4.5 Article

A dynamic model for the risk of bladder cancer progression

Journal

STATISTICS IN MEDICINE
Volume 31, Issue 3, Pages 287-300

Publisher

WILEY
DOI: 10.1002/sim.4433

Keywords

survival; multistate model; predictive process; bladder cancer; progression of disease

Funding

  1. Ministerio de Ciencia e Innovacion (Spain) [MTM2008-06747-C02-00]
  2. European Commission [201663-UROMOL]
  3. Generalitat de Catalunya (Spain) [2009SGR-581]
  4. La Marato de TV3 Foundation (Spain) [050831]
  5. Commission for Universities and Research of the Ministry of Innovation, Universities and Enterprise of the Government of Catalunya
  6. European Social Funds

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We propose a multistate modeling approach to describe the observed evolution of patients diagnosed with non-muscle-invasive bladder cancer. On the basis of data from the Spanish Bladder Cancer/EPICURO study, we adjust a multistate model taking into account the disease-related events of interest (recurrence, progression, and disease-related deaths) as well as competing deaths due to other causes. We then develop a dynamic predictive process for bladder cancer progression, which allows the risk of a patient to be updated whenever new information of his or her evolution is available. By using specific measures of prospective accuracy in the presence of competing risks, the proposed dynamic model has shown to improve prediction accuracy and provides a more personalized management of bladder patients. Copyright (C) 2011 John Wiley & Sons, Ltd.

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