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000147686 0247_ $$2ISSN$$a0002-9270
000147686 0247_ $$2ISSN$$a1948-9498
000147686 0247_ $$2ISSN$$a1948-9501
000147686 037__ $$aDKFZ-2019-02674
000147686 041__ $$aeng
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000147686 1001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b0$$eFirst author$$udkfz
000147686 245__ $$aOverestimated Sensitivity of Fecal Immunochemical Tests in Screening Cohorts With Registry-Based Follow-up.
000147686 260__ $$aLondon [u.a.]$$bNature$$c2019
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000147686 520__ $$aSeveral recent studies have reported very high estimates of sensitivity and specificity of fecal immunochemical tests (FITs) at seemingly high levels of precision using registry-based follow-up of participants in very large FIT-based screening programs. We aimed to assess the validity of estimates of diagnostic performance parameters derived by this indirect approach.We modeled expected values of sensitivity and specificity of colorectal cancer detection in studies using the indirect approach and their deviation from true values under a broad range of plausible assumptions, and we compared these expected values with recently reported estimates of FIT sensitivity and specificity from such studies.Using a sensitivity of 75% and specificity of 93.6% (from studies using a direct approach, i.e., colonoscopy follow-up of all participants), the indirect approach would be expected to yield sensitivities between 84.5% and 91.1% and specificities between 93.4% and 93.6% under a range of realistic assumptions regarding colonoscopic follow-up rates of positive FITs and clinical manifestation rates of preclinical colorectal cancer.Very high sensitivities of FITs recently reported with seemingly very high levels of precision by several large-scale registry-based studies, which are in line with expected results based on our model calculations, are likely to be strongly overestimated and need to be interpreted with due caution.
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000147686 7001_ $$0P:(DE-He78)6d4d6a0e2d726f899086ca98cd560922$$aGies, Anton$$b1$$udkfz
000147686 7001_ $$aSelby, Kevin$$b2
000147686 773__ $$0PERI:(DE-600)2003227-4$$a10.14309/ajg.0000000000000412$$gVol. 114, no. 11, p. 1795 - 1801$$n11$$p1795 - 1801$$tThe American journal of gastroenterology$$v114$$x0002-9270$$y2019
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