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@ARTICLE{Brenner:147686,
      author       = {H. Brenner$^*$ and A. Gies$^*$ and K. Selby},
      title        = {{O}verestimated {S}ensitivity of {F}ecal {I}mmunochemical
                      {T}ests in {S}creening {C}ohorts {W}ith {R}egistry-{B}ased
                      {F}ollow-up.},
      journal      = {The American journal of gastroenterology},
      volume       = {114},
      number       = {11},
      issn         = {0002-9270},
      address      = {London [u.a.]},
      publisher    = {Nature},
      reportid     = {DKFZ-2019-02674},
      pages        = {1795 - 1801},
      year         = {2019},
      abstract     = {Several 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.},
      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:31658130},
      doi          = {10.14309/ajg.0000000000000412},
      url          = {https://inrepo02.dkfz.de/record/147686},
}