{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:36:12Z","timestamp":1789450572162,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T00:00:00Z","timestamp":1479772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Beckman Coulter Incorporated"},{"name":"Laura and Isaac Perlmutter Cancer Center at New York University"},{"name":"Louis Feil Charitable Lead Trust"},{"name":"National Institutes of Health\/National Cancer Institute (NIH\/NCI) Johns Hopkins Prostate SPORE","award":["#P50CA58236"],"award-info":[{"award-number":["#P50CA58236"]}]},{"name":"Early Detection Research Network NIH\/NCI","award":["#U01-CA86323"],"award-info":[{"award-number":["#U01-CA86323"]}]},{"name":"Early Detection Research Network NIH\/NCI","award":["U24 CA115102"],"award-info":[{"award-number":["U24 CA115102"]}]},{"name":"Early Detection Research Network NIH\/NCI","award":["U01CA113913"],"award-info":[{"award-number":["U01CA113913"]}]},{"name":"Urological Research Foundation"},{"name":"Northwestern-University of Chicago-NorthShore University Prostate SPORE","award":["NIH\/NCI P50 CA90386-05S2"],"award-info":[{"award-number":["NIH\/NCI P50 CA90386-05S2"]}]},{"DOI":"10.13039\/100011249","name":"Robert H. Lurie Comprehensive Cancer Center","doi-asserted-by":"crossref","award":["NIH\/NCI P30 CA60553"],"award-info":[{"award-number":["NIH\/NCI P30 CA60553"]}],"id":[{"id":"10.13039\/100011249","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To examine the use of the Prostate Health Index (\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      ) as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicentre\n                      <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n                      study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      The study population included 728 men, with prostate\u2010specific antigen (\n                      <jats:styled-content style=\"fixed-case\">PSA<\/jats:styled-content>\n                      ) levels of 2\u201310 ng\/\n                      <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\n                      and a negative digital rectal examination, enrolled in a prospective, multi\u2010site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score \u22657. First, we evaluated whether the addition of\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      improves the performance of currently available risk calculators (the Prostate Cancer Prevention Trial [\n                      <jats:styled-content style=\"fixed-case\">PCPT<\/jats:styled-content>\n                      ] and European Randomised Study of Screening for Prostate Cancer [\n                      <jats:styled-content style=\"fixed-case\">ERSPC<\/jats:styled-content>\n                      ] risk calculators). We also designed and internally validated a new\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      \u2010based multivariable predictive model, and created a nomogram.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 728 men undergoing biopsy, 118 (16.2%) had aggressive prostate cancer. The\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      predicted the risk of aggressive prostate cancer across the spectrum of values. Adding\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      significantly improved the predictive accuracy of the\n                      <jats:styled-content style=\"fixed-case\">PCPT<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">ERSPC<\/jats:styled-content>\n                      risk calculators for aggressive disease. A new model was created using age, previous biopsy, prostate volume,\n                      <jats:styled-content style=\"fixed-case\">PSA<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      , with an area under the curve of 0.746. The bootstrap\u2010corrected model showed good calibration with observed risk for aggressive prostate cancer and had net benefit on decision\u2010curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Using\n                      <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>\n                      as part of multivariable risk assessment leads to a significant improvement in the detection of aggressive prostate cancer, potentially reducing harms from unnecessary prostate biopsy and overdiagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.13676","type":"journal-article","created":{"date-parts":[[2016,10,15]],"date-time":"2016-10-15T09:06:52Z","timestamp":1476522412000},"page":"61-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":74,"title":["Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer"],"prefix":"10.1111","volume":"120","author":[{"given":"Stacy","family":"Loeb","sequence":"first","affiliation":[{"name":"Department of Urology and Population Health NYU Langone Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghyuk S.","family":"Shin","sequence":"additional","affiliation":[{"name":"Beckman Coulter Incorporated Carlsbad CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis L.","family":"Broyles","sequence":"additional","affiliation":[{"name":"Beckman Coulter Incorporated Carlsbad CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Urology University of Michigan School of Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Sanda","sequence":"additional","affiliation":[{"name":"Department of Urology Emory University and Emory Healthcare Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Klee","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan W.","family":"Partin","sequence":"additional","affiliation":[{"name":"Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Sokoll","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris H.","family":"Bangma","sequence":"additional","affiliation":[{"name":"Department of Urology Erasmus University Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron H.N.","family":"van Schaik","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Erasmus University Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Slawin","sequence":"additional","affiliation":[{"name":"Vanguard Urologic Institute and Texas Prostate Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard S.","family":"Marks","sequence":"additional","affiliation":[{"name":"Department of Urology University of California Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Catalona","sequence":"additional","affiliation":[{"name":"Department of Urology Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.12.032"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.10.121"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.01.091"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.06.009"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-013-1566-2"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12556"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.10.021"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.11.012"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-011-0804-y"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_7_12_1","volume-title":"Applied Regression Analysis and Other Multivariable Methods (Duxbury Applied)","author":"Kleinbaum DG","year":"2008"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X0102100106"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.04.029"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13143"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa031918"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.06.051"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2011.10611.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.06.025"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.12.005"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.juro.2015.02.253","volume-title":"Prostate Health Index Predicts Upgrading of Men on 5\u2010Alpha Reductase Inhibitors","author":"Crawford ED","year":"2015"},{"key":"e_1_2_7_23_1","first-page":"1017","article-title":"Improving the prediction of pathologic outcomes in patients undergoing radical prostatectomy: the value of prostate cancer antigen 3 (PCA3), Prostate Health Index (phi) and sarcosine","volume":"35","author":"Ferro M","year":"2015","journal-title":"Anticancer Res"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms150813299"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2015.12.004"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.08.010"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.22898"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbju.13676","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbju.13676","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.13676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T10:41:20Z","timestamp":1761734480000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.13676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,22]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1111\/bju.13676"],"URL":"https:\/\/doi.org\/10.1111\/bju.13676","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,22]]},"assertion":[{"value":"2016-11-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}