Update and validation of a diagnostic model to identify prevalent malignant lesions in esophagus in general population

Liu, Mengfei; Zhou, Ren; Liu, Zhen; Guo, Chuanhai; Xu, Ruiping; Zhou, Fuyou; Liu, Anxiang; Yang, Haijun; Li, Fenglei; Duan, Liping; Shen, Lin; Wu, Qi; Zheng, Hongchen; Tian, Hong‐Rui; Liu, Fangfang; Liu, Ying; Pan, Yaqi; Chen, Huanyu; Hu, Zhe; Cai, Hong; He, Zhonghu; Ke, Yang

doi:10.1016/j.eclinm.2022.101394

Cited by 6 publications

(7 citation statements)

References 24 publications

(44 reference statements)

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“…SDA might be the more appropriate outcome for screening because the primary purpose of both population-based screening and opportunistic screening in hospitals is to detect precancerous lesions and early-stage cancers. In general, the logistic models of cross-sectional design (15)(16)(17)(18)(19) were diagnostic and more suitable for prescreening before endoscopic screening, and the Cox proportional hazards models of cohort design (23)(24)(25) were prognostic and more suitable for predicting long-term risk. The event rate of the prediction models varied depending on the outcome and study design.…”

Section: Discussionmentioning

confidence: 99%

“…Although Liu et al (2022) ( 17 ) added 2 new predictors (gender and family history of ESCC), compared with Liu et al (2020) ( 18 ), its discrimination was not improved in external validation (Table 3 ). Liu et al (2022) ( 15 ) was an updated version of Liu et al (2017) ( 16 ) that incorporated cases with ESCC diagnosed within 1 year after screening, added the quadratic term for age as a predictor, and fitted an all-age model. While this update slightly improved the discrimination, the calibration was much worse than the previous model (Figure 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…The outcomes for external validation were SDA and ESCC, which would be adjusted for different models based on their original definitions. The outcome of logistic models (15)(16)(17)(18)(19)(20)(21)(22) was defined as the endoscopic diagnosis at baseline and 2 of the models, Liu et al (2022) (15) and Chen et al (2021) (19), also included cases with ESCC diagnosed within 1 and 3 years of follow-up, respectively. The outcome of Cox proportional hazards models (23)(24)(25) was defined as new cases with ESCC during follow-up in participants without any tumors and severe dysplasia at baseline.…”

Section: Outcomes and Predictorsmentioning

confidence: 99%

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Performance of Prediction Models for Esophageal Squamous Cell Carcinoma in General Population: A Systematic Review and External Validation Study

Jiang,

Chen,

et al. 2023

Am J Gastroenterol

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Introduction Prediction models for esophageal squamous cell carcinoma (ESCC) need to be proven effective in the target population before they can be applied to population-based endoscopic screening to improve cost-effectiveness. We have systematically reviewed ESCC prediction models applicable to the general population and performed external validation and head-to-head comparisons in a large multicenter prospective cohort including five high-risk areas of China (Fei Cheng, Lin Zhou, Ci Xian, Yang Zhong, and Yan Ting). Methods Models were identified through a systematic review and validated in a large population-based multicenter prospective cohort which included 89,753 participants aged 40-69 years who underwent their first endoscopic examination between April 2017 and March 2021 and were followed until December 31, 2022. Model performance in external validation was estimated based on discrimination and calibration. Discrimination was assessed by C-statistic (concordance statistic) and calibration was assessed by calibration plot and HL test (Hosmer Lemeshow test). Results The systematic review identified 15 prediction models that predicted severe dysplasia and above lesion (SDA) or ESCC in the general population, of which 11 models (4 SDA and 7 ESCC) were externally validated. The C-statistics ranged from 0.67 (95% confidence interval: 0.66 to 0.69) to 0.70 (0.68 to 0.71) of the SDA models and the highest was achieved by Liu Z (2020) and Liu Z (2022). The C-statistics ranged from 0.51 (0.48 to 0.54) to 0.74 (0.71 to 0.77) and Han J (2023) had the best discrimination of the ESCC models. Most models were well calibrated after recalibration as the calibration plots coincided with the x=y line. Discussion Several prediction models showed moderate performance in external validation and the prediction models may be useful in screening for ESCC. Further research is needed on model optimization, generalization, and implementation, as well as health economic evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Outcomes and Predictorsmentioning

confidence: 99%

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Performance of Prediction Models for Esophageal Squamous Cell Carcinoma in General Population: A Systematic Review and External Validation Study

Jiang,

Chen,

et al. 2023

Am J Gastroenterol

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“…Among the 13 eligible studies included, 5 are about colorectal cancer [9][10][11][12][13], 5 are about esophageal cancer [14][15][16][17][18], and 3 are about gastric cancer [19][20][21]. Furthermore, the gastric cancer risk stratification method was more systematic and mature than other cancers.…”

Section: Risk Stratification Strategy In Other Digestive Cancersmentioning

confidence: 99%

Liver cancer screening: risk stratification indication from other main digestive cancer in Chinese populations

Zhao

2023

International Conference on Modern Medicine and Global Health (ICMMGH 2023)

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“…The National Health Commission of China suggested that it is necessary to complete mass endoscopic screening once every 3 to 5 years in regions with an extremely high incidence of EC. Meanwhile, a newly developed prediction model has been validated for EC screening for the high‐risk and general populations 20,21 …”

Section: Screeningmentioning

confidence: 99%

Esophageal cancer in China: Practice and research in the new era

Zhu

et al. 2022

Intl Journal of Cancer

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China, as the one of the largest developing countries in the world and with about onefifth of the global population, is bearing an increasing burden on health from cancer.In the area of esophageal cancer (EC), China accounts for more than 50% of the global cases, with this disease being a particularly worse for those in disadvantaged populations. Along with China's socioeconomic condition, the epidemiology, diagnosis, therapeutics and research of EC have developed throughout the 21st century. In the current review, existing control measures for EC in China are outlined, including the incidence, mortality, screening, clinical diagnosis, multidisciplinary treatment and research landscape. EC in China are very different from those in some other parts of the world, especially in Western countries. Core measures that could contribute to the prevention of EC and improve clinical outcomes in patients of less developed countries and beyond are recommended. International cooperation among academia, government and industry is especially warranted in global EC control.

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Update and validation of a diagnostic model to identify prevalent malignant lesions in esophagus in general population

Cited by 6 publications

References 24 publications

Performance of Prediction Models for Esophageal Squamous Cell Carcinoma in General Population: A Systematic Review and External Validation Study

Performance of Prediction Models for Esophageal Squamous Cell Carcinoma in General Population: A Systematic Review and External Validation Study

Liver cancer screening: risk stratification indication from other main digestive cancer in Chinese populations

Esophageal cancer in China: Practice and research in the new era

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