Their study population was a prospective collection of patients with intermediate or high-risk NMIBC scheduled for induction BCG therapy. They obtained urine testing for Urovysion FISH analysis at the following time points: t0 (before BCG), t1 (before the 6th instillation), t2 (3 months post induction during the first cystoscopy). They underwent routine follow-up to identify recurrences.
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They then provided key markers of the test at each time point: specificity, sensitivity, PPV, NPV and accuracy. The utility at the t0 time point was very low. The t2 time point however demonstrated a NPV of 85% and specificity of 84%. Its positive predictive value and sensitivity were much lower.
While the authors focus on the benefit of a positive test at 3 months, I actually thought the negative test at 3 months was more useful. As the sensitivity and PPV were low (59% and 56%), but the specificity and NPV were quite high (84 and 85%), that is where the value lies.
Further work is warranted.
Presented by: Esmée Liem
Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, twitter: @tchandra_uromd, at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal