Systematic review: risk prediction models for metachronous advanced colorectal neoplasia after polypectomy.

Autor: Kang JH; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Levine E; University of California, San Francisco, San Francisco, California, USA., Fleet A; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Padilla MS; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Lee JK; Kaiser Permanente Northern California Division of Research, Oakland, California, USA., Harrison H; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Usher-Smith JA; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Jazyk: angličtina
Zdroj: Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2024 Jul 30. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1111/jgh.16682
Abstrakt: Background and Aim: Colorectal cancer (CRC) is the fourth leading cause of cancer death globally. CRC surveillance is a common indication for colonoscopy, representing a considerable burden for endoscopy services. Accurate identification of high-risk patients who would benefit from more intensive surveillance, as well as low-risk patients suitable for less frequent follow-up, could improve the effectiveness of surveillance protocols and resource use. Our aim was to identify and critically appraise published risk models for the occurrence of metachronous advanced colorectal neoplasia (ACN), defined here as CRC or advanced adenomas detected during surveillance colonoscopy.
Methods: We searched PubMed and EMBASE for primary research studies reporting the development and/or validation of multivariable models that predict metachronous ACN risk. Screening of studies for inclusion, data extraction, and risk of bias assessment were conducted by two researchers independently.
Results: We identified nine studies describing nine risk models. Six models were internally validated and two were externally validated. No model underwent both internal and external validation. Good model discrimination (concordance index > 0.7) was reported for two models during internal validation and for one model during external validation. Calibration was acceptable when assessed (n = 4). Methodological limitations and a high risk of bias were observed for all studies.
Conclusions: Several published models predicting metachronous ACN risk showed some promise. However, adherence to methodological standards was limited, and only two models were externally validated. Head-to-head comparisons of existing models using populations independent from model development cohorts should be prioritized to identify models suitable for use in clinical practice.
(© 2024 The Author(s). Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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