{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T23:23:21Z","timestamp":1785713001902,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,5,24]],"date-time":"2015-05-24T00:00:00Z","timestamp":1432425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Beckman Coulter UK Ltd."}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2016,3]]},"abstract":"\n Objectives<\/jats:title>\n \n To analyse the clinical utility of a prediction model\u00a0incorporating both clinical information and a novel\u00a0biomarker, p2\n PSA<\/jats:styled-content>\n , in order to inform the decision\u00a0for prostate biopsy in an Irish cohort of men referred for prostate cancer assessment.\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n Serum isolated from 250 men from three tertiary referral\u00a0centres with pre\u2010biopsy blood draws was analysed for total prostate\u2010specific antigen (\n PSA<\/jats:styled-content>\n ), free\n PSA<\/jats:styled-content>\n (\n fPSA<\/jats:styled-content>\n )\u00a0and p2\n PSA<\/jats:styled-content>\n . From this, the Prostate Health Index (\n PHI<\/jats:styled-content>\n ) score was calculated (\n PHI<\/jats:styled-content>\n = (p2\n PSA<\/jats:styled-content>\n \/\n fPSA<\/jats:styled-content>\n )*\u221a\n tPSA<\/jats:styled-content>\n ). The men's clinical information was used to derive their risk according to the Prostate Cancer Prevention Trial (\n PCPT<\/jats:styled-content>\n ) risk model. Two clinical prediction models were created via multivariable regression consisting of age, family history, abnormality on digital rectal examination, previous negative biopsy and either\n PSA<\/jats:styled-content>\n or\n PHI<\/jats:styled-content>\n score, respectively. Calibration plots, receiver\u2010operating characteristic (\n ROC<\/jats:styled-content>\n ) curves and decision curves were generated to assess the performance of the three\u00a0models.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The\n PSA<\/jats:styled-content>\n model and\n PHI<\/jats:styled-content>\n model were both well calibrated in this cohort, with the\n PHI<\/jats:styled-content>\n model showing the best correlation between predicted probabilities and actual outcome. The areas under the\n ROC<\/jats:styled-content>\n curve for the\n PHI<\/jats:styled-content>\n model,\n PSA<\/jats:styled-content>\n model and\n PCPT<\/jats:styled-content>\n model were 0.77, 0.71 and 0.69, respectively, for the prediction of prostate cancer (\n PC<\/jats:styled-content>\n a) and 0.79, 0.72 and 0.72, respectively, for the prediction of high grade\n PC<\/jats:styled-content>\n a. Decision\u2010curve analysis showed a superior net benefit of the\n PHI<\/jats:styled-content>\n model over both the\n PSA<\/jats:styled-content>\n model and the\n PCPT<\/jats:styled-content>\n risk model in the diagnosis of\n PC<\/jats:styled-content>\n a and high grade\n PC<\/jats:styled-content>\n a over the entire range of risk probabilities.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n A logical and standardized approach to the use of clinical risk factors can allow more accurate risk stratification of men under investigation for\n PC<\/jats:styled-content>\n a. The measurement of p2\n PSA<\/jats:styled-content>\n and the integration of this biomarker into a clinical prediction model can further increase the accuracy of risk stratification, helping to better inform the decision for prostate biopsy in a referral population.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.13143","type":"journal-article","created":{"date-parts":[[2015,4,3]],"date-time":"2015-04-03T14:07:54Z","timestamp":1428070074000},"page":"409-417","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Improving multivariable prostate cancer risk assessment using the Prostate Health Index"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5457-2392","authenticated-orcid":false,"given":"Robert W.","family":"Foley","sequence":"first","affiliation":[{"name":"Conway Institute of Biomolecular and Biomedical Research University College Dublin Dublin Ireland"},{"name":"UCD School of Medicine and Medical Science University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gorman","sequence":"additional","affiliation":[{"name":"Conway Institute of Biomolecular and Biomedical Research University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Sharifi","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Beaumont Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keefe","family":"Murphy","sequence":"additional","affiliation":[{"name":"UCD School of Mathematical Sciences University College Dublin Dublin Ireland"},{"name":"Insight Centre for Data Analytics University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Beaumont Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra V.","family":"Tuzova","sequence":"additional","affiliation":[{"name":"Prostate Molecular Oncology Institute of Molecular Medicine Trinity College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette S.","family":"Perry","sequence":"additional","affiliation":[{"name":"Prostate Molecular Oncology Institute of Molecular Medicine Trinity College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Brendan","family":"Murphy","sequence":"additional","affiliation":[{"name":"UCD School of Mathematical Sciences University College Dublin Dublin Ireland"},{"name":"Insight Centre for Data Analytics University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dara J.","family":"Lundon","sequence":"additional","affiliation":[{"name":"Conway Institute of Biomolecular and Biomedical Research University College Dublin Dublin Ireland"},{"name":"UCD School of Medicine and Medical Science University College Dublin Dublin Ireland"},{"name":"Department of Urology Mater Misericordiae University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. William G.","family":"Watson","sequence":"additional","affiliation":[{"name":"Conway Institute of Biomolecular and Biomedical Research University College Dublin Dublin Ireland"},{"name":"UCD School of Medicine and Medical Science University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,24]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"National Cancer Registry.Cancer in Ireland 1994\u20132011: Annual Report of the National Cancer Registry 2014 2014. Available at:http:\/\/www.ncri.ie\/sites\/ncri\/files\/pubs\/annualreport2014.pdf. Accessed July 2014"},{"key":"e_1_2_7_3_1","unstructured":"Irish National Cancer Control Programme.nccP Prostate Cancer Referral Guideline 2011. Available at:http:\/\/www.healthlink.ie\/Oncology\/NCCPProstateCancerReferralGuidelineVersion1.3January2011.pdf. 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