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Assessment of performance of the Gail model for predicting breast cancer risk: a systematic review and meta-analysis with trial sequential analysis

Overview of attention for article published in Breast Cancer Research, March 2018
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Title
Assessment of performance of the Gail model for predicting breast cancer risk: a systematic review and meta-analysis with trial sequential analysis
Published in
Breast Cancer Research, March 2018
DOI 10.1186/s13058-018-0947-5
Pubmed ID
Authors

Xin Wang, Yubei Huang, Lian Li, Hongji Dai, Fengju Song, Kexin Chen

Abstract

The Gail model has been widely used and validated with conflicting results. The current study aims to evaluate the performance of different versions of the Gail model by means of systematic review and meta-analysis with trial sequential analysis (TSA). Three systematic review and meta-analyses were conducted. Pooled expected-to-observed (E/O) ratio and pooled area under the curve (AUC) were calculated using the DerSimonian and Laird random-effects model. Pooled sensitivity, specificity and diagnostic odds ratio were evaluated by bivariate mixed-effects model. TSA was also conducted to determine whether the evidence was sufficient and conclusive. Gail model 1 accurately predicted breast cancer risk in American women (pooled E/O = 1.03; 95% CI 0.76-1.40). The pooled E/O ratios of Caucasian-American Gail model 2 in American, European and Asian women were 0.98 (95% CI 0.91-1.06), 1.07 (95% CI 0.66-1.74) and 2.29 (95% CI 1.95-2.68), respectively. Additionally, Asian-American Gail model 2 overestimated the risk for Asian women about two times (pooled E/O = 1.82; 95% CI 1.31-2.51). TSA showed that evidence in Asian women was sufficient; nonetheless, the results in American and European women need further verification. The pooled AUCs for Gail model 1 in American and European women and Asian females were 0.55 (95% CI 0.53-0.56) and 0.75 (95% CI 0.63-0.88), respectively, and the pooled AUCs of Caucasian-American Gail model 2 for American, Asian and European females were 0.61 (95% CI 0.59-0.63), 0.55 (95% CI 0.52-0.58) and 0.58 (95% CI 0.55-0.62), respectively. The pooled sensitivity, specificity and diagnostic odds ratio of Gail model 1 were 0.63 (95% CI 0.27-0.89), 0.91 (95% CI 0.87-0.94) and 17.38 (95% CI 2.66-113.70), respectively, and the corresponding indexes of Gail model 2 were 0.35 (95% CI 0.17-0.59), 0.86 (95% CI 0.76-0.92) and 3.38 (95% CI 1.40-8.17), respectively. The Gail model was more accurate in predicting the incidence of breast cancer in American and European females, while far less useful for individual-level risk prediction. Moreover, the Gail model may overestimate the risk in Asian women and the results were further validated by TSA, which is an addition to the three previous systematic review and meta-analyses. PROSPERO CRD42016047215 .

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 77 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 77 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 17%
Student > Master 10 13%
Student > Ph. D. Student 8 10%
Student > Bachelor 8 10%
Student > Postgraduate 6 8%
Other 20 26%
Unknown 12 16%
Readers by discipline Count As %
Medicine and Dentistry 25 32%
Nursing and Health Professions 6 8%
Pharmacology, Toxicology and Pharmaceutical Science 4 5%
Unspecified 4 5%
Psychology 3 4%
Other 15 19%
Unknown 20 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 March 2018.
All research outputs
#10,119,736
of 12,651,470 outputs
Outputs from Breast Cancer Research
#1,168
of 1,438 outputs
Outputs of similar age
#205,793
of 274,082 outputs
Outputs of similar age from Breast Cancer Research
#8
of 9 outputs
Altmetric has tracked 12,651,470 research outputs across all sources so far. This one is in the 10th percentile – i.e., 10% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,438 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.7. This one is in the 8th percentile – i.e., 8% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 274,082 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 13th percentile – i.e., 13% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one.