PD19-11 WHAT FALSE-NEGATIVE RATES ARE BLADDER CANCER PATIENTS AND URO-ONCOLOGISTS WILLING TO ACCEPT IN ORDER TO AVOID SURVEILLANCE CYSTOSCOPY?
Bibliographic record
Abstract
You have accessJournal of UrologyBladder Cancer: Non-invasive II1 Apr 2017PD19-11 WHAT FALSE-NEGATIVE RATES ARE BLADDER CANCER PATIENTS AND URO-ONCOLOGISTS WILLING TO ACCEPT IN ORDER TO AVOID SURVEILLANCE CYSTOSCOPY? Rashid Sayyid, Abdallah Sayyid, Ricardo Leao, Ardalanejaz Ahmad, Hanan Goldberg, Robert Hamilton, Girish Kulkarni, Antonio Finelli, Alexandre Zlotta, and Neil Fleshner Rashid SayyidRashid Sayyid More articles by this author , Abdallah SayyidAbdallah Sayyid More articles by this author , Ricardo LeaoRicardo Leao More articles by this author , Ardalanejaz AhmadArdalanejaz Ahmad More articles by this author , Hanan GoldbergHanan Goldberg More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , and Neil FleshnerNeil Fleshner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.884AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surveillance cystoscopy in patients with non-muscle invasive bladder cancer is associated with pain, anxiety, and often necessitates antibiotic prophylaxis. Novel imaging and blood/urine based non-invasive alternatives are being developed to detect bladder cancer recurrence/progression in this patient population. We conducted a questionnaire-based hypothetical study to determine what test performance characteristics and cost would a non-invasive test(s) need in order for patients and their physicians to avoid cystoscopy. METHODS A questionnaire was administered to two populations (patients with previous history of non-muscle invasive bladder cancer and uro-oncologists) to establish an acceptable false negative (FN) rate and cost for such test(s). Patients were surveyed at time of follow up in the cystoscopy clinic at Toronto General Hospital. Physician members of the Society of Urologic Oncology were surveyed via an online questionnaire. Participants were questioned regarding demographics and other characteristics that might influence chosen error rate and cost. A chi-square test was used to determine if such relationships exist. Statistical significance was set at p <0.05. RESULTS 137 patient and 51 physician responses were obtained. 102 (75%) of the patients were male and 35 (25%) were female. 77% of patients were not comfortable with a non-invasive test(s) in place of repeat cystoscopy, with a further 14% requesting a false-negative (FN) rate of 0.5% or better. 75% of uro-oncologists were comfortable with an alternative non-invasive test, with 31% of responders requesting a FN rate of 5% or better and 33% a FN rate of 1% or better. A cost of $100-500 was deemed appropriate by 61% of physician responders. Demographics and other participant characteristics did not influence FN rate or cost choices. CONCLUSIONS Majority of bladder cancer patients are not comfortable with a non-invasive test(s) in place of surveillance cystoscopy, as opposed to most uro-oncologists who are. Given the importance of patient input in clinical decision-making, it appears that non-invasive tests will not replace surveillance cystoscopies in the near future, unless they achieve equivalent accuracy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e369 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Rashid Sayyid More articles by this author Abdallah Sayyid More articles by this author Ricardo Leao More articles by this author Ardalanejaz Ahmad More articles by this author Hanan Goldberg More articles by this author Robert Hamilton More articles by this author Girish Kulkarni More articles by this author Antonio Finelli More articles by this author Alexandre Zlotta More articles by this author Neil Fleshner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.058 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.017 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".