Mobile application-based Seoul National University Prostate Cancer Risk Calculator: development, validation, and comparative analysis with two Western risk calculators in Korean men.
OBJECTIVE
We developed a mobile application-based Seoul National University Prostate Cancer Risk Calculator (SNUPC-RC) that predicts the probability of prostate cancer (PC) at the initial prostate biopsy in a Korean cohort. Additionally, the application was validated and subjected to head-to-head comparisons with internet-based Western risk calculators in a validation cohort. Here, we describe its development and validation.


METHODS
As a retrospective study, consecutive men who underwent initial prostate biopsy with more than 12 cores at a tertiary center were included. In the development stage, 3,482 cases from May 2003 through November 2010 were analyzed. Clinical variables were evaluated, and the final prediction model was developed using the logistic regression model. In the validation stage, 1,112 cases from December 2010 through June 2012 were used. SNUPC-RC was compared with the European Randomized Study of Screening for PC Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC). The predictive accuracy was assessed using the area under the receiver operating characteristic curve (AUC). The clinical value was evaluated using decision curve analysis.


RESULTS
PC was diagnosed in 1,240 (35.6%) and 417 (37.5%) men in the development and validation cohorts, respectively. Age, prostate-specific antigen level, prostate size, and abnormality on digital rectal examination or transrectal ultrasonography were significant factors of PC and were included in the final model. The predictive accuracy in the development cohort was 0.786. In the validation cohort, AUC was significantly higher for the SNUPC-RC (0.811) than for ERSPC-RC (0.768, p<0.001) and PCPT-RC (0.704, p<0.001). Decision curve analysis also showed higher net benefits with SNUPC-RC than with the other calculators.


CONCLUSIONS
SNUPC-RC has a higher predictive accuracy and clinical benefit than Western risk calculators. Furthermore, it is easy to use because it is available as a mobile application for smart devices.
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Chang Wook
CW
Jeong
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Sangchul
S
Lee
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Jin-Woo
JW
Jung
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Byung Ki
BK
Lee
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Seong Jin
SJ
Jeong
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Sung Kyu
SK
Hong
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Seok-Soo
SS
Byun
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
Sang Eun
SE
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D016015:Logistic Models; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D063731:Mobile Applications; D015999:Multivariate Analysis; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D066106:Seoul; D014495:Universities