{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T21:36:47Z","timestamp":1773437807703,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Prostate specific antigen (PSA) testing is a low\u2010cost screening method for prostate cancer (PCa). However, its accuracy is limited. While progress is being made using medical imaging for PCa screening, PSA testing can still be improved as an easily accessible first step in the screening process. We aimed to develop and validate a new model by further personalizing the analysis of PSA with demographic, medical history, lifestyle parameters, and digital rectal examination (DRE) results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from 34,224 patients in the screening arm of the PLCO trial (22,188 for the training set and 12,036 for the validation set), we applied a gradient\u2010boosting model whose features (Model 1) were one PSA value and the personal variables available in the PLCO trial except those that signaled an ex\u2010ante\u00a0assumption of PCa. A second algorithm (Model 2) included a DRE result. The primary outcome was the occurrence of PCa, while the aggressiveness of PCa was a secondary outcome. ROC analyses were used to compare both models to other initial screening tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The areas under the curve\u00a0(AUC) for Model 2 was 0.894 overall and 0.908 for patients with a suspicious DRE, compared to 0.808 for PSA for patients with a suspicious DRE. The AUC for Model 1 was 0.814 compared to 0.821 for PSA. Model 2 predicted 58% more high\u2010risk PCa than PSA \u22654 combined with an abnormal DRE and had a positive predictive value of 74.7% (vs. 50.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Personalizing the interpretation of PSA values and DRE results with a gradient\u2010boosting model showed promising results as a potential novel, low\u2010cost method for the initial screening of PCa. The importance of DRE, when included in such a model, was also highlighted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24703","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T07:30:02Z","timestamp":1712215802000},"page":"842-849","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Development and validation of an imageless machine\u2010learning algorithm for the initial screening of prostate cancer"],"prefix":"10.1002","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5846-3241","authenticated-orcid":false,"given":"Nicolas","family":"Martelin","sequence":"first","affiliation":[{"name":"Prostperia Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"De Witt","sequence":"additional","affiliation":[{"name":"Prostperia Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Chen","sequence":"additional","affiliation":[{"name":"Prostperia Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Eschw\u00e8ge","sequence":"additional","affiliation":[{"name":"Urology Department Nancy University Hospital Vand\u0153uvre\u2010l\u00e8s\u2010Nancy France"},{"name":"Unit\u00e9 de Biologie des Tumeurs, CRAN UMR 7039 CNRS, Institut de canc\u00e9rologie de Lorraine Vandoeuvre\u2010L\u00e8s\u2010Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1191"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.02.009"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.09.042"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000128"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.12.055"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31178"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70146-7"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15444"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.19.2336"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-157-2-201207170-00459"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.3710"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-0143(05)70375-X"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.10.021"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2205"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)32416-3"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.4.921"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2006.06694.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11060959"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prnil.2019.01.001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00429-x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03392-9"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15122"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.11.969"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1994.tb07601.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2014.10.002"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115910"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-019-0178-6"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2018.02.007"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148563"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyg116"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/01635589209514199"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000519"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-32656-2_1"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2586"},{"key":"e_1_2_9_36_1","first-page":"221","article-title":"The use of biomarkers in prostate cancer screening and treatment","volume":"19","author":"Alford AV","year":"2017","journal-title":"Rev Urol"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.24703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T13:21:44Z","timestamp":1715260904000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.24703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,4]]},"references-count":35,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/pros.24703"],"URL":"https:\/\/doi.org\/10.1002\/pros.24703","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,4]]},"assertion":[{"value":"2022-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}