Diagnostic accuracy estimates of TRUS-guided biopsy, mpMRI and MRI-targeted biopsy used in the base case analysis
| Index test | Sensitivity | Specificity | Reference test | Source and patient population |
|---|---|---|---|---|
| TRUS-guided biopsy | 50% (16/34 patients, 95% CIs 27% to 73%) α=25, β=25 | 90% (57/62 patients, 95% CIs 78% to 97%) α=45, β=5 | Whole-mount pathology | Lecornet et al16: simulated biopsy results on digitally reconstructed prostates of 96 men who had undergone surgery for bladder cancer which revealed prostate cancer |
| mpMRI | 80% (252/302, 95% CIs 66% to 90%) α=40, β=5 | 60% (154/253 patients, 95% CIs 45% to 76%) α=30, β=20 | TRUS-guided extended systematic biopsies (10–12 core) plus two targeted biopsies for those with any area suspicious on mpMRI (score ≥3) | Haffner et al17: 555 men with suspected localised prostate defined as raised PSA of >3–4 ng/mL and/or abnormal DRE with no clinical or biological suspicion of stage T>3 or metastases and had no prior biopsy |
| MRI-targeted biopsy | 80% (94/121 patients, 95% CIs 66% to 90%) α=40, β=10 | 90% Assumed to be equivalent to the specificity of TRUS-guided biopsy, (57/62 patients, 95% CIs 78% to 97%) α=45, β=5 | 20 sector-TPM | Kasivisvanathan et al19: 182 men who had a suspicious lesion on mpMRI; 78 of whom were biopsy naive, 32 had a prior negative biopsy and 72 had a prior positive biopsy |
TRUS, transrectal ultrasound; TPM, template mapping biopsy; mpMRI, multiparametric MRI; MRI-TB, MRI-targeted biopsy. Data inputs were rounded to the nearest 5%. Beta distributions were estimated using the integer form in Excel according to the parameters α and β.