Limited value of logistic regression analysis in solid solitary pulmonary nodules characterization: A single-center experience on 288 consecutive cases
Background and Objectives Preoperative characterization of the solitary pulmonary nodule is a delicate task faced by surgeons, radiologists, and clinicians. Mathematical models have been developed to overcome subjectivity. The Mayo Clinic model was suggested in the latest ACCP evidence‐based clinica...
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Published in | Journal of surgical oncology Vol. 110; no. 7; pp. 883 - 887 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Blackwell Publishing Ltd
01.12.2014
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Background and Objectives
Preoperative characterization of the solitary pulmonary nodule is a delicate task faced by surgeons, radiologists, and clinicians. Mathematical models have been developed to overcome subjectivity. The Mayo Clinic model was suggested in the latest ACCP evidence‐based clinical practice guidelines for the preoperative risk assessment of solitary pulmonary nodule malignancy. The aim of the study is to assess the validity of the Mayo Clinic model in a current continuous case series of biopsy‐proven nodules.
Methods
The Mayo Clinic model was applied to estimate probability of malignancy in 288 consecutive cases in this single‐center retrospective study.
Results
ROC curve analysis returned an AUC of 0.767, while analysis performed on 158 malignant nodules showed a mean predicted risk value of 38.15%. In our clinical setting, using a risk observational threshold set at 5% and a risk surgical threshold set at 60%, there would have been 4 cases of unnecessary surgery (false positives) at the cost of 13 cases of cancer progression (false negatives), while 68.75% of all nodules would have received non‐decisional values.
Conclusions
Surgeons should be aware that current data shows how the Mayo Clinic model is of little use in preoperative nodule characterization. J. Surg. Oncol. 2014 110:883–887. © 2014 Wiley Periodicals, Inc. |
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Bibliography: | ArticleID:JSO23730 ark:/67375/WNG-14D6GPND-7 istex:D07AC65980D1FDBE28266495D76E548664200489 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 0022-4790 1096-9098 |
DOI: | 10.1002/jso.23730 |