Risk prediction models with incomplete data with application to prediction of estrogen receptor-positive breast cancer: prospective data from the Nurses Health StudyReportar como inadecuado




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Breast Cancer Research

, 10:R55

First Online: 03 July 2008Received: 07 March 2008Revised: 08 May 2008Accepted: 03 July 2008

Abstract

IntroductionA number of breast cancer risk prediction models have been developed to provide insight into a woman-s individual breast cancer risk. Although circulating levels of estradiol in postmenopausal women predict subsequent breast cancer risk, whether the addition of estradiol levels adds significantly to a model-s predictive power has not previously been evaluated.

MethodsUsing linear regression, the authors developed an imputed estradiol score using measured estradiol levels the outcome and both case status and risk factor data for example, body mass index from a nested case-control study conducted within a large prospective cohort study and used multiple imputation methods to develop an overall risk model including both risk factor data from the main cohort and estradiol levels from the nested case-control study.

ResultsThe authors evaluated the addition of imputed estradiol level to the previously published Rosner and Colditz log-incidence model for breast cancer risk prediction within the larger Nurses- Health Study cohort. The follow-up was from 1980 to 2000; during this time, 1,559 invasive estrogen receptor-positive breast cancer cases were confirmed. The addition of imputed estradiol levels significantly improved risk prediction; the age-specific concordance statistic increased from 0.635 ± 0.007 to 0.645 ± 0.007 P < 0.001 after the addition of imputed estradiol.

ConclusionCirculating estradiol levels in postmenopausal women appear to add to other lifestyle factors in predicting a woman-s individual risk of breast cancer.

AbbreviationsBBDbenign breast disease

BMIbody mass index

C statisticconcordance statistic

CIconfidence interval

ERestrogen receptor

PMHpostmenopausal hormone

Q1Q2, Q3, and Q4 = first, second, third, and fourth quartile

RRrelative risk.

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Autor: Bernard Rosner - Graham A Colditz - J Dirk Iglehart - Susan E Hankinson

Fuente: https://link.springer.com/







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