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How do we estimate survival? External validation of a tool for survival estimation in patients with metastatic bone disease—decision analysis and comparison of three international patient populations

Overview of attention for article published in BMC Cancer, May 2015
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Title
How do we estimate survival? External validation of a tool for survival estimation in patients with metastatic bone disease—decision analysis and comparison of three international patient populations
Published in
BMC Cancer, May 2015
DOI 10.1186/s12885-015-1396-5
Pubmed ID
Authors

Andrea Piccioli, M. Silvia Spinelli, Jonathan A. Forsberg, Rikard Wedin, John H. Healey, Vincenzo Ippolito, Primo Andrea Daolio, Pietro Ruggieri, Giulio Maccauro, Alessandro Gasbarrini, Roberto Biagini, Raimondo Piana, Flavio Fazioli, Alessandro Luzzati, Alberto Di Martino, Francesco Nicolosi, Francesco Camnasio, Michele Attilio Rosa, Domenico Andrea Campanacci, Vincenzo Denaro, Rodolfo Capanna

Abstract

We recently developed a clinical decision support tool, capable of estimating the likelihood of survival at 3 and 12 months following surgery for patients with operable skeletal metastases. After making it publicly available on www.PATHFx.org , we attempted to externally validate it using independent, international data. We collected data from patients treated at 13 Italian orthopaedic oncology referral centers between 2010 and 2013, then applied to PATHFx, which generated a probability of survival at three and 12-months for each patient. We assessed accuracy using the area under the receiver-operating characteristic curve (AUC), clinical utility using Decision Curve Analysis (DCA), and compared the Italian patient data to the training set (United States) and first external validation set (Scandinavia). The Italian dataset contained 287 records with at least 12 months follow-up information. The AUCs for the three-month and 12-month estimates was 0.80 and 0.77, respectively. There were missing data, including the surgeon's estimate of survival that was missing in the majority of records. Physiologically, Italian patients were similar to patients in the training and first validation sets. However notable differences were observed in the proportion of those surviving three and 12-months, suggesting differences in referral patterns and perhaps indications for surgery. PATHFx was successfully validated in an Italian dataset containing missing data. This study demonstrates its broad applicability to European patients, even in centers with differing treatment philosophies from those previously studied.

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 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 37 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 7 19%
Other 5 14%
Researcher 5 14%
Student > Master 3 8%
Student > Ph. D. Student 3 8%
Other 10 27%
Unknown 4 11%
Readers by discipline Count As %
Medicine and Dentistry 24 65%
Engineering 2 5%
Nursing and Health Professions 1 3%
Biochemistry, Genetics and Molecular Biology 1 3%
Unknown 9 24%

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 22 May 2015.
All research outputs
#3,603,315
of 5,131,029 outputs
Outputs from BMC Cancer
#1,795
of 2,838 outputs
Outputs of similar age
#123,417
of 172,491 outputs
Outputs of similar age from BMC Cancer
#162
of 202 outputs
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