What is risk prediction - Fred Hutchinson Cancer Research ：弗莱德哈钦森癌症研究所的风险预测.ppt

* * * * * * * Tamoxifen Effects on Events LIFE-THREATENING RR (95%CI) INVASIVE BREAST CA 0.51 (.39-.66) HIP FRACTURE 0.55 (.25-1.1) ENDOMETRIAL CA 50 2.5 (1.4-5.0) 50+ 4.0 (1.7-11) STROKE 1.6 (0.9-2.8) PUL. EMBOLUS 3.0 (1.2-9.3) OTHER SEVERE EVENTS IN SITU BREAST CA 0.50 (0.33-0.77) DEEP VEIN THROMBOSIS 1.60 (0.91-2.86) Calculating Tamoxifen Benefit/Risk Index Net number of life-threatening events prevented (the total number of invasive breast cancers + hip fractures - the total number of endometrial cancers, strokes, and pulmonary embolisms) + half the net number of serious events prevented (the number of in situ breast cancers - the number of deep vein thromboses) over a 5-year period. Gail et al. JNCI 1999;91:1829-46 10,000 40 year old white women with a uterus, with a 5-year risk of invasive breast cancer of 2%. LIFE-THREATENING EXPECTED PREVENTED INVASIVE BREAST CA 200 97 HIP FRACTURE 2 1 ENDOMETRIAL CA 10 -16 STROKE 22 - 13 PUL. EMBOLUS 7 -15 net 54 OTHER SEVERE EVENTS IN SITU BREAST CA 106 53 DEEP VEIN THROMBOSIS 24 -15 net 38 net 38 Net Risk Benefit Index = 1x54 + 0.5x38 = 73 1Five-year projected risk of invasive breast cancer IBC is greater than or equal to 1.67%. Benefit/risk indices for tamoxifen chemoprevention by level of 5-year projected risk of invasive breast cancer among white women with and w