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External validity of two nomograms for predicting distant brain failure after radiosurgery for brain metastases in a bi-institutional independent patient cohort

Overview of attention for article published in Journal of Neuro-Oncology, December 2017
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Title
External validity of two nomograms for predicting distant brain failure after radiosurgery for brain metastases in a bi-institutional independent patient cohort
Published in
Journal of Neuro-Oncology, December 2017
DOI 10.1007/s11060-017-2707-2
Pubmed ID
Authors

Roshan S. Prabhu, Robert H. Press, Danielle M. Boselli, Katherine R. Miller, Scott P. Lankford, Robert J. McCammon, Benjamin J. Moeller, John H. Heinzerling, Carolina E. Fasola, Kirtesh R. Patel, Anthony L. Asher, Ashley L. Sumrall, Walter J. Curran, Hui-Kuo G. Shu, Stuart H. Burri

Abstract

Patients treated with stereotactic radiosurgery (SRS) for brain metastases (BM) are at increased risk of distant brain failure (DBF). Two nomograms have been recently published to predict individualized risk of DBF after SRS. The goal of this study was to assess the external validity of these nomograms in an independent patient cohort. The records of consecutive patients with BM treated with SRS at Levine Cancer Institute and Emory University between 2005 and 2013 were reviewed. Three validation cohorts were generated based on the specific nomogram or recursive partitioning analysis (RPA) entry criteria: Wake Forest nomogram (n = 281), Canadian nomogram (n = 282), and Canadian RPA (n = 303) validation cohorts. Freedom from DBF at 1-year in the Wake Forest study was 30% compared with 50% in the validation cohort. The validation c-index for both the 6-month and 9-month freedom from DBF Wake Forest nomograms was 0.55, indicating poor discrimination ability, and the goodness-of-fit test for both nomograms was highly significant (p < 0.001), indicating poor calibration. The 1-year actuarial DBF in the Canadian nomogram study was 43.9% compared with 50.9% in the validation cohort. The validation c-index for the Canadian 1-year DBF nomogram was 0.56, and the goodness-of-fit test was also highly significant (p < 0.001). The validation accuracy and c-index of the Canadian RPA classification was 53% and 0.61, respectively. The Wake Forest and Canadian nomograms for predicting risk of DBF after SRS were found to have limited predictive ability in an independent bi-institutional validation cohort. These results reinforce the importance of validating predictive models in independent patient cohorts.

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The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Librarian 1 6%
Other 1 6%
Student > Bachelor 1 6%
Professor 1 6%
Student > Ph. D. Student 1 6%
Other 3 19%
Unknown 8 50%
Readers by discipline Count As %
Medicine and Dentistry 6 38%
Pharmacology, Toxicology and Pharmaceutical Science 1 6%
Engineering 1 6%
Unknown 8 50%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 April 2018.
All research outputs
#14,967,526
of 23,023,224 outputs
Outputs from Journal of Neuro-Oncology
#1,908
of 2,987 outputs
Outputs of similar age
#252,893
of 440,086 outputs
Outputs of similar age from Journal of Neuro-Oncology
#47
of 112 outputs
Altmetric has tracked 23,023,224 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,987 research outputs from this source. They receive a mean Attention Score of 4.2. This one is in the 34th percentile – i.e., 34% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 440,086 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 112 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.