{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:40:05Z","timestamp":1793299205703,"version":"4.5.0"},"reference-count":45,"publisher":"BMJ","issue":"1","funder":[{"name":"National Health Service Research Scotland Senior Fellowship"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2017,12,8]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Accurate prognostication is difficult in malignant pleural mesothelioma (MPM). We developed a set of robust computational models to quantify the prognostic value of routinely available clinical data, which form the basis of published MPM prognostic models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data regarding 269 patients with MPM were allocated to balanced training (n=169) and validation sets (n=100). Prognostic signatures (minimal length best performing multivariate trained models) were generated by least absolute shrinkage and selection operator regression for overall survival (OS), OS\u2009&lt;6 months and OS\u2009&lt;12 months. OS prediction was quantified using Somers D<jats:sub>XY<\/jats:sub> statistic, which varies from 0 to 1, with increasing concordance between observed and predicted outcomes. 6-month survival and 12-month survival were described by area under the curve (AUC) scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median OS was 270 (IQR 140\u2013450) days. The primary OS model assigned high weights to four predictors: age, performance status, white cell count and serum albumin, and after cross-validation performed significantly better than would be expected by chance (mean D<jats:sub>XY<\/jats:sub>0.332 (\u00b10.019)). However, validation set D<jats:sub>XY<\/jats:sub> was only 0.221 (0.0935\u20130.346), equating to a 22% improvement in survival prediction than would be expected by chance. The 6-month and 12-month OS signatures included the same four predictors, in addition to epithelioid histology plus platelets and epithelioid histology plus C-reactive protein (mean AUC 0.758 (\u00b10.022) and 0.737 (\u00b10.012), respectively). The &lt;6-month OS model demonstrated 74% sensitivity and 68% specificity. The &lt;12-month OS model demonstrated 63% sensitivity and 79% specificity. Model content and performance were generally comparable with previous studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The prognostic value of the basic clinical information contained in these, and previously published models, is fundamentally of limited value in accurately predicting MPM prognosis. The methods described are suitable for expansion using emerging predictors, including tumour genomics and volumetric staging.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2017-000240","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T20:20:18Z","timestamp":1517343618000},"page":"e000240","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":160,"title":["Survival prediction in mesothelioma using a scalable Lasso regression model: instructions for use and initial performance using clinical predictors"],"prefix":"10.1136","volume":"5","author":[{"given":"Andrew C","family":"Kidd","sequence":"first","affiliation":[{"name":"Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McGettrick","sequence":"additional","affiliation":[{"name":"Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selina","family":"Tsim","sequence":"additional","affiliation":[{"name":"Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L","family":"Halligan","sequence":"additional","affiliation":[{"name":"Fios Genomics, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Bylesjo","sequence":"additional","affiliation":[{"name":"Fios Genomics, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G","family":"Blyth","sequence":"additional","affiliation":[{"name":"Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"},{"name":"Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,1,30]]},"reference":[{"key":"2025083112363285000_5.1.e000240.1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.11.136"},{"key":"2025083112363285000_5.1.e000240.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01238-6"},{"key":"2025083112363285000_5.1.e000240.3","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/j.jtho.2016.09.123","article-title":"The IASLC mesothelioma staging project: improving staging of a rare disease through international participation","volume":"11","author":"Pass","year":"2016","journal-title":"J Thorac Oncol"},{"key":"2025083112363285000_5.1.e000240.4","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/j.jtho.2016.04.027","article-title":"North American multicenter volumetric CT study for clinical staging of malignant pleural mesothelioma: feasibility and logistics of setting up a quantitative imaging study","volume":"11","author":"Gill","year":"2016","journal-title":"J Thorac Oncol"},{"key":"2025083112363285000_5.1.e000240.5","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00146110"},{"key":"2025083112363285000_5.1.e000240.6","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3520"},{"key":"2025083112363285000_5.1.e000240.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.113.3.723"},{"key":"2025083112363285000_5.1.e000240.8","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1200\/JCO.1998.16.1.145","article-title":"Prognostic factors in patients with pleural mesothelioma: the European organization for research and treatment of cancer experience","volume":"16","author":"Curran","year":"1998","journal-title":"J Clin Oncol"},{"key":"2025083112363285000_5.1.e000240.9","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jtho.2015.12.108","article-title":"A novel clinical prediction model for prognosis in malignant pleural mesothelioma using decision tree analysis","volume":"11","author":"Brims","year":"2016","journal-title":"J Thorac Oncol"},{"key":"2025083112363285000_5.1.e000240.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7594"},{"key":"2025083112363285000_5.1.e000240.11","unstructured":"Scottish Government. 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