BACKGROUND: We provide a statistical analysis of the learning phase for sentinel node biopsy. METHODS: Four learning phases were analyzed: 25, 50, 75, and 150 procedures with a corresponding number of 10, 20, 30, and 60 tumor-positive cases. Critical values of nonidentification rate and false-negative rate were defined. The binomial distribution was used to calculate the probabilities of correctly or incorrectly accepting the quality of the performance, given a certain long-term nonidentification or false-negative rate. RESULTS: The chance of incorrectly reaching a favorable false-negative rate of <10% (critical value) in 20 metastasized patients was 18% for a surgeon with a long-term probability of false-negative procedures of 15%. This chance was reduced to 10% with a learning phase of 60 tumor-positive cases. When this chance has to be further reduced to 5%, the critical value has to be lower in smaller groups of patients: 5% false-negative rate in 20 tumor-positive procedures. CONCLUSIONS: A learning phase of at least 150 procedures with 60 tumor-positive cases is needed to draw any reliable conclusion about the quality of sentinel node biopsy. In general, a compromise has to be made between the reliability of the results and the practically achievable number of procedures.
BACKGROUND: We provide a statistical analysis of the learning phase for sentinel node biopsy. METHODS: Four learning phases were analyzed: 25, 50, 75, and 150 procedures with a corresponding number of 10, 20, 30, and 60 tumor-positive cases. Critical values of nonidentification rate and false-negative rate were defined. The binomial distribution was used to calculate the probabilities of correctly or incorrectly accepting the quality of the performance, given a certain long-term nonidentification or false-negative rate. RESULTS: The chance of incorrectly reaching a favorable false-negative rate of <10% (critical value) in 20 metastasized patients was 18% for a surgeon with a long-term probability of false-negative procedures of 15%. This chance was reduced to 10% with a learning phase of 60 tumor-positive cases. When this chance has to be further reduced to 5%, the critical value has to be lower in smaller groups of patients: 5% false-negative rate in 20 tumor-positive procedures. CONCLUSIONS: A learning phase of at least 150 procedures with 60 tumor-positive cases is needed to draw any reliable conclusion about the quality of sentinel node biopsy. In general, a compromise has to be made between the reliability of the results and the practically achievable number of procedures.
Authors: Christina Bluemel; Ken Herrmann; Francesco Giammarile; Omgo E Nieweg; Julien Dubreuil; Alessandro Testori; Riccardo A Audisio; Odysseas Zoras; Michael Lassmann; Annette H Chakera; Roger Uren; Sotirios Chondrogiannis; Patrick M Colletti; Domenico Rubello Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-25 Impact factor: 9.236
Authors: Katherine E Posther; Linda M McCall; Peter W Blumencranz; William E Burak; Peter D Beitsch; Nora M Hansen; Monica Morrow; Lee G Wilke; James E Herndon; Kelly K Hunt; Armando E Giuliano Journal: Ann Surg Date: 2005-10 Impact factor: 12.969
Authors: Kelvin A Moses; John P Sfakianos; Andrew Winer; Melanie Bernstein; Paul Russo; Guido Dalbagni Journal: World J Urol Date: 2013-12-01 Impact factor: 4.226