Updating risk prediction tools a case study in prostate cancer help dating a

The content of these guidelines is formatted as shown in Table 1.

The systematic review utilized in the creation of this guideline was completed in part through the Agency for Healthcare Research and Quality (AHRQ) and through additional supplementation that further addressed additional key questions and more recently published literature.

The familiar TNM staging system — which is based on the local extent of the cancer at the site of origin (T), the degree of metastatic regional lymph node involvement (N) and the presence or absence of distant metastasis (M) — is simple and easy to use, enabling its global adoption.

But that need for simplicity and the emphasis on anatomic measures restricts the TNM classification system’s ability to include other prognostic elements that would improve its accuracy in predicting individual patient outcomes.

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As a result, a patient who is a “bad” stage 3, for example, might be undertreated for a cancer that is likely to metastasize.

These guideline products are no longer viewed as guidance for current medical practice, and are provided for archival purposes only. Agency for Healthcare Research and Quality, Rockville, MD.

Internet Citation: Clinical Guidelines and Recommendations.

The new guidelines, published January 19 in CA: A Cancer Journal for Clinicians, define for the first time the standards that cancer risk models or risk calculators must meet to gain the endorsement of the American Joint Committee on Cancer (AJCC).

“The guidelines will dictate which predictive tools receive AJCC approval and then move forward into clinical use,” said Michael Kattan, Ph D, MBA, Chair of Cleveland Clinic’s Department of Quantitative Health Sciences, who led the group of healthcare statistical specialists that developed the new standards. When these improved risk models are available to physicians, the way patients are treated and counseled will be forever changed for the better.” The AJCC created and oversees the traditional anatomic staging system that physicians worldwide have used for decades to classify patients’ solid tumors and guide treatment.

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