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Diagnostic Performance of Prostate Cancer Disease-Specific Phenotypes Identified Using Real-World Databases: A

Ami Vyas1, Shweta Kamat1, Sadie Thomas1

  • 1College of Pharmacy, Department of Pharmacy Practice and Clinical Research, University of Rhode Island, Kingston, Rhode Island, USA.

Pharmacoepidemiology and Drug Safety
|October 15, 2025
PubMed
Summary

This systematic review found that computable phenotypes for prostate cancer (PC) outcomes like metastasis and biochemical recurrence (BCR) are accurate in real-world databases (RWD). Further validation is needed as treatments evolve.

Keywords:
biochemical recurrencemetastasisprostate cancerreal‐world databasessystematic review

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Area of Science:

  • Oncology
  • Health Informatics
  • Real-World Evidence Research

Background:

  • Real-world databases (RWD) require computable phenotypes for clinical research.
  • Existing prostate cancer (PC) phenotypes lack systematic summarization of their validation.
  • Accurate phenotypes are crucial for reliable analysis of PC outcomes in RWD.

Purpose of the Study:

  • To systematically review validation statistics of PC-specific computable phenotypes.
  • To summarize diagnostic accuracy of phenotypes for metastasis, biochemical recurrence (BCR), castration-resistant prostate cancer (CRPC), hormone-sensitive prostate cancer (HSPC), and performance status.
  • To assess phenotypes developed using clinical reasoning or prediction models in RWD.

Main Methods:

  • Systematic review conducted following PRISMA diagnostic accuracy guidelines.
  • Searched PubMed/Medline and EMBASE for studies (2012-2024) on PC phenotypes in RWD.
  • Included studies reporting algorithms/models with validation against reference standards; AUC > 0.7 considered acceptable.

Main Results:

  • 29 retrospective studies were included.
  • Claims-based and prediction model-based phenotypes for metastasis showed acceptable performance (AUC > 0.7, high specificity).
  • Prediction model-based BCR phenotypes were acceptable, but claims-based BCR had low sensitivity; metastatic CRPC and performance status phenotypes showed good accuracy.

Conclusions:

  • Computable phenotypes for PC metastasis, BCR, and performance status demonstrate acceptable accuracy in RWD.
  • Validation of RWD-based phenotypes is essential, especially considering evolving PC treatment landscapes.
  • Further research is needed to refine and validate phenotypes for diverse PC outcomes.