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Sökning: WFRF:(Adolfsson J) > Konferensbidrag

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  • Gronberg, H, et al. (författare)
  • The risk-based STHLM3 model to improve prostate cancer testing in men 50-69 years: Further health, economic, and clinic evaluation
  • 2016
  • Ingår i: JOURNAL OF CLINICAL ONCOLOGY. - : American Society of Clinical Oncology (ASCO). - 0732-183X .- 1527-7755. ; 34:2
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • 36 Background: Prostate-specific antigen (PSA) is used to screen for prostate cancer but suffers from a high false-positive rate that translates into unnecessary prostate biopsies and over-diagnosis of low-risk prostate cancers. We aimed to develop a model for prostate cancer screening with better test characteristics than PSA. Methods: STHLM3 is a prospective, population-based, paired screen-positive diagnostic study. It investigates whether the predefined STHLM3 model, a combination of 6 plasma protein biomarkers (PSA, free-PSA, intact-PSA, HK2, MIC-1, and MSMB), genetic polymorphisms (232 SNPs), and clinical variables (age, family history, previous biopsies, DRE, and prostate volume) can substantially reduce the proportion of men biopsied while maintaining the same sensitivity to diagnose Gleason score ≥ 7 prostate cancer as PSA ≥3 ng/ml. In addition, a health economic evaluation was performed comparing the STHLM3 model with current clinical practice in Stockholm. Results: 58,818 men without prostate cancer aged 50-69, participated in the STHLM3 study, with 6,700 undergoing subsequent prostate biopsy. The STHLM3 model performed significantly better (p<0.001) than PSA for detecting GS ≥7 cancers, increasing the Area Under the Curve from 0.56 to 0.74. All variables used in the STHLM3 Model were significantly associated with Gleason score ≥7 prostate cancers (p<0.05) in a multiple logistic regression model. Using the same sensitivity as PSA ≥3 ng/ml to diagnose Gleason score ≥7 prostate cancer, the STHLM3 model reduced the number of biopsies by 32% (95% CI 24%-39%) and avoided 44% (95% CI; 35%-54%) of the negative biopsies. The number of Gleason score 6 cancers was reduced by 17% (95% CI; 7%-26%). Positive ICER for the STHLM3 model was seen in all models of the health economic analysis. Conclusions: The STHLM3 model reduces unnecessary biopsies without compromising the ability to diagnose Gleason score ≥7 prostate cancer in a cost-efficient way. This is a significant step towards personalized risk-based prostate cancer diagnostic programs. Clinical trial information: ISRCTN84445406.
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  • Brinkfeldt, Klas, et al. (författare)
  • Simulations of a high temperature pressure sensor packaging and interconnection
  • 2012
  • Ingår i: EuroSimE 2012. - 9781467315128
  • Konferensbidrag (refereegranskat)abstract
    • Modeling and thermal cycling of a high temperature pressure sensor packaging is presented. The packaging is based on the green-state milling of alumina to the desired geometry and conduits for the electrical conductors, followed by sintering of the ceramics with the electrical conductors inside. The electrical interconnections are based on silver. For short term operation, the package can be exposed to temperatures close to the melting temperature of silver (961°C). It has shown operational in temperature cycling above 600°C for more than 1800 hours. Modeling of the package show that the stress in the electrical interconnections are close to the yield stress of silver at 20°C. The stress free temperature in the modeling was set to 850°C. Temperature induced stress and strains in the packaging and a fatigue simulation are performed. The package is generic and can be converted to fit most geometries and high temperature applications. © 2012 IEEE.
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