[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias.

[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Research Abstract Details 

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[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Abstract Text:

Michael S Lauer,Sudish C Murthy,Eugene H Blackstone,Ikenna C Okereke,Thomas W Rice,

BACKGROUND: Verification bias occurs when test findings influence the decision to perform a gold standard test. It adversely influences diagnostic test accuracy by inflating sensitivity and deflating specificity. We studied the impact of verification bias on the estimated accuracy of a test commonly used in suspected lung cancer. METHODS: We studied 534 consecutive patients referred for [(18)F]fluorodeoxyglucose uptake by positron emission tomography (PET). Primary outcomes were tissue diagnoses of cancer and of mediastinal lymph node metastases. A secondary outcome was 3-year mortality. We accounted for verification bias using 2 validated methods. RESULTS: The gold standard test, namely tissue acquisition, was performed in 419 patients (78%); mediastinal lymph node sampling occurred in 301 (56%). While the 410 patients with PET-diagnosed stage I cancer or higher were more likely than patients with negative PET scan findings to undergo tissue diagnosis testing (92% vs 34%) (P<.001), there was no association between PET findings and performance of mediastinal sampling. Without accounting for verification bias, the sensitivity and specificity of PET for diagnosis of cancer were 0.95 (95% confidence interval [CI], 0.92-0.97) and 0.31 (95% CI, 0.21-0.42), respectively. After adjustment, sensitivity fell to 0.85 (95% CI, 0.81-0.89), while specificity increased to 0.51 (95% CI, 0.40-0.60). For diagnosis of mediastinal disease, verification bias had slight effects on test accuracy. There were 224 deaths, with a strong gradient between PET stage and death (P<.001). CONCLUSION: The diagnostic accuracy of PET for assessment of suspected lung cancer is substantially affected by verification bias.

[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Publishing Authors By Initials

MS Lauer,SC Murthy,EH Blackstone,IC Okereke,TW Rice,

For similar investigative techniques: epidemiologic methods: statistics as topic: sensitivity and specificity research abstracts see: investigative techniques: epidemiologic methods: statistics as topic: sensitivity and specificity research

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[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Archives of internal medicine

VOLUME: 167

Page Numbers: 161-5

Journal Abbreviation: Arch. Intern. Med.

ISSN: 0003-9926

DAY: 22

MONTH: Jan

YEAR: 2007

[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 372440

[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Keywords Mesh Terms:

KEYWORDS: Sensitivity and Specificity

MESH TERMS: pharmacokinetics

Chemical & Substance for Abstract: [18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias. Information

Substance Name: Fluorodeoxyglucose F18

Registry Number: 63503-12-8

Grant and Affiliation Information for [18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias.

AFFILIATION: Department of Cardiovascular Medicine, The Cleveland Clinic, Ohio 44122, USA. lauerm@ccf.org

Country: United States

AGENCY: United States NHLBI

GRANT: R01 HL-66004-2

ACRONYM: HL

MEDLINETA: Arch Intern Med

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