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NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy

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Harvard

Hansen, CR, Friborg, J, Jensen, K, Samsøe, E, Johnsen, L, Zukauskaite, R, Grau, C, Maare, C, Johansen, J, Primdahl, H, Bratland, Å, Kristensen, CA, Andersen, M, Eriksen, JG & Overgaard, J 2019, 'NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy' Acta oncologica , bind 58, nr. 10, s. 1410-1415. https://doi.org/10.1080/0284186X.2019.1654129

APA

CBE

Hansen CR, Friborg J, Jensen K, Samsøe E, Johnsen L, Zukauskaite R, Grau C, Maare C, Johansen J, Primdahl H, Bratland Å, Kristensen CA, Andersen M, Eriksen JG, Overgaard J. 2019. NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy. Acta oncologica . 58(10):1410-1415. https://doi.org/10.1080/0284186X.2019.1654129

MLA

Vancouver

Author

Hansen, C R ; Friborg, J ; Jensen, K ; Samsøe, E ; Johnsen, L ; Zukauskaite, R ; Grau, C ; Maare, C ; Johansen, J ; Primdahl, H ; Bratland, Å ; Kristensen, C A ; Andersen, M ; Eriksen, J G ; Overgaard, J. / NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy. I: Acta oncologica . 2019 ; Bind 58, Nr. 10. s. 1410-1415.

Bibtex

@article{8f775c3326694f1da2910961b313ed64,
title = "NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy",
abstract = "Introduction: Prediction models using logistic regression may perform poorly in external patient cohorts. However, there is a need to standardize and validate models for clinical use. The purpose of this project was to describe a method for validation of external NTCP models used for patient selection in the randomized trial of protons versus photons in head and neck cancer radiotherapy, DAHANCA 35. Material and methods: Organs at risk of 588 patients treated primarily with IMRT in the randomized controlled DAHANCA19 trial were retrospectively contoured according to recent international recommendations. Dose metrics were extracted using MatLab and all clinical parameters were retrieved from the DAHANCA database. The model proposed by Christianen et al. to predict physician-rated dysphagia was validated through the closed testing, where change of the model intercept, slope and individual beta's were tested for significant prediction improvements. Results: Six months prevalence of dysphagia in the validation cohort was 33{\%}. The closed testing procedure for physician-rated dysphagia showed that the Christianen et al. model needed an intercept refitting for the best match for the Danish patients. The intercept update increased the risk of dysphagia for the validation cohort by 7.9 ± 2.5{\%} point. For the raw model performance, the Brier score (mean squared residual) was 0.467, which improved significantly with a new intercept to 0.415. Conclusions: The previously published Dutch dysphagia model needed an intercept update to match the Danish patient cohort. The implementation of a closed testing procedure on the current validation cohort allows quick and efficient validation of external NTCP models for patient selection in the future.",
author = "Hansen, {C R} and J Friborg and K Jensen and E Sams{\o}e and L Johnsen and R Zukauskaite and C Grau and C Maare and J Johansen and H Primdahl and {\AA} Bratland and Kristensen, {C A} and M Andersen and Eriksen, {J G} and J Overgaard",
year = "2019",
month = "10",
day = "3",
doi = "10.1080/0284186X.2019.1654129",
language = "English",
volume = "58",
pages = "1410--1415",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Informa Healthcare",
number = "10",

}

RIS

TY - JOUR

T1 - NTCP model validation method for DAHANCA patient selection of protons versus photons in head and neck cancer radiotherapy

AU - Hansen, C R

AU - Friborg, J

AU - Jensen, K

AU - Samsøe, E

AU - Johnsen, L

AU - Zukauskaite, R

AU - Grau, C

AU - Maare, C

AU - Johansen, J

AU - Primdahl, H

AU - Bratland, Å

AU - Kristensen, C A

AU - Andersen, M

AU - Eriksen, J G

AU - Overgaard, J

PY - 2019/10/3

Y1 - 2019/10/3

N2 - Introduction: Prediction models using logistic regression may perform poorly in external patient cohorts. However, there is a need to standardize and validate models for clinical use. The purpose of this project was to describe a method for validation of external NTCP models used for patient selection in the randomized trial of protons versus photons in head and neck cancer radiotherapy, DAHANCA 35. Material and methods: Organs at risk of 588 patients treated primarily with IMRT in the randomized controlled DAHANCA19 trial were retrospectively contoured according to recent international recommendations. Dose metrics were extracted using MatLab and all clinical parameters were retrieved from the DAHANCA database. The model proposed by Christianen et al. to predict physician-rated dysphagia was validated through the closed testing, where change of the model intercept, slope and individual beta's were tested for significant prediction improvements. Results: Six months prevalence of dysphagia in the validation cohort was 33%. The closed testing procedure for physician-rated dysphagia showed that the Christianen et al. model needed an intercept refitting for the best match for the Danish patients. The intercept update increased the risk of dysphagia for the validation cohort by 7.9 ± 2.5% point. For the raw model performance, the Brier score (mean squared residual) was 0.467, which improved significantly with a new intercept to 0.415. Conclusions: The previously published Dutch dysphagia model needed an intercept update to match the Danish patient cohort. The implementation of a closed testing procedure on the current validation cohort allows quick and efficient validation of external NTCP models for patient selection in the future.

AB - Introduction: Prediction models using logistic regression may perform poorly in external patient cohorts. However, there is a need to standardize and validate models for clinical use. The purpose of this project was to describe a method for validation of external NTCP models used for patient selection in the randomized trial of protons versus photons in head and neck cancer radiotherapy, DAHANCA 35. Material and methods: Organs at risk of 588 patients treated primarily with IMRT in the randomized controlled DAHANCA19 trial were retrospectively contoured according to recent international recommendations. Dose metrics were extracted using MatLab and all clinical parameters were retrieved from the DAHANCA database. The model proposed by Christianen et al. to predict physician-rated dysphagia was validated through the closed testing, where change of the model intercept, slope and individual beta's were tested for significant prediction improvements. Results: Six months prevalence of dysphagia in the validation cohort was 33%. The closed testing procedure for physician-rated dysphagia showed that the Christianen et al. model needed an intercept refitting for the best match for the Danish patients. The intercept update increased the risk of dysphagia for the validation cohort by 7.9 ± 2.5% point. For the raw model performance, the Brier score (mean squared residual) was 0.467, which improved significantly with a new intercept to 0.415. Conclusions: The previously published Dutch dysphagia model needed an intercept update to match the Danish patient cohort. The implementation of a closed testing procedure on the current validation cohort allows quick and efficient validation of external NTCP models for patient selection in the future.

U2 - 10.1080/0284186X.2019.1654129

DO - 10.1080/0284186X.2019.1654129

M3 - Journal article

VL - 58

SP - 1410

EP - 1415

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 10

ER -

ID: 58596458