E-Book Overview
A much-needed collection of cutting-edge methods for the detection and discovery of new cancer markers, particularly molecular tumor markers. Each method is fully described by a hands-on expert who regularly uses it in the laboratory and has perfected it to a high degree of ready reproducibility. Special emphasis is given to statistical considerations in the analysis of tumor markers, recent discoveries in the field of serum and tissue marker proteins, cytogenetic markers, molecular markers, and markers for the early detection of cancer. The well-honed procedures detailed here will enable cancer researchers and clinical oncologists alike to realize the promise of these powerful new diagnostic strategies for the detection, therapy, and successful prevention of cancer.
E-Book Content
1 Integrating Multiple Clinical Tests to Increase Predictive Power Harry B. Burke 1. Introduction Clmical tests provide information that can be used by statistical methods to make patient outcome predictions. Outcomes are risk of disease, existence of disease, and prognosis. In this chapter we define and describe predictive factors and clinical prediction and explain how combmmg predictive factors can mcrease predictive accuracy, describe the advantages and disadvantages of commonly used statistical methods, and recommend an approach to the reporting of predictive factor research. 2. Predictive Factors A predictive factor predicts an outcome (risk of disease, extstence of disease, or prognosis) by virtue of its relationshtp with the disease process that causes the outcome. For example, the prognostic factor mutant p53 is associated with breast cancer because of its role m the regulation of apoptosis. Such terms as marker, biomarker, predictor, prognosticator, indicator, surrogate factor, and intermediate biomarker have been used to identify variables that are connected to medical outcomes. Their