brought into clinical practice in a three worded statement – “Validation, validation, validation.” Due to only using 63 bladder cancer urine samples we did not perform an analysis of associating various grades and stages of bladder cancers to specific urinary microRNA levels. This study did have a balanced split between low-and high-grade disease of 53% and 47% respectively, which was not the case for other similar studies. Further studies with an increased number of urines samples may allow the opportunity to allow disease stratification with the various grades and stages bladder cancer. An argument for not performing differentiation between the identification of low-and high-grade disease is that we targeted our study to be a diagnosis of bladder cancer universally and not just a specific subset of disease. The diagnosis of low-grade bladder cancer is pathologically and clinically of a lower priority than it’s high-grade counterpart however it must always be appreciated that a significant proportion of low-grade disease will to develop into the high-grade form. An obvious criticism and weakness with regards to the diagnostic data is the specificity value of 51%. This was at the opportunity cost of a high sensitivity value 94.1%. Of note when implementing a urinary test to stratify the need for a cystoscopy, it is sensitivity (and hence the reduction of false negative tests) that takes priority over specificity. This study did not incorporate the analysis of post-operative urine samples for those undergoing the resection of their tumours. However it can be argued that
brought into clinical practice in a three worded statement – “Validation, validation, validation.” Due to only using 63 bladder cancer urine samples we did not perform an analysis of associating various grades and stages of bladder cancers to specific urinary microRNA levels. This study did have a balanced split between low-and high-grade disease of 53% and 47% respectively, which was not the case for other similar studies. Further studies with an increased number of urines samples may allow the opportunity to allow disease stratification with the various grades and stages bladder cancer. An argument for not performing differentiation between the identification of low-and high-grade disease is that we targeted our study to be a diagnosis of bladder cancer universally and not just a specific subset of disease. The diagnosis of low-grade bladder cancer is pathologically and clinically of a lower priority than it’s high-grade counterpart however it must always be appreciated that a significant proportion of low-grade disease will to develop into the high-grade form. An obvious criticism and weakness with regards to the diagnostic data is the specificity value of 51%. This was at the opportunity cost of a high sensitivity value 94.1%. Of note when implementing a urinary test to stratify the need for a cystoscopy, it is sensitivity (and hence the reduction of false negative tests) that takes priority over specificity. This study did not incorporate the analysis of post-operative urine samples for those undergoing the resection of their tumours. However it can be argued that
Saiful%20Miah%20-%20PhD%20Thesis%20-%20Corrections.docx