This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Urinary Tract Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

	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: The results of the study of the NMP22 assay for bladder cancer surveillance by Dr Grossman and colleagues¹ do not justify adopting this test for such use. First, the assessment of the sensitivity and specificity of the NMP22 assay was flawed. Diagnostic test evaluation requires the uniform application of an unambiguous reference standard.² The authors used the reference standard of cystoscopy, but it is unclear how often it was applied. The cross-sectional design of the study implies that all patients underwent a single cystoscopy at the time of NMP22 testing. However, at least 9 patients—and as many as 574 not diagnosed as having cancer at their initial cystoscopy—also underwent repeat cystoscopy. If not all 574 patients underwent a repeat examination, then the reference standard was applied inconsistently, raising questions about whether the NMP22 result prompted the repeat cystoscopy, thus inflating the sensitivity of the NMP22 assay (workup . . . [Full Text of this Article]

Chad T. Wilson, MD
chad.t.wilson@dartmouth.edu
VA Outcomes Group
Vermont Veterans Affairs Medical Center
White River Junction

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

NMP22 and Surveillance for Recurrent Bladder Cancer
Scott Eggener and Harry Herr
JAMA. 2006;296(1):45.
EXTRACT | FULL TEXT  

NMP22 and Surveillance for Recurrent Bladder Cancer—Reply
H. Barton Grossman
JAMA. 2006;296(1):45-46.
EXTRACT | FULL TEXT  

Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay
H. Barton Grossman, Mark Soloway, Edward Messing, Giora Katz, Barry Stein, Vahan Kassabian, and Yu Shen
JAMA. 2006;295(3):299-305.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Group writing of letters to the editor as the goal of journal club.
Kallen et al.
JAMA 2006;296:1053-1054.
FULL TEXT