionnaire. Ovarian cancer (OC) conversion rates by age, menopausal status and referral pathway. Results: Overall, 1355/2596 (52.1%) and 1781/2596 (68.6%) experienced moderate‐to‐severe distress and anxiety, respectively, at recruitment. Younger age and emergency presentations had higher distress levels. The clinical category for anxiety and distress remained unchanged/worsened in 76% of respondents at 12 months, despite a non‐cancer diagnosis. The OC rates by age were 1.6% (95% CI 0.5%–5.9%) for age <40 years and 10.9% (95% CI 8.7%–13.6%) for age ≥40 years. In women referred through fast‐track pathways, 3.3% (95% CI 1.9%–5.7%) of pre‐ and 18.5% (95% CI 16.1%–21.0%) of postmenopausal women were diagnosed with OC. Conclusions: Women undergoing diagnostic testing display severe anxiety and distress. Younger women are especially vulnerable and should be targeted for support. Women under the age of 40 years have low conversion rates and we advocate reducing testing in this group to reduce the harms of testing. [ABSTRACT FROM AUTHOR]

Published
2024
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6. A quality assessment tool for artificial intelligence-centered diagnostic test accuracy studies: QUADAS-AI

Author

Sounderajah, Viknesh, Ashrafian, Hutan, Rose, Sherri, Shah, Nigam H., Ghassemi, Marzyeh, Golub, Robert, Kahn, Jr, Charles E., Esteva, Andre, Karthikesalingam, Alan, Mateen, Bilal, Webster, Dale, Milea, Dan, Ting, Daniel, Treanor, Darren, Cushnan, Dominic, King, Dominic, McPherson, Duncan, Glocker, Ben, Greaves, Felix, Harling, Leanne, Ordish, Johan, Cohen, Jérémie F., Deeks, Jon, Leeflang, Mariska, Diamond, Matthew, McInnes, Matthew D. F., McCradden, Melissa, Abràmoff, Michael D., Normahani, Pasha, Markar, Sheraz R., Chang, Stephanie, Liu, Xiaoxuan, Mallett, Susan, Shetty, Shravya, Denniston, Alastair, Collins, Gary S., Moher, David, Whiting, Penny, Bossuyt, Patrick M., and Darzi, Ara

Published
2021
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7. IDENTIFY: The investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer: A multicentre cohort study

Author

Ahmed, Hashim, Deeks, Jon, Emberton, Mark, Kumaradeevan, Jeevan, Mallett, Susan, Takwoingi, Yemisi, Morris, Steve, Knight, Allen, Blick, Chris, Catto, James, Cohen, Daniel, Green, James, Kelly, John, Mostafid, Hugh, Khadhouri, Sinan, Gallagher, Kevin M, MacKenzie, Kenneth, Shah, Taimur T, Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor, Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, MacLennan, Graeme, McGrath, John S, and Kasivisvanathan, Veeru

Published
2020
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8. Biological variation of measured and estimated glomerular filtration rate in patients with chronic kidney disease

Author

Rowe, Ceri, Sitch, Alice J., Barratt, Jonathan, Brettell, Elizabeth A., Cockwell, Paul, Dalton, R. Neil, Deeks, Jon J., Eaglestone, Gillian, Pellatt-Higgins, Tracy, Kalra, Philip A., Khunti, Kamlesh, Loud, Fiona C., Morris, Frances S., Ottridge, Ryan S., Stevens, Paul E., Sharpe, Claire C., Sutton, Andrew J., Taal, Maarten W., and Lamb, Edmund J.

Published
2019
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9. Accuracy of glomerular filtration rate estimation using creatinine and cystatin C for identifying and monitoring moderate chronic kidney disease: the eGFR-C study.

Author

Lamb, Edmund J., Barratt, Jonathan, Brettell, Elizabeth A., Cockwell, Paul, Dalton, R. Neil, Deeks, Jon J., Eaglestone, Gillian, Pellatt-Higgins, Tracy, Kalra, Philip A., Khunti, Kamlesh, Loud, Fiona C., Ottridge, Ryan S., Potter, Aisling, Rowe, Ceri, Scandrett, Katie, Sitch, Alice J., Stevens, Paul E., Sharpe, Claire C., Shinkins, Bethany, and Smith, Alison

Published
2024
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15. A Vein Bypass First Versus a Best Endovascular Treatment First Revascularisation Strategy for Chronic Limb Threatening Ischaemia Requiring an Infra-Popliteal with or Without a More Proximal Procedure to Restore Limb Perfusion: The Bypass Versus Angioplasty for Severe Ischaemia of the Leg (BASIL) 2 Randomised Controlled Trial

Author

Bradbury, Andrew Walter, primary, Hewitt, Catherine, additional, Popplewell, Matthew, additional, Meecham, Lewis, additional, Bate, Gareth, additional, Kelly, Lisa, additional, Chetter, Ian, additional, Diamantopoulos, Athansios, additional, Ganeshan, Arul, additional, Hall, Jack, additional, Hobbs, Simon, additional, Houlind, Kim, additional, Jarrett, Hugh, additional, Lockyer, Suzanne, additional, Malmstedt, Jonas, additional, Patel, Jai, additional, Patel, Smitaa, additional, Rashid, S. Tawqeer, additional, Saratzis, Athanasios, additional, Slinn, Gemma, additional, Scott, David Julian, additional, Zayed, Hany, additional, and Deeks, Jon, additional

Published
2023
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18. Guidelines and regulations applicable to vitro diagnostic tests in the UK: a scoping review

Author

Staworko, Magdalena, Khawar, Oscar, Sullivan, Frank, Donnelly, Peter D, Deeks, Jon, and McCartney, Margaret

Abstract

ObjectiveTo describe recommendations applicable to new diagnostic and screening tests brought to market in the UK as of 01 June 2023; and extract agreements, disagreements and gaps.DesignExtant regulations, recommendations and guidelines for new diagnostic and screening tests applicable to new products placed in the UK market as of 01 June 2023. Non-English and references not applicable to new tests seeking market access in the UK on 01 June 2023 were excluded.Data sourcesPubMed, Web of Science Core Collection and Scopus; grey literature via EuropePMC and Google, government regulations and guidelines, and relevant professional societies. References of relevant included data were scanned for includable articles. Resultant data were thematically analysed and presented as a narrative scoping review.Eligibility for selecting studiesPubMed, Web of Science Core Collection and Scopus were searched from 1/1/2018 for regulations, guidelines or recommendations for in vitro diagnositic tests as applied to the UK on 1/6/23. Relevant papers also had references searched.Results943 items were initially identified with 892 excluded. Reference searching located a further 31 papers and 82 items were analysed. Seven themes were identified: regulation, companion diagnostics and lab developed tests, safety and evidence, test specific recommendations, data, innovation and recommendations for patients/the public. Wide agreement included the need to reduce bureaucracy and duplication; to mitigate to avoid unintended consequences of In Vitro Diagnostic Regulation. Disagreement over whether high-quality evidence should precede regulatory approval, or could be gathered as part of postmarketing surveillance emerged.ConclusionsIndustry, regulators, academics, patients representing a variety of views, should collaborate to work through areas of disagreement.

Published
2024
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20. Diagnostic Models Combining Clinical Information, Ultrasound and Biochemical Markers for Ovarian Cancer: Cochrane Systematic Review and Meta-Analysis

Author

Davenport, Clare F., primary, Rai, Nirmala, additional, Sharma, Pawana, additional, Deeks, Jon, additional, Berhane, Sarah, additional, Mallett, Sue, additional, Saha, Pratyusha, additional, Solanki, Rita, additional, Bayliss, Susan, additional, Snell, Kym, additional, and Sundar, Sudha, additional

Published
2022
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22. EXPERT CONSENSUS DOCUMENT: Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Author

Fabritz, Larissa, Guasch, Eduard, Antoniades, Charalambos, Bardinet, Isabel, Benninger, Gerlinde, Betts, Tim R., Brand, Eva, Breithardt, Günter, Bucklar-Suchankova, Gabriela, Camm, John A., Cartlidge, David, Casadei, Barbara, Chua, Winnie W. L., Crijns, Harry J. G. M., Deeks, Jon, Hatem, Stéphane, Hidden-Lucet, Françoise, Kääb, Stefan, Maniadakis, Nikos, Martin, Stephan, Mont, Lluis, Reinecke, Holger, Sinner, Moritz F., Schotten, Ulrich, Southwood, Taunton, Stoll, Monika, Vardas, Panos, Wakili, Reza, West, Andy, Ziegler, André, and Kirchhof, Paulus

Published
2016
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24. When Can Odds Ratios Mislead?

Author

Deeks, Jon, Bracken, Michael B., Sinclair, John C., Davies, Huw Talfryn Oakley, Tavakoli, Manouche, and Crombie, Iain Kinloch

Published
1998

26. The IDENTIFY Study: The Investigation and Detection of Urological Neoplasia in Patients Referred with Suspected Urinary Tract Cancer; A multicentre observational study

Author

Khadhouri, Sinan, Gallagher, Kevin M., MacKenzie, Kenneth R., Shah, Taimur T., Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F., Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Mannas, Miles P., Lee, Taeweon, Marra, Giancarlo, Lillaz, Beatrice, Gómez Rivas, Juan, Olivier, Jonathan, Assmus, Mark A., Uçar, Taha, Claps, Francesco, Boltri, Matteo, Burnhope, Tara, Nkwam, Nkwam, Tanasescu, George, Boxall, Nicholas E., Downey, Alison P., Lal, Asim A, Antón-Juanilla, Marta, Clarke, Holly, Lau, David H. W., Gillams, Kathryn, Crockett, Matthew, Nielsen, Matthew, Takwoingi, Yemisi, Chuchu, Naomi, O'Rourke, John, MacLennan, Graeme, McGrath, John S., Kasivisvanathan, Veeru, Chaudry, Aasem, Sharma, Abhishek, Bennett, Adam, Ahmad, Adnan, Abroaf, Ahmed, Suliman, Ahmed M, Lloyd, Aimee, McKay, Alastair, Wong, Albert, Silva, Alberto, Schneider, Alexandre, MacKay, Alison, Knight, Allen, Grigorakis, Alkiviadis, Bdesha, Amar, Nagle, Amy, Cebola, Ana, Dhanasekaran, Ananda Kumar, Kond?a, Andra?, Barcelos, André, Galosi, Andrea B, Ebur, Andrea, Minervini, Andrea, Russell, Andrew, Webb, Andrew, García de Jalón, Ángel, Desai, Ankit, Czech, Anna K, Mainwaring, Anna, Adimonye, Anthony, Das, Arighno, Figueiredo, Arnaldo, Villers, Arnauld, Leminski, Artur, Chippagiri, Arvinda, Y?ld?r?m, As?f, Voulgaris, Athanasios M, Uzan, Audrey, Oo, Aye Moh Moh, Younis, Ayman, Zelhof, Bachar, Mukhtar, Bashir, Ayres, Ben, Challacombe, Ben, Sherwood, Benedict, Ristau, Benjamin, Lai, Billy, Nellensteijn, Brechtje, Schreiter, Brielle, Trombetta, Carlo, Dowling, Catherine, Hobbs, Catherine, Benitez, Cayo Augusto Estigarribia, Lebacle, Cédric, Ho, Cherrie Wing Yin, Ng, ChiFai, Mount, Chloe, Lam, Chon Meng, Blick, Chris, Brown, Christian, Gallegos, Christopher, Higgs, Claire, Browne, Clíodhna, McCann, Conor, Alonso, Cristina Plaza, Beder, Daniel, Cohen, Daniel, Gordon, Daniel, Wilby, Daniel, Gordon, Danny, Lau, David Hua Wu, Hrouda, David, Karsza, Dávid, Mak, David, Martin-Way, David, Suthaharan, Denula, Patel, Dhruv, Carrion, Diego M, Nyanhongo, Donald, Bass, Edward, Mains, Edward, Chau, Edwin, Castillo, Elba Canelon, Day, Elizabeth, Desouky, Elsayed, Gaines, Emily, Papworth, Emma, Yuruk, Emrah, Kilic, Enes, Dinneen, Eoin, Palagonia, Erika, Xylinas, Evanguelos, Khawaja, Faizan, Cimarra, Fernando, Bardet, Florian, Kum, Francesca, Peters, Francesca, Kovács, Gábor, Tanasescu, Geroge, Hellawell, Giles, Tasso, Giovanni, Lam, Gitte, La Montagna, Giuseppe, Pizzuto, Giuseppe, Lenart, Gordan, Özgür, Günal, Bi, Hai, Lyons, Hannah, Warren, Hannah, Ahmed, Hashim, Simpson, Helen, Burden, Helena, Gresty, Helena, Pita, Hernado Rios, Serag, Hosam, Kynaston, Howard, Crawford-Smith, Hugh, Mostafid, Hugh, Otaola-Arca, Hugo, Fen Koo, Hui, Ibrahim, Ibrahim, Ouzaid, Idir, Puche-Sanz, Ignacio, Tomakovi, Igor, Tinay, Ilker, Sahibzada, Iqbal, Thangasamy, Isaac, Cadena, Iván Revelo, Irani, Jacques, Udzik, Jakub, Brittain, James, Catto, James, Green, James, Tweedle, James, Hernando, Jamie Borrego, Leask, Jamie, Kalsi, Jas, Frankel, Jason, Toniolo, Jason, Raman, Jay D, Courcier, Jean, Kumaradeevan, Jeevan, Clark, Jennifer, Jones, Jennifer, Teoh, Jeremy YuenChun, Iacovou, John, Kelly, John, Selph, John P, Aning, Jonathan, Deeks, Jon, Maw, Jonny, Herranz-Yagüe, José Antonio, Nolazco, Jose Ignacio, Cózar-Olmo, Jose Manuel, Bagley, Joseph, Jelski, Joseph, Norris, Joseph, Testa, Joseph, Meeks, Joshua, Hernandez, Juan, Vásquez, Juan Luis, Randhawa, Karen, Dhera, Karishma, Gronostaj, Katarzyna, Houlton, Kathleen, Lehman, Kathleen, Adasonla, Kelvin, Brown, Kevin, Murtagh, Kevin, Mistry, Kiki, Davenport, Kim, Kitamura, Kosuke, Derbyshire, Laura, Clarke, Laurence, Morton, Lawrie, Martinez, Levin, Goldsmith, Louise, Paramore, Louise, Cormier, Luc, Dell'Atti, Lucio, Simmons, Lucy, Martinez-Piñeiro, Luis, Rico, Luis, Chan, Luke, Forster, Luke, Ma, Lulin, Moore, Madeline, Gallego, Maria Camacho, Freire, Maria José, Emberton, Mark, Feneley, Mark, Rivero, Marta Viridiana Muñoz, Pira, Matea, Tallè, Matteo, Liew, Matthew, Trail, Matthew, Cooper, Meghan, Kulkarni, Meghana, Ager, Michael, He, Ming, Li, Mo, Omran Breish, Mohamed, Tarin, Mohamed, Aldiwani, Mohammed, Matanhelia, Mudit, Pasha, Muhammad, Akaln, Mustafa Kaan, Abdullah, Nasreen, Hale, Nathan, Gadiyar, Neha, Kocher, Neil, Bullock, Nicholas, Campain, Nicholas, Pavan, Nicola, Al?Ibraheem, Nihad, Bhatt, Nikita, Bedi, Nishant, Shrotri, Nitin, Lobo, Niyati, Balderas, Olga, Kouli, Omar, Capoun, Otakar, Manjavacas, Pablo Oteo, Gontero, Paolo, Mariappan, Paramananthan, Marchiñena, Patricio Garcia, Erotocritou, Paul, Sweeney, Paul, Planelles, Paula, Acher, Peter, Black, Peter C, Osei?Bonsu, Peter K, Østergren, Peter, Smith, Peter, Willemse, Peter-Paul Michiel, Chlosta, Piotr L, Ul Ain, Qurrat, Barratt, Rachel, Esler, Rachel, Khalid, Raihan, Hsu, Ray, Stamirowski, Remigiusz, Mangat, Reshma, Cruz, Ricardo, Ellis, Ricky, Adams, Robert, Hessell, Robert, Oomen, Robert J.A., McConkey, Robert, Ritchie, Robert, Jarimba, Roberto, Chahal, Rohit, Andres, Rosado Mario, Hawkins, Rosalyn, David, Rotimi, Manecksha, Rustom P, Agrawal, Sachin, Hamid, Syed Sami, Deem, Samuel, Goonewardene, Sanchia, Swami, Satchi Kuchibhotla, Hori, Satoshi, Khan, Shahid, Inder, Shakeel Mohammud, Sangaralingam, Shanthi, Marathe, Shekhar, Raveenthiran, Sheliyan, Horie, Shigeo, Sengupta, Shomik, Parson, Sian, Parker, Sidney, Hawlina, Simon, Williams, Simon, Mazzoli, Simone, Kata, Slawomir Grzegorz, Lopes, Sofia Pinheiro, Ramos, Sónia, Rai, Sonpreet, Rintoul-Hoad, Sophie, O'Meara, Sorcha, Morris, Steve, Turner, Stacey, Venturini, Stefano, Almpanis, Stephanos, Joniau, Steven, Jain, Sunjay, Mallett, Susan, Nikles, Sven, Yan, Shahzad Sylvia, Drake, Tamsin, Toma, Tarq, Plo, Teresa Cabañuz, Bonnin, Thierry, Muilwijk, Tim, Wollin, Tim, Chu, Timothy Shun Man, Appanna, Timson, Brophy, Tom, Ellul, Tom, Austin, Tomas, Smrkolj, Toma, Rowe, Tracey, Sukhu, Troy, Patel, Trushar, Garg, Tullika, Çakurlu, Turhan, Bele, Uros, Haroon, Usman, Crespo-Atín, Víctor, Cortes, Victor Parejo, Poves, Victoria Capapé, Gnanapragasam, Vincent, Gauhar, Vineet, During, Vinnie, Kumar, Vivek, Fiala, Vojtech, Mahmalji, Wasim, Lam, Wayne, Chin, Yew Fung, Filtekin, Yigit, Phan, Yih Chyn, Ibrahim, Youssed, Glaser, Zachary A, Adwin, Zainal, Qin, Zijian, Zotter, Zsuzsanna, Zainuddin, Zulkifli, Khadhouri, Sinan, Gallagher, Kevin M, Mackenzie, Kenneth R, Shah, Taimur T, Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F, Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Mannas, Miles P, Lee, Taeweon, Marra, Giancarlo, Lillaz, Beatrice, Gómez Rivas, Juan, Olivier, Jonathan, Assmus, Mark A, Uçar, Taha, Claps, Francesco, Boltri, Matteo, Burnhope, Tara, Nkwam, Nkwam, Tanasescu, George, Boxall, Nicholas E, Downey, Alison P, Lal, Asim Ahmed, Antón-Juanilla, Marta, Clarke, Holly, Hw Lau, David, Gillams, Kathryn, Crockett, Matthew, Nielsen, Matthew, Takwoingi, Yemisi, Chuchu, Naomi, O'Rourke, John, Maclennan, Graeme, Mcgrath, John S, Kasivisvanathan, Veeru, Khadhouri, Sinan [0000-0002-1836-8992], Moore, Sacha [0000-0002-0914-2051], Gómez Rivas, Juan [0000-0002-0556-3035], Olivier, Jonathan [0000-0002-5409-2911], Assmus, Mark A [0000-0003-3615-9251], Claps, Francesco [0000-0003-2812-5553], Nkwam, Nkwam [0000-0003-1086-6388], and Apollo - University of Cambridge Repository

Subjects
Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, Male, =+16+years%2C+referred+to+secondary+care+with+suspected+urinary+tract+cancer%2E+Patients+with+a+known+or+previous+urological+malignancy+were+excluded%2E+We+estimated+the+prevalence+of+bladder+cancer%2C+UTUC%2C+renal+cancer+and+prostate+cancer%22">Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged >= 16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer, stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05, P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15, P < 0.001), male sex 1.30 (95% CI 1.14-1.50, P < 0.001), and smoking 2.70 (95% CI 2.30-3.18, P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer, renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), bladder cancer, cancer prevalence, haematuria, hematuria, prostate cancer, renal cancer, upper tract urothelial cancer, urinary tract cancer, Adult, Aged, Female, Hematuria, Humans, Kidney Neoplasms, Middle Aged, Prospective Studies, Referral and Consultation, Ureteral Neoplasms, Urinary Bladder Neoplasms, Disease, urologic and male genital diseases, Prostate cancer, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, =+16+years%22">adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged >= 16 years, Medicine, bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, education.field_of_study, and smoking 2.70 (95% CI 2.30-3.18, stratified by age, female genital diseases and pregnancy complications, renal cancer and prostate cancer, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer, age 1.04 (95% CI 1.03-1.05 [stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were], UTUC (n = 128) 1.14% (95% CI 0.77-1.52), 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), visible haematuria 3.47 (95% CI 2.90-4.15, type of haematuria, P < 0.001), medicine.medical_specialty, Urology, Urinary system, Population, and countries. Results Of the 11 059 patients assessed for eligibility, Malignancy, smoking, UTUC, Internal medicine, sex, education, Bladder cancer, and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05, business.industry, Cancer, Odds ratio, medicine.disease, male sex 1.30 (95% CI 1.14-1.50, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, hospitals, business
Abstract

Funder: Action Bladder Cancer UK, Funder: Rosetrees Trust; Id: http://dx.doi.org/10.13039/501100000833, Funder: Urology Care Foundation; Id: http://dx.doi.org/10.13039/100006280, OBJECTIVE: To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. PATIENTS AND METHODS: This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. RESULTS: Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15; P < 0.001), male sex 1.30 (95% CI 1.14-1.50; P < 0.001), and smoking 2.70 (95% CI 2.30-3.18; P < 0.001). CONCLUSIONS: A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer.

Published
2021
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29. New technologies for diagnosing active TB: the VANTDET diagnostic accuracy study

Author

Halliday, Alice, primary, Jain, Pooja, additional, Hoang, Long, additional, Parker, Robert, additional, Tolosa-Wright, Mica, additional, Masonou, Tereza, additional, Green, Nathan, additional, Boakye, Aime, additional, Takwoingi, Yemisi, additional, Hamilton, Shea, additional, Mandagere, Vinay, additional, Fries, Anastasia, additional, Coin, Lachlan, additional, Deeks, Jon, additional, White, Peter J, additional, Levin, Michael, additional, Beverley, Peter, additional, Kon, Onn Min, additional, and Lalvani, Ajit, additional

Published
2021
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31. Modified GRAS score for prognostic classification of adrenocortical carcinoma: an ENSAT multicentre study

Author

Elhassan, Yasir, primary, Altieri, Barbara, additional, Berhane, Sarah, additional, Cook, Harriet, additional, Bertherat, Jerome, additional, Fragoso, Maria, additional, Kastelan, Darko, additional, Terzolo, Massimo, additional, Calabrese, Anna, additional, Berruti, Alfredo, additional, Cosentini, Deborah, additional, Laganà, Marta, additional, Loli, Paola, additional, Baudin, Eric, additional, Haak, Harm, additional, Canu, Letizia, additional, Haissaguerre, Magalie, additional, Kimpel, Otilia, additional, Deeks, Jon, additional, Arlt, Wiebke, additional, Libé, Rossella, additional, Fassnacht, Martin, additional, and Ronchi, Cristina, additional

Published
2020
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32. Variation in the observed effect of Xpert MTB/RIF testing for tuberculosis on mortality: A systematic review and analysis of trial design considerations

Author

Ochodo, Eleanor A., primary, Kalema, Nelson, additional, Schumacher, Samuel, additional, Steingart, Karen, additional, Young, Taryn, additional, Mallett, Susan, additional, Deeks, Jon, additional, Cobelens, Frank, additional, Bossuyt, Patrick M., additional, Nicol, Mark P., additional, and Cattamanchi, Adithya, additional

Published
2020
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33. Cochrane Column

Author

Siegfried, Nandi, Muller, Martie, Deeks, Jon, and Volmink, James

Published
2010

34. Adaptive trial designs in diagnostic accuracy research

Author

Zapf, Antonia, Stark, Maria, Gerke, Oke, Ehret, Christoph, Benda, Norbert, Bossuyt, Patrick, Deeks, Jon, Reitsma, Johannes, Alonzo, Todd, Friede, Tim, Zapf, Antonia, Stark, Maria, Gerke, Oke, Ehret, Christoph, Benda, Norbert, Bossuyt, Patrick, Deeks, Jon, Reitsma, Johannes, Alonzo, Todd, and Friede, Tim

Published
2020

35. Adaptive trial designs in diagnostic accuracy research

Author

Epi Methoden Team 4, Circulatory Health, JC onderzoeksprogramma Methodologie, Zapf, Antonia, Stark, Maria, Gerke, Oke, Ehret, Christoph, Benda, Norbert, Bossuyt, Patrick, Deeks, Jon, Reitsma, Johannes, Alonzo, Todd, Friede, Tim, Epi Methoden Team 4, Circulatory Health, JC onderzoeksprogramma Methodologie, Zapf, Antonia, Stark, Maria, Gerke, Oke, Ehret, Christoph, Benda, Norbert, Bossuyt, Patrick, Deeks, Jon, Reitsma, Johannes, Alonzo, Todd, and Friede, Tim

Published
2020

36. Evaluation of US Elastography in Thyroid Nodule Diagnosis: The ElaTION Randomized Control Trial

Author

Mehanna, Hisham, Sidhu, Paul S., Madani, Gitta, Woolley, Rebecca, Boelaert, Kristien, Nankivell, Paul, Forno, Phil Da, Moreman, Kate, Palmer, Andrew, Fulton-Lieuw, Tessa, Sharma, Neil, Taylor, Judith, Rajaguru, Kanchana, Bekker, Jasper, Vaidhyanath, Ram, Rehman, Thaj, and Deeks, Jon

Abstract

The ElaTION trial demonstrated that US elastography adds no diagnostic advantage over conventional US and fine-needle aspiration in evaluating thyroid nodules, showing similar rates of nondiagnostic outcomes and malignancy detection.

Published
2024
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40. PROBAST: A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies

Author

Wolff, Robert F, Moons, Karel GM, Riley, Richard D, Whiting, Penny F, Westwood, Marie, Collins, Gary S, Reitsma, Johannes B, Kleijnen, Jos, Mallett, Sue, Altman, Doug, Bossuyt, Patrick, Cook, Nancy R, D'Amico, Gennaro, Debray, Thomas PA, Deeks, Jon, De Groot, Joris, Di Angelantonio, Emanuele, Fahey, Tom, Harrell, Frank, Hayden, Jill A, Heymans, Martijn W, Hooft, Lotty, Hyde, Chris, Ioannidis, John, Iorio, Alfonso, Kaptoge, Stephen, Knottnerus, Andre, Leeflang, Mariska, Nixon, Frances, Perel, Pablo, Phillips, Bob, Raatz, Heike, Riemsma, Rob, Rovers, Maroeska, Rutjes, Anne WS, Sauerbrei, Willi, Sauerland, Stefan, Scheibler, Fueloep, Scholten, Rob, Schuit, Ewoud, Steyerberg, Ewout, Tan, Toni, Ter Riet, Gerben, Van Der Windt, Danielle, Vergouwe, Yvonne, Vickers, Andrew, Wood, Angela M, Grp, PROBAST, Grp, PROBAST Steering, Grp, PROBAST Delphi, Family Medicine, RS: CAPHRI - R6 - Promoting Health & Personalised Care, RS: CAPHRI - R5 - Optimising Patient Care, Bureau FHML, Public Health, Di Angelantonio, Emanuele [0000-0001-8776-6719], Kaptoge, Stephen [0000-0002-1155-4872], Wood, Angela [0000-0002-7937-304X], and Apollo - University of Cambridge Repository

Subjects
Delphi Technique, Delphi method, MEDLINE, 01 natural sciences, Decision Support Techniques, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, Bias, Diagnosis, Internal Medicine, Medicine, Humans, 030212 general & internal medicine, 0101 mathematics, computer.programming_language, Models, Statistical, business.industry, CARDIOVASCULAR RISK, Explanation, 010102 general mathematics, DIAGNOSIS TRIPOD, INDIVIDUAL PROGNOSIS, General Medicine, Evidence-based medicine, Prognosis, R1, Data science, Critical appraisal, Systematic review, Research Design, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], Model risk, business, RA, computer, Predictive modelling, Delphi, Systematic Reviews as Topic
Abstract

Prediction models in health care use predictors to estimate for an individual the probability that a condition or disease is already present (diagnostic model) or will occur in the future (prognostic model). Publications on prediction models have become more common in recent years, and competing prediction models frequently exist for the same outcome or target population. Health care providers, guideline developers, and policymakers are often unsure which model to use or recommend, and in which persons or settings. Hence, systematic reviews of these studies are increasingly demanded, required, and performed. A key part of a systematic review of prediction models is examination of risk of bias and applicability to the intended population and setting. To help reviewers with this process, the authors developed PROBAST (Prediction model Risk Of Bias ASsessment Tool) for studies developing, validating, or updating (for example, extending) prediction models, both diagnostic and prognostic. PROBAST was developed through a consensus process involving a group of experts in the field. It includes 20 signaling questions across 4 domains (participants, predictors, outcome, and analysis). This explanation and elaboration document describes the rationale for including each domain and signaling question and guides researchers, reviewers, readers, and guideline developers in how to use them to assess risk of bias and applicability concerns. All concepts are illustrated with published examples across different topics. The latest version of the PROBAST checklist, accompanying documents, and filled-in examples can be downloaded from www.probast.org.

Published
2019
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41. The authors reply

Author

Lamb, Edmund J., primary, Sitch, Alice J., additional, Barratt, Jonathan, additional, Brettell, Elizabeth A., additional, Cockwell, Paul, additional, Dalton, R. Neil, additional, Deeks, Jon J., additional, Eaglestone, Gillian, additional, Pellatt-Higgins, Tracy, additional, Kalra, Philip A., additional, Khunti, Kamlesh, additional, Loud, Fiona C., additional, Morris, Frances S., additional, Ottridge, Ryan S., additional, Stevens, Paul E., additional, Sharpe, Claire C., additional, Sutton, Andrew J., additional, Taal, Maarten W., additional, and Rowe, Ceri, additional

Published
2020
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42. IDENTIFY: The investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer: A multicentre cohort study

Author

Khadhouri, Sinan, primary, Gallagher, Kevin M, additional, MacKenzie, Kenneth, additional, Shah, Taimur T, additional, Gao, Chuanyu, additional, Moore, Sacha, additional, Zimmermann, Eleanor, additional, Edison, Eric, additional, Jefferies, Matthew, additional, Nambiar, Arjun, additional, MacLennan, Graeme, additional, McGrath, John S, additional, Kasivisvanathan, Veeru, additional, Ahmed, Hashim, additional, Deeks, Jon, additional, Emberton, Mark, additional, Kumaradeevan, Jeevan, additional, Mallett, Susan, additional, Takwoingi, Yemisi, additional, Morris, Steve, additional, Knight, Allen, additional, Blick, Chris, additional, Catto, James, additional, Cohen, Daniel, additional, Green, James, additional, Kelly, John, additional, and Mostafid, Hugh, additional

Published
2020
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43. MICE or NICE? An economic evaluation of clinical decision rules in the diagnosis of heart failure in primary care

Author

Monahan, Mark, Barton, Pelham, Taylor, Clare J, Roalfe, Andrea K, Hobbs, FD Richard, REFER Investigators, Cowie, Martin, Davis, Russell, Deeks, Jon, Mant, Jonathan, McCahon, Deborah, McDonagh, Theresa, Sutton, George, Tait, Lynda, Mant, Jonathan [0000-0002-9531-0268], and Apollo - University of Cambridge Repository

Subjects
Heart Failure, Male, Primary Health Care, Cost-Benefit Analysis, Clinical Decision-Making, Myocardial Infarction, State Medicine, England, Cost benefit analysis, Practice Guidelines as Topic, Medical economics, Economic model, Edema, Humans, Female, Prospective Studies, General practice, Natriuretic peptide, Aged, Follow-Up Studies
Abstract

BACKGROUND: Detection and treatment of heart failure (HF) can improve quality of life and reduce premature mortality. However, symptoms such as breathlessness are common in primary care, have a variety of causes and not all patients require cardiac imaging. In systems where healthcare resources are limited, ensuring those patients who are likely to have HF undergo appropriate and timely investigation is vital. DESIGN: A decision tree was developed to assess the cost-effectiveness of using the MICE (Male, Infarction, Crepitations, Edema) decision rule compared to other diagnostic strategies to identify HF patients presenting to primary care. METHODS: Data from REFER (REFer for EchocaRdiogram), a HF diagnostic accuracy study, was used to determine which patients received the correct diagnosis decision. The model adopted a UK National Health Service (NHS) perspective. RESULTS: The current recommended National Institute for Health and Care Excellence (NICE) guidelines for identifying patients with HF was the most cost-effective option with a cost of £4400 per quality adjusted life year (QALY) gained compared to a "do nothing" strategy. That is, patients presenting with symptoms suggestive of HF should be referred straight for echocardiography if they had a history of myocardial infarction or if their NT-proBNP level was ≥400pg/ml. The MICE rule was more expensive and less effective than the other comparators. Base-case results were robust to sensitivity analyses. CONCLUSIONS: This represents the first cost-utility analysis comparing HF diagnostic strategies for symptomatic patients. Current guidelines in England were the most cost-effective option for identifying patients for confirmatory HF diagnosis. The low number of HF with Reduced Ejection Fraction patients (12%) in the REFER patient population limited the benefits of early detection.

Published
2018
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44. Adaptive trial designs in diagnostic accuracy research

Author

Zapf, Antonia, primary, Stark, Maria, additional, Gerke, Oke, additional, Ehret, Christoph, additional, Benda, Norbert, additional, Bossuyt, Patrick, additional, Deeks, Jon, additional, Reitsma, Johannes, additional, Alonzo, Todd, additional, and Friede, Tim, additional

Published
2019
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46. Variation in the observed effect of Xpert MTB/RIF testing for tuberculosis on mortality: A systematic review and analysis of trial design considerations

Author

Ochodo, Eleanor A., primary, Kalema, Nelson, additional, Schumacher, Samuel, additional, Steingart, Karen, additional, Young, Taryn, additional, Mallett, Susan, additional, Deeks, Jon, additional, Cobelens, Frank, additional, Bossuyt, Patrick M., additional, Nicol, Mark P., additional, and Cattamanchi, Adithya, additional

Published
2019
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47. MP24-18 SYSTEMATIC REVIEW AND META-ANALYSIS OF SIGNIFICANT CANCER DETECTION BY MRI-TARGETED BIOPSY COMPARED TO SYSTEMATIC BIOPSY

Author

Kasivisvanathan*, Veeru, primary, Stabile, Armando, additional, Neves, Joana, additional, Giganti, Francesco, additional, Valerio, Massimo, additional, Shanmugabavan, Yaalini, additional, Clement, Keiran, additional, Sarkar, Debashis, additional, Philippou, Yiannis, additional, Thurtle, David, additional, Deeks, Jon, additional, Emberton, Mark, additional, Takwoingi, Yemisi, additional, and Moore, Caroline, additional

Published
2019
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48. Heavier molecular weight ocular viscoelastic devices and timing of post-operative review following cataract surgery

Author

Brooker Lucenne, Blamires Trudi L, Thirumalai Balaji, and Deeks Jon

Subjects
Ophthalmology, RE1-994
Abstract

Abstract Background To assess the safety of abandoning the next day post-operative review in preference for assessment only 2 hours post-surgery for both phacoemulsification and extracapsular surgery with heavier molecular weight ocular viscoelastic devices (OVD). Methods 475 patients who underwent uncomplicated cataract surgery using heavier molecular weight ocular viscoelastic device (Healon GV) were studied. Of these 415 were phacoemulsification and 60 extracapsular and none received Intraocular pressure (IOP) lowering prophylaxis at the end of surgery. All were examined at 2 hours post-surgery and on the following day. Results were tabulated and analysed assessing wound stability, corneal clarity, anterior chamber reaction and IOP. Results In the time between the two assessments 44 (10.6%) patients developed a total of 53 new problems, with a majority being increases in IOP. Based on the lower threshold of IOP of 30 mmHg, the incidence of new problems at the next-day assessment was 9.8% (95% CI: 7.0 to 13.6) in the phacoemulsification group and 16.3% (7.3 to 29.7)in the extracapsular surgery group. At the higher threshold of IOP of 35 mmHg the corresponding figures were 6.6% and 16.3%. Conclusion There is a higher incidence of new problems at the next-day assessment than previous studies with conventional OVD. Therefore results from previous studies using standard OVDs cannot be simply extrapolated to heavier molecular weight OVDs. When these agents are used, routine use of an ocular hypotensive agent may be necessary to increase the safety of abandoning the review on the first post-operative day for phacoemulsification patients. This is to be studied.

Published
2007
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50. PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer

Author

Ghaneh, Paula, Hanson, Robert, Titman, Andrew, Lancaster, Gill, Plumpton, Catrin, Lloyd-Williams, Huw, Tien Yeo, Seow, Edwards, Rhiannon T., Johnson, Colin, Hilal, Mohammed Abul., Higginson, Antony P., Armstrong, Tom, Smith, Andrew, Scarsbrook, Andrew, McKay, Colin, Carter, Ross, Sutcliffe, Robert P., Bramhall, Simon, Kocher, Hemant M., Pereira, Stephen P., Davidson, Brian, Chang, David, Khan, Saboor, Zealley, Ian, Sarker, Dabashis, Al Sarireh, Bilal, Charnley, Richard, Lobo, Dileep, Nicolson, Marianne, Halloran, Christopher, Raraty, Michael, Sutton, Robert, Vinjamuri, Sobhan, Evans, Jonathan, Campbell, Fiona, Deeks, Jon, Sanghera, Bal, Wong, Wai-Lup, and Neoptolemos, John P.

Abstract

Background: Pancreatic cancer diagnosis and staging can be difficult in 10–20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer.Objective: To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer.Design: A multicentre prospective diagnostic accuracy and clinical value study of PET/CT in suspected pancreatic malignancy.Participants: Patients with suspected pancreatic malignancy.Interventions: All patients to undergo PET/CT following standard diagnostic work-up.Main outcome measures: The primary outcome was the incremental diagnostic value of PET/CT in addition to standard diagnostic work-up with multidetector computed tomography (MDCT). Secondary outcomes were (1) changes in patients’ diagnosis, staging and management as a result of PET/CT; (2) changes in the costs and effectiveness of patient management as a result of PET/CT; (3) the incremental diagnostic value of PET/CT in chronic pancreatitis; (4) the identification of groups of patients who would benefit most from PET/CT; and (5) the incremental diagnostic value of PET/CT in other pancreatic tumours.Results: Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUVmax.) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity (p = 0.01) and specificity (p = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios (p < 0.0002). PET/CT correctly changed the staging of pancreatic cancer in 56 patients (p = 0.001). PET/CT influenced management in 250 (45%) patients. PET/CT stopped resection in 58 (20%) patients who were due to have surgery. The benefit of PET/CT was limited in patients with chronic pancreatitis or other pancreatic tumours. PET/CT was associated with a gain in quality-adjusted life-years of 0.0157 (95% confidence interval –0.0101 to 0.0430). In the base-case model PET/CT was seen to dominate MDCT alone and is thus highly likely to be cost-effective for the UK NHS. PET/CT was seen to be most cost-effective for the subgroup of patients with suspected pancreatic cancer who were thought to be resectable.Conclusion: PET/CT provided a significant incremental diagnostic benefit in the diagnosis of pancreatic cancer and significantly influenced the staging and management of patients. PET/CT had limited utility in chronic pancreatitis and other pancreatic tumours. PET/CT is likely to be cost-effective at current reimbursement rates for PET/CT to the UK NHS. This was not a randomised controlled trial and therefore we do not have any information from patients who would have undergone MDCT only for comparison. In addition, there were issues in estimating costs for PET/CT. Future work should evaluate the role of PET/CT in intraductal papillary mucinous neoplasm and prognosis and response to therapy in patients with pancreatic cancer.

Published
2018

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