dc.contributor.author
Winzer, Klaus-Jürgen
dc.contributor.author
Buchholz, Anika
dc.contributor.author
Schumacher, Martin
dc.contributor.author
Sauerbrei, Willi
dc.date.accessioned
2018-06-08T02:54:49Z
dc.date.available
2016-04-15T08:27:04.695Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/14113
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-18310
dc.description.abstract
Background Prognostic factors and prognostic models play a key role in medical
research and patient management. The Nottingham Prognostic Index (NPI) is a
well-established prognostic classification scheme for patients with breast
cancer. In a very simple way, it combines the information from tumor size,
lymph node stage and tumor grade. For the resulting index cutpoints are
proposed to classify it into three to six groups with different prognosis. As
not all prognostic information from the three and other standard factors is
used, we will consider improvement of the prognostic ability using suitable
analysis approaches. Methods and Findings Reanalyzing overall survival data of
1560 patients from a clinical database by using multivariable fractional
polynomials and further modern statistical methods we illustrate suitable
multivariable modelling and methods to derive and assess the prognostic
ability of an index. Using a REMARK type profile we summarize relevant steps
of the analysis. Adding the information from hormonal receptor status and
using the full information from the three NPI components, specifically
concerning the number of positive lymph nodes, an extended NPI with improved
prognostic ability is derived. Conclusions The prognostic ability of even one
of the best established prognostic index in medicine can be improved by using
suitable statistical methodology to extract the full information from standard
clinical data. This extended version of the NPI can serve as a benchmark to
assess the added value of new information, ranging from a new single clinical
marker to a derived index from omics data. An established benchmark would also
help to harmonize the statistical analyses of such studies and protect against
the propagation of many false promises concerning the prognostic value of new
measurements. Statistical methods used are generally available and can be used
for similar analyses in other diseases.
en
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Improving the Prognostic Ability through Better Use of Standard Clinical Data
- The Nottingham Prognostic Index as an Example
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
PLoS ONE. - 11 (2016), 3, Artikel Nr. e0149977
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0149977
dcterms.bibliographicCitation.url
http://dx.doi.org/10.1371/journal.pone.0149977
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000024376
refubium.note.author
Der Artikel wurde in einer Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000006283
dcterms.accessRights.openaire
open access