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使用现实世界的数据来弥合前列腺癌查试验留下的证据缺口
N Norori1, N Burns-Cox2, L Blaney3
1Prostate Cancer UK, London.
概括
英国的新前列腺癌诊断方法显著减少了伤害. 现实数据显示,诊断伤害减少了79%,改善了患者安全和前列腺癌查结果.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医学诊断 医学诊断 医学诊断
背景情况:
- 基于人口的前列腺癌查目前不建议在英国,因为潜在的危害超过了好处.
- 诊断途径的最新进展旨在提高安全性和准确性,但它们对危害益处比率的影响需要评估.
- 关于更新的诊断技术对前列腺癌查结果的净影响,仍然存在不确定性.
研究的目的:
- 评估最近前列腺癌诊断途径的变化对危害益处比的影响.
- 通过使用现实世界的数据,量化与新诊断技术相关的损害减少.
- 将当前英国临床实践的结果与历史数据和预测模型进行比较.
主要方法:
- 来自两个NHS登记处的现实世界数据 (RWD) 的分析,涵盖16家男性医院,进入目前的前列腺癌诊断途径.
- 将目前英国临床实践结果与前列腺癌PSA检测集群随机试验 (CAP) /ProtecT试验和过去英国临床实践的历史数据进行比较.
- 使用一个预测模型,代表英国目前诊断途径的预期结果.
主要成果:
- 在活检后诊断出没有癌症的男性比例显著下降,从MRI前的9.46%降至2.33% (RAPID) 和1.52% (西南RWD).
- 临床上无意义的前列腺癌的诊断减少到0.73% (RAPID) 和0.83% (西南RWD).
- 败血症率从历史上的0.10%下降到RAPID途径的0.02%,临床上显著的前列腺癌诊断估计增加.
结论:
- 高质量的RWD分析估计,与之前的途径相比,诊断过程的危害减少了79%.
- 新的诊断技术已经明显减少了英国目前的前列腺癌诊断途径中的危害.
- 这些发现量化了通过实施改进的诊断策略来实现的危害减少.
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