TOPLINE:
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.
