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Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn. Prognostic value of the CAPRA clinical prediction rule: a systematic review and meta-analysis Rose Galvin, Pieter Meurs, Floris van de Laar , Tom Fahey. Outline. Background Methods Results Calibration analysis

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Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

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  1. Royal College of Surgeons in IrelandColáiste Ríoga na Máinleá in Éirinn Prognostic value of the CAPRAclinical prediction rule: a systematic review and meta-analysis Rose Galvin, Pieter Meurs, Floris van de Laar, Tom Fahey

  2. Outline • Background • Methods • Results • Calibration analysis • Methodological quality • Discussion

  3. Background • Prevalence prostate cancer in Europe: ~382,000 • Risk assessment tools • Risk groups • Nomograms • Clinical Prediction Rule

  4. CAPRA-score 0-2 points Low risk 3-5 points Intermediate risk ≥6 points High risk

  5. Study aim To determine the prognostic value of the CAPRA-score in patients with localized prostate cancer after radical prostatectomy - 3 and 5 year survival rates across 3 strata of risk

  6. Methods

  7. Statistical methods- Calibration • Original derivation study used as a predictive model against which the validation studies are compared • Results are presented as a ratio measurement across three strata of risk RR >1 = over prediction by rule RR<1 = under prediction by rule RR=1 = correct prediction by rule

  8. Quality assessment • To assess the methodological quality of the validation studies • 2 independent raters • McGinn quality checklist • internal validity • external validity

  9. Results

  10. PRISMA Flow diagram search strategy Figure 1: Flow diagram search strategy

  11. Recurrence free survival at 3 years

  12. Recurrence free survival at 5 years

  13. Quality assessment

  14. Discussion • This is the first study to review the validity of the CAPRA-score systematically • Heterogeneity between studies needs to be considered • Future studies • Larger studies • Different treatments

  15. Conclusion • The CAPRAscore correctly predicts recurrence free survival 3 years after RP in all three risk groups • The CAPRA-score significantly under-predicts recurrence free survival 5 years after RP

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