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TOPLINE:

The Kettles Esophageal and Cardia Adenocarcinoma prediction (K-ECAN) tool predicts esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA) using data from the electronic health record (EHR) and is more accurate than other tools, a large study suggests.

METHODOLOGY:

  • Researchers performed a case-control study using data from the Veterans Affairs Central Cancer Registry.
  • They identified 8,430 patients with EAC and 2,965 patients GCA; these patients were compared with more than 10 million control patients.
  • K-ECAN uses basic information in the EHR to determine an individual’s future risk of developing EAC or GCA.

TAKEAWAY:

  • With an area under the receiver operating characteristic of 0.77, K-ECAN demonstrated better discrimination than previously validated models and published guidelines.
  • Using only data from 3 to 5 years prior to diagnosis only slightly diminished its accuracy (AUROC, 0.75).
  • K-ECAN remained the most accurate tool when undersampling men to simulate a non-VHA population (AUROC, 0.85).
  • Although gastroesophageal reflux disease (GERD) was strongly associated with EAC, it only contributed a small proportion of gain in information for prediction.

IN PRACTICE:

Because K-ECAN does not rely heavily on GERD symptoms to assess risk, it has the “potential to guide providers to increase appropriate uptake of screening. De-emphasizing GERD in decisions to offer screening could paradoxically increase appropriate uptake of screening for EAC and GCA,” the authors wrote.

SOURCE:

The study, with first author Joel H. Rubenstein, MD, with the LTC Charles S. Kettles VA Medical Center, Ann Arbor, Mich., was published online in Gastroenterology.

LIMITATIONS:

K-ECAN was developed and validated among U.S. veterans and needs to be validated in other populations.

DISCLOSURES:

Funding for the study was provided by the Department of Defense. Dr. Rubenstein has received research support from Lucid Diagnostics.

A version of this article first appeared on Medscape.com.

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TOPLINE:

The Kettles Esophageal and Cardia Adenocarcinoma prediction (K-ECAN) tool predicts esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA) using data from the electronic health record (EHR) and is more accurate than other tools, a large study suggests.

METHODOLOGY:

  • Researchers performed a case-control study using data from the Veterans Affairs Central Cancer Registry.
  • They identified 8,430 patients with EAC and 2,965 patients GCA; these patients were compared with more than 10 million control patients.
  • K-ECAN uses basic information in the EHR to determine an individual’s future risk of developing EAC or GCA.

TAKEAWAY:

  • With an area under the receiver operating characteristic of 0.77, K-ECAN demonstrated better discrimination than previously validated models and published guidelines.
  • Using only data from 3 to 5 years prior to diagnosis only slightly diminished its accuracy (AUROC, 0.75).
  • K-ECAN remained the most accurate tool when undersampling men to simulate a non-VHA population (AUROC, 0.85).
  • Although gastroesophageal reflux disease (GERD) was strongly associated with EAC, it only contributed a small proportion of gain in information for prediction.

IN PRACTICE:

Because K-ECAN does not rely heavily on GERD symptoms to assess risk, it has the “potential to guide providers to increase appropriate uptake of screening. De-emphasizing GERD in decisions to offer screening could paradoxically increase appropriate uptake of screening for EAC and GCA,” the authors wrote.

SOURCE:

The study, with first author Joel H. Rubenstein, MD, with the LTC Charles S. Kettles VA Medical Center, Ann Arbor, Mich., was published online in Gastroenterology.

LIMITATIONS:

K-ECAN was developed and validated among U.S. veterans and needs to be validated in other populations.

DISCLOSURES:

Funding for the study was provided by the Department of Defense. Dr. Rubenstein has received research support from Lucid Diagnostics.

A version of this article first appeared on Medscape.com.

 

TOPLINE:

The Kettles Esophageal and Cardia Adenocarcinoma prediction (K-ECAN) tool predicts esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA) using data from the electronic health record (EHR) and is more accurate than other tools, a large study suggests.

METHODOLOGY:

  • Researchers performed a case-control study using data from the Veterans Affairs Central Cancer Registry.
  • They identified 8,430 patients with EAC and 2,965 patients GCA; these patients were compared with more than 10 million control patients.
  • K-ECAN uses basic information in the EHR to determine an individual’s future risk of developing EAC or GCA.

TAKEAWAY:

  • With an area under the receiver operating characteristic of 0.77, K-ECAN demonstrated better discrimination than previously validated models and published guidelines.
  • Using only data from 3 to 5 years prior to diagnosis only slightly diminished its accuracy (AUROC, 0.75).
  • K-ECAN remained the most accurate tool when undersampling men to simulate a non-VHA population (AUROC, 0.85).
  • Although gastroesophageal reflux disease (GERD) was strongly associated with EAC, it only contributed a small proportion of gain in information for prediction.

IN PRACTICE:

Because K-ECAN does not rely heavily on GERD symptoms to assess risk, it has the “potential to guide providers to increase appropriate uptake of screening. De-emphasizing GERD in decisions to offer screening could paradoxically increase appropriate uptake of screening for EAC and GCA,” the authors wrote.

SOURCE:

The study, with first author Joel H. Rubenstein, MD, with the LTC Charles S. Kettles VA Medical Center, Ann Arbor, Mich., was published online in Gastroenterology.

LIMITATIONS:

K-ECAN was developed and validated among U.S. veterans and needs to be validated in other populations.

DISCLOSURES:

Funding for the study was provided by the Department of Defense. Dr. Rubenstein has received research support from Lucid Diagnostics.

A version of this article first appeared on Medscape.com.

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