 |
|
Reliability and Validity of Prostate-Specific Antigen
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
|
|
|
To the Editor: Dr Eastham and colleagues1 found that many men with abnormal levels of prostate-specific antigen (PSA) were found to have normal levels when retested 1 year later. The authors thus concluded that PSA lacks specificity and that a single PSA test is unreliable. They recommend confirmatory assessment before undergoing further testing. We disagree with this logic. Specificity can only be improved by more stringent test criteria, not by further testing. Because the proposed ancillary evaluation includes biopsy, the interval of a few weeks is unnecessary for establishing a diagnosis or reducing adverse effects, but the delay is likely to increase the patient's anxiety and fear.
We also believe that the evidence of Eastham et al was insufficient to make these claims. Assessment of the validity of a screening test requires knowledge of the true disease status; this was not available in the study by Eastham et al. On . . . [Full Text of this Article]
Matti Hakama, ScD;
Anssi Auvinen, MD, PhD
Tampere School of Public Health
University of Tampere
Tampere, Finland
RELATED ARTICLES
Reliability and Validity of Prostate-Specific Antigen—Reply
James A. Eastham, Peter T. Scardino, and Colin B. Begg
JAMA. 2003;290(13):1705-1706.
EXTRACT
| FULL TEXT
Variation of Serum Prostate-Specific Antigen Levels: An Evaluation of Year-to-Year Fluctuations
James A. Eastham, Elyn Riedel, Peter T. Scardino, Moshe Shike, Martin Fleisher, Arthur Schatzkin, Elaine Lanza, Lianne Latkany, and Colin B. Begg
JAMA. 2003;289(20):2695-2700.
ABSTRACT
| FULL TEXT
|
