Development And Validation Of A Nomogram For Predicting Positive Initial Prostate Biopsy In Chinese Populations

Objective: In order to improve the positive rate of prostate biopsy and reduce unnecessary biopsy,abnormal MRI results,as a risk factor,were included in the logistic regression analysis of prostate cancer,and a clinical prediction model was developed and validated to predict the probability of prostate cancer at the initial prostate biopsy in Chinese populations.Methods: The case data of the initial prostate biopsy in the electronic medical record system of our center were retrieved.Since then,eligible cases were screened according to the inclusion and exclusion criteria,then they were divided into the development and validation groups,based on the admission time.Following this,Predictors,indicated by univariate and multivariate Logistic regression analysis,were used to develop a model for predicting prostate cancer.Ultimately,the model was externally validated(Temporal validation)and evaluated in terms of discrimination,calibration and clinical utility.Results: A total of 636 patients were included in this study,of which the development and validation cohorts was 450 and 186,respectively.Prostate cancer accounted for59.3% and 56.7%,and there was no statistical difference between the two groups(P =0.621).After univariate and multivariate logistic regression analysis,age,PSA,PV,TRUS,DRE and MRI were used as predictors in the final model.Meanwhile,the model was visualized as a Nomogram.Furthermore,discrimination,calibration,and clinical utility were evaluated in the development and validation populations.As a results,AUC was 0.901 and 0.885,respectively,which indicated that the model had excellent ability to distinguish between patients and non-patients.The calibration plots drawn separately showed that the model's prediction of prostate cancer risk was highly consistent with the actual risk of occurrence.The combination of decision curve analysis and cut-off value could benefit the whole populations.Conclusions: In this study,a clinical prediction model was developed to predict the probability of prostate cancer in Chinese populations.This model has been externally validated and has excellent performance in discrimination,calibration and clinical utility,which may aid in decision-making of initial prostate biopsy in Chinese populations.