Predictive Accuracy of the Liverpool Lung Project Risk Model
Authors: Robert P. Young, Raewyn J. Hopkins, David E. Midthun
Journal: Annals of Internal Medicine (2013)

Letters2 April 2013Predictive Accuracy of the Liverpool Lung Project Risk ModelRobert P. Young, MD, Raewyn J. Hopkins, MD, and David E. Midthun, MDRobert P. Young, MDFrom Schools of Biological Science and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, and Mayo Clinic, Rochester, Minnesota.Search for more papers by this author, Raewyn J. Hopkins, MDFrom Schools of Biological Science and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, and Mayo Clinic, Rochester, Minnesota.Search for more papers by this author, and David E. Midthun, MDFrom Schools of Biological Science and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, and Mayo Clinic, Rochester, Minnesota.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-7-201304020-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We agree with Raji and colleagues (1) that the selection of current and former smokers for computed tomography (CT) screening for lung cancer should target those at greatest risk “to maximize the benefit–harm ratio” (2). We also agree that a multivariate approach to risk assessment is the best way to achieve this goal (3) but question whether the validated Liverpool Lung Project (LLP) model maximizes this ratio as suggested.Although the LLP multivariate model performs better than risk models for lung cancer that use age and smoking history alone (1), it is less clear that this superior ...References1. Raji OY, Duffy SW, Agbaje OF, Baker SG, Christiani DC, Cassidy A, et al. Predictive accuracy of the Liverpool Lung Project risk model for stratifying patients for computed tomography screening for lung cancer: a case-control and cohort validation study. Ann Intern Med. 2012;157:242-50. [PMID: 22910935] LinkGoogle Scholar2. Young RP, Hopkins RJ. CT screening for lung cancer [Letter]. Thorax. 2012;67:650-1. [PMID: 21917652] CrossrefMedlineGoogle Scholar3. Young RP, Hopkins RJ. Diagnosing COPD and targeted lung cancer screening [Letter]. Eur Respir J. 2012;40:1063-4. [PMID: 23024333] CrossrefMedlineGoogle Scholar4. Bach PB, Gould MK. When the average applies to no one: personalized decision making about potential benefits of lung cancer screening. Ann Intern Med. 2012;157:571-3. [PMID: 22893040] LinkGoogle Scholar5. Baldwin DR, Duffy SW, Wald NJ, Page R, Hansell DM, Field JK. UK Lung Screen (UKLS) nodule management protocol: modelling of a single screen randomised controlled trial of low-dose CT screening for lung cancer. Thorax. 2011;66:308-13. [PMID: 21317179] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert P. Young, MD; Raewyn J. Hopkins, MD; David E. Midthun, MDAffiliations: From Schools of Biological Science and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand, and Mayo Clinic, Rochester, Minnesota.Disclosures: Dr. Young: Consultancy and patents (planned, pending, or issued): Synergenz BioSciences Ltd. Dr. Midthun: Royalties: UpToDate; Payment for development of educational presentations: American Physician Institute, MKSAP 16, ACP PIER series, Clinical Care Options inPractice; Other: Integrated Diagnostics. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPredictive Accuracy of the Liverpool Lung Project Risk Model for Stratifying Patients for Computed Tomography Screening for Lung Cancer Olaide Y. Raji , Stephen W. Duffy , Olorunshola F. Agbaje , Stuart G. Baker , David C. Christiani , Adrian Cassidy , and John K. Field Predictive Accuracy of the Liverpool Lung Project Risk Model John K. Field , Olaide Y. Raji , and Stephen W. Duffy Metrics 2 April 2013Volume 158, Issue 7Page: 568KeywordsCancer screeningChronic obstructive pulmonary diseaseComputed axial tomographyConflicts of interestDeath ratesDiagnostic techniquesLung and intrathoracic tumorsLungsMedical risk factorsRisk assessments ePublished: 2 April 2013 Issue Published: 2 April 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...