Journal article
Adding a Coefficient for Race to the 4Kscore Improves Calibration for Black Men
The Journal of urology, Vol.211(3), pp.392-398
03/01/2024
DOI: 10.1097/JU.0000000000003834
PMCID: PMC10922923
PMID: 38150383
Abstract
Black men face a higher incidence of high-risk prostate cancer (PCa) compared with non-Black men. While the 4Kscore is a widely utilized commercial test for PCa risk assessment, it does not currently account for racial differences. The aim of this study is to describe and validate a prespecified race coefficient for the 4Kscore with the goal of improving the accuracy of this test for Black men.
Using data from 85 Black men from the initial US prospective validation study, a race coefficient of 0.6 on the log-odds scale was prespecified. We calculated discrimination, calibration, and clinical utility of the 4Kscore with and without this coefficient for Black race in our primary analysis cohort of 205 Black men undergoing biopsy for PCa in a Veterans Affairs (VA) institution. We performed a sensitivity analysis using a combined cohort from the US prospective validation and the VA studies.
The mean probability of high-grade PCa from the 4Kscore in the primary cohort increased from 25% to 37% with race coefficient addition. Incorporating the race coefficient improved 4Kscore's calibration in Black men, with consequent improvements in clinical utility based on decision curve analysis. Model discrimination was maintained (AUC 0.825 vs 0.828,
= .14) in the combined cohort of Black and non-Black men from the US prospective and VA studies and the calibration remained largely unchanged.
Incorporating a prespecified coefficient for Black race improved calibration and clinical utility of the 4Kscore among Black men and should be added to the 4Kscore.
Details
- Title: Subtitle
- Adding a Coefficient for Race to the 4Kscore Improves Calibration for Black Men
- Creators
- Helen Y Hougen - University of IowaDaniel D Sjoberg - Memorial Sloan Kettering Cancer CenterJamie Thomas - University of MiamiBrandon A Mahal - Sylvester Comprehensive Cancer CenterAndrew J Vickers - Memorial Sloan Kettering Cancer CenterSanoj Punnen - Sylvester Comprehensive Cancer Center
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.211(3), pp.392-398
- DOI
- 10.1097/JU.0000000000003834
- PMID
- 38150383
- PMCID
- PMC10922923
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Grant note
- U01 CA239141 / NCI NIH HHS P30 CA008748 / NCI NIH HHS P30 CA240139 / NCI NIH HHS R01 CA272766 / NCI NIH HHS
- Language
- English
- Date published
- 03/01/2024
- Academic Unit
- Urology
- Record Identifier
- 9984701555302771
Metrics
23 Record Views