Validation and update of a multivariable prediction model for the identification and management of patients at risk for hepatocellular carcinoma

Li, Bo; Zhao, Youyun; Cai, Wangxi; Ming, Anping; Li, Hanmin

doi:10.1186/s12014-021-09326-w

Clinical Proteomics

Table. 3 Classification statistics of the selected thresholds for the recalibration-in-the-large of the validation cohort and subsets

From: Validation and update of a multivariable prediction model for the identification and management of patients at risk for hepatocellular carcinoma

Probability threshold¹	Proportions divided		Sensitivity (95% CI)²	Specificity (95% CI)²	PPV (95% CI)²	NPV (95% CI)²	NB (95% CI)²
Probability threshold¹	All patients	HCC patients	Sensitivity (95% CI)²	Specificity (95% CI)²	PPV (95% CI)²	NPV (95% CI)²	NB (95% CI)²
For HCC of any etiology, [15.5% (157/1012)]
1.3%	427/685	0/157	1 (1–1)	0.499 (0.466–0.532)	0.268 (0.256–0.282)	1 (1–1)	0.150 (0.125–0.173)
13.1%	823/189	13/144	0.917 (0.873–0.955)	0.947 (0.931–0.963)	0.763 (0.71–0.818)	0.984 (0.976–0.992)	0.136 (0.113–0.160)
15.5%	829/183	15/142	0.905 (0.854–0.949)	0.952 (0.937–0.966)	0.777 (0.724–0.832)	0.982 (0.973–0.99)	0.133 (0.112–0.155)
1/3	856/156	20/137	0.873 (0.815–0.924)	0.978 (0.966–0.987)	0.879 (0.828–0.927)	0.977 (0.967–0.986)	0.126 (0.104–0.145)
50%	874/138	26/131	0.834 (0.771–0.892)	0.992 (0.985–0.998)	0.950 (0.909–0.985)	0.970 (0.960–0.980)	0.123 (0.102–0.143)
2/3	888/124	37/120	0.764 (0.694–0.828)	0.995 (0.991–0.999)	0.968 (0.934–0.992)	0.958 (0.947–0.969)	0.111 (0.090–0.132)
98.3%	933/79	78/79	0.503 (0.427–0.580)	1 (1–1)	1 (1–1)	0.916 (0.905–0.928)	0.078 (0.061–0.095)
For single HBV-related HCC, [15.6% (122/782)]
1.3%	367/415	0/122	1 (1–1)	0.556 (0.520–0.596)	0.294 (0.278–0.314)	1 (1–1)	0.151 (0.129–0.178)
13.1%	646/136	8/114	0.934 (0.885–0.975)	0.967 (0.952–0.979)	0.839 (0.782–0.892)	0.988 (0.979–0.995)	0.142 (0.120–0.168)
15.5%	652/130	10/112	0.918 (0.869–0.959)	0.973 (0.959–0.985)	0.862 (0.807–0.916)	0.985 (0.976–0.992)	0.139 (0.114–0.163)
1/3	664/118	13/109	0.893 (0.836–0.943)	0.986 (0.977–0.994)	0.924 (0.875–0.966)	0.980 (0.970–0.989)	0.134 (0.109–0.160)
50%	675/107	19/103	0.844 (0.779–0.910)	0.994 (0.988–0.996)	0.963 (0.924–0.991)	0.972 (0.960–0.984)	0.127 (0.102–0.153)
2/3	685/97	28/94	0.771 (0.697–0.844)	0.995 (0.989–1)	0.969 (0.931–1)	0.959 (0.947–0.972)	0.113 (0.087–0.141)
98.3%	716/66	56/66	0.541 (0.451–0.631)	1 (1–1)	1 (1–1)	0.922 (0.908–0.936)	0.084 (0.064–0.105)
For HCC of other causes, [15.2% (35/230)]
1.3%	60/170	0/35	1 (1–1)	0.308 (0.246–0.369)	0.206 (0.192–0.222)	1 (1–1)	0.144 (0.100–0.193)
13.1%	177/53	5/30	0.857 (0.743–0.971)	0.882 (0.836–0.928)	0.569 (0.475–0.680)	0.972 (0.949–0.994)	0.115 (0.073–0.159)
15.5%	177/53	5/30	0.857 (0.743–0.971)	0.882 (0.836–0.928)	0.569 (0.475–0.680)	0.972 (0.949–0.994)	0.112 (0.067–0.157)
1/3	192/38	7/28	0.800 (0.657–0.914)	0.949 (0.918–0.974)	0.737 (0.620–0.862)	0.964 (0.939–0.984)	0.100 (0.057–0.148)
50%	199/31	7/28	0.800 (0.657–0.914)	0.985 (0.964–1)	0.906 (0.800–1)	0.965 (0.941–0.985)	0.109 (0.061–0.157)
2/3	203/27	9/26	0.743 (0.600–0.886)	0.995 (0.985–1)	0.964 (0.880–1)	0.956 (0.932–0.980)	0.104 (0.061–0.152)
98.3%	217/13	22/13	0.371 (0.229–0.543)	1 (1–1)	1 (1–1)	0.899 (0.878–0.924)	0.057 (0.030–0.091)

CI confidence interval, HCC hepatocellular cancer, NB net benefit, NPV negative prediction value, PPV positive prediction value
¹1.3%, the median prediction probability of non-HCC; 13.1%, the optimal cutoff value; 15.5%, the incidence rate of HCC in the validation cohort; 1/3, the low threshold in the original ASAP model; 50%, the midpoint of the sigmoid curve; 2/3, the high threshold in the original ASAP model; 98.3%, the median prediction probability of HCC
²Computed with 2000 stratified bootstrap replicates

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