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@ARTICLE{Gies:142934,
      author       = {A. Gies$^*$ and K. Cuk$^*$ and P. Schrotz-King$^*$ and H.
                      Brenner$^*$},
      title        = {{C}ombination of {D}ifferent {F}ecal {I}mmunochemical
                      {T}ests in {C}olorectal {C}ancer {S}creening: {A}ny {G}ain
                      in {D}iagnostic {P}erformance?},
      journal      = {Cancers},
      volume       = {11},
      number       = {1},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2019-00562},
      pages        = {120},
      year         = {2019},
      abstract     = {A variety of fecal immunochemical tests (FITs) are used for
                      colorectal cancer screening. FIT performance could be
                      improved further. It is unclear, whether the combination of
                      different FITs with different analytical characteristics
                      (such as, different antibodies for the detection of fecal
                      hemoglobin) can yield a better diagnostic performance. Fecal
                      samples were obtained from 2042 participants of screening
                      colonoscopy. All participants with advanced neoplasm (AN,
                      colorectal cancer (n = 16) or advanced adenoma (n = 200))
                      and 300 randomly selected participants without AN were
                      included. Nine quantitative FITs were evaluated
                      simultaneously. Sensitivity and specificity was calculated
                      for single tests (n = 9) and for their pairwise test
                      combinations (n = 36) (requiring either both FITs (P++) or
                      at least one FIT (P+) to be positive for defining a positive
                      test result). Mean age of the participants (n = 516) was 63
                      (range: 50⁻79) years and $56\%$ were men. At cutoffs
                      yielding a specificity of $96.7\%$ for single FITs, the
                      median gain in specificity by P++ combination was $+1.0\%,$
                      whereas the median loss in sensitivity for AN was $-4.2\%.$
                      For P+ combination the median gain in sensitivity for AN was
                      $+2.8\%,$ at a prize of median loss of $-1.0\%$ of
                      specificity. Combinations of different FITs do not yield any
                      relevant gain in diagnostic performance.},
      cin          = {C070 / C120 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30669538},
      pmc          = {pmc:PMC6356298},
      doi          = {10.3390/cancers11010120},
      url          = {https://inrepo02.dkfz.de/record/142934},
}