Gianmarco Altoè, Giulia Bertoldo, Claudio Zandonella Callegher, Enrico Toffalini, Antonio Calcagnì, Livio Finos, Massimiliano Pastore
Enhancing Statistical Inference in Psychological Research via Prospective and Retrospective Design Analysis
Frontiers in psychology
patient factors associated urinary tract cancer used risk stratify patients referred haematuria prioritising higher risk cancer prompt investigation develop prediction model urinary tract cancer patients referred haematuria prospective observational study conducted 10 282 patients 110 hospitals across 26 countries aged 16 yr referred secondary care haematuria patients known previous urological malignancy excluded primary outcomes presence absence urinary tract cancer bladder cancer upper tract urothelial cancer utuc renal cancer mixedeffect multivariable logistic regression performed site country random effects clinically important patientlevel candidate predictors chosen priori fixed effects predictors selected primarily using clinical reasoning addition backward stepwise selection calibration discrimination calculated bootstrap validation performed calculate optimism unadjusted prevalence 172 n 1763 bladder cancer 120 n 123 utuc 100 n 103 renal cancer final model included predictors increased risk visible haematuria age smoking history male sex family history reduced risk previous haematuria investigations urinary tract infection dysuriasuprapubic pain anticoagulation catheter use previous pelvic radiotherapy area receiver operating characteristic curve final model 086 95 confidence interval 085087 model limited patients without previous urological malignancy cancer prediction model first consider established novel urinary tract cancer diagnostic markers used secondary care risk stratifying patients aid clinicians decisionmaking process prioritising patients investigation developed tool uses persons characteristics determine risk cancer person develops blood urine haematuria used help prioritise patients investigation