Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma: a critical assessment of the R-IPI, IPI, and NCCN-IPI

Jorne Biccler, Sandra Eloranta, Peter de Nully Brown, Henrik Frederiksen, Mats Jerkeman, Karin E Smedby, Martin Bøgsted, Tarec C El-Galaly

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Resumé

The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the curve and other relevant tests. Furthermore, the generation of patient-specific survival curves rather than assigning patients to one of few predefined risk groups is a relevant step toward personalized management and treatment. A test-version is available on lymphomapredictor.org.

OriginalsprogEngelsk
TidsskriftCancer Medicine
Vol/bind7
Udgave nummer1
Sider (fra-til)114–122
ISSN2045-7634
DOI
StatusUdgivet - jan. 2018

Fingeraftryk

Lymphoma, Large B-Cell, Diffuse
Proportional Hazards Models
Area Under Curve
Population

Citer dette

Biccler, Jorne ; Eloranta, Sandra ; de Nully Brown, Peter ; Frederiksen, Henrik ; Jerkeman, Mats ; Smedby, Karin E ; Bøgsted, Martin ; El-Galaly, Tarec C. / Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma : a critical assessment of the R-IPI, IPI, and NCCN-IPI. I: Cancer Medicine. 2018 ; Bind 7, Nr. 1. s. 114–122.
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title = "Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma: a critical assessment of the R-IPI, IPI, and NCCN-IPI",
abstract = "The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the curve and other relevant tests. Furthermore, the generation of patient-specific survival curves rather than assigning patients to one of few predefined risk groups is a relevant step toward personalized management and treatment. A test-version is available on lymphomapredictor.org.",
keywords = "Diffuse large B-cell lymphoma, IPI, prognosis, prognostic factors, risk modeling",
author = "Jorne Biccler and Sandra Eloranta and {de Nully Brown}, Peter and Henrik Frederiksen and Mats Jerkeman and Smedby, {Karin E} and Martin B{\o}gsted and El-Galaly, {Tarec C}",
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Biccler, J, Eloranta, S, de Nully Brown, P, Frederiksen, H, Jerkeman, M, Smedby, KE, Bøgsted, M & El-Galaly, TC 2018, 'Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma: a critical assessment of the R-IPI, IPI, and NCCN-IPI', Cancer Medicine, bind 7, nr. 1, s. 114–122. https://doi.org/10.1002/cam4.1271

Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma : a critical assessment of the R-IPI, IPI, and NCCN-IPI. / Biccler, Jorne; Eloranta, Sandra; de Nully Brown, Peter; Frederiksen, Henrik; Jerkeman, Mats; Smedby, Karin E; Bøgsted, Martin; El-Galaly, Tarec C.

I: Cancer Medicine, Bind 7, Nr. 1, 01.2018, s. 114–122.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma

T2 - a critical assessment of the R-IPI, IPI, and NCCN-IPI

AU - Biccler, Jorne

AU - Eloranta, Sandra

AU - de Nully Brown, Peter

AU - Frederiksen, Henrik

AU - Jerkeman, Mats

AU - Smedby, Karin E

AU - Bøgsted, Martin

AU - El-Galaly, Tarec C

N1 - © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

PY - 2018/1

Y1 - 2018/1

N2 - The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the curve and other relevant tests. Furthermore, the generation of patient-specific survival curves rather than assigning patients to one of few predefined risk groups is a relevant step toward personalized management and treatment. A test-version is available on lymphomapredictor.org.

AB - The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the curve and other relevant tests. Furthermore, the generation of patient-specific survival curves rather than assigning patients to one of few predefined risk groups is a relevant step toward personalized management and treatment. A test-version is available on lymphomapredictor.org.

KW - Diffuse large B-cell lymphoma

KW - IPI

KW - prognosis

KW - prognostic factors

KW - risk modeling

U2 - 10.1002/cam4.1271

DO - 10.1002/cam4.1271

M3 - Journal article

C2 - 29239133

VL - 7

SP - 114

EP - 122

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 1

ER -