PEB - Pacific Edge Ltd

[psychic]

What Hancocks and Miner said. Great stuff CJ. Lots to absorb here. Chuck the Triage results with G&P index in there and they have the test they are looking for - correct?

http://nhc.health.govt.nz/system/fil...maturia-t2.pdf

Thanks PT also. Will definately leave this with you and Miner to sort out.

[Crystal Ball]

Yes. Carparks in Invercargill cost $5. In the Auckland CBD they cost $50000 or more for prime parks. Buy up all the cheap Invercargill parks and freight them to Auckland to sell at a huge markup.

I trust this is of use.

Kind regards,
NBT

Ummmm, I think I recall reading PT was asking for " sensible ideas" .....I can t quite see the correlation here but maybe others can.

[Minerbarejet]

Yes. Carparks in Invercargill cost $5. In the Auckland CBD they cost $50000 or more for prime parks. Buy up all the cheap Invercargill parks and freight them to Auckland to sell at a huge markup.

I trust this is of use.

Kind regards,
NBT

Probably not a lot, NBT.
Its the wrong way round.
Shift some Aucklanders to Invercargill instead.
Tim might be pleased to have company but he could be bluffing.

Still working on macro and micro, far out, its complicated!

[psychic]

Hey NG. Out on the road so don't have any data. But no stress - we have the best test. The (Breen ?) paper about to be released will evidence the advantages over UroVysion. Secondly , data from Triage or G&P won't be in there right? I'll rat out some more info when back.

[AndyLP]

What am I missing here? Table 11 in that document shows that CX bladder has neither the best sensitivity nor specificity? And, one test (UroVysion) has similar sensitivity to CX bladder but MUCH better specificity.

What do you all make of this?

Seems to depend on the source.
Firstly, it appears ImmunoCyt isn't FDA cleared for outright initial diagnosis.. only recurrence according to Blue Cross / Blue Sheild. (Not 100% but I don't think its CLIA approved either, like cxbladder.)

https://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/urinary_tumor_markers_for_bladder_cancer.pdf

That document also states a sensitivity / specificity of 74 and 80. Middle of the road stuff.
You'd think the nhc would dig up the numbers to put PEB in the best light! Ah well..

[Minerbarejet]

What am I missing here? Table 11 in that document shows that CX bladder has neither the best sensitivity nor specificity? And, one test (UroVysion) has similar sensitivity to CX bladder but MUCH better specificity.

What do you all make of this?

Think those are overall indications and need to be taken together. i.e 82% at 85%
Try the PEB website clinical outcomes in cxbladder.com healthcare professionals for the basics.
I know Urovysion is not there which is why we await the Breen report with some interest.

[twotic]

What am I missing here? Table 11 in that document shows that CX bladder has neither the best sensitivity nor specificity? And, one test (UroVysion) has similar sensitivity to CX bladder but MUCH better specificity.

What do you all make of this?

Seems to depend on the source.
Firstly, it appears ImmunoCyt isn't FDA cleared for outright initial diagnosis.. only recurrence according to Blue Cross / Blue Sheild. (Not 100% but I don't think its CLIA approved either, like cxbladder.)

https://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/urinary_tumor_markers_for_bladder_cancer.pdf

That document also states a sensitivity / specificity of 74 and 80. Middle of the road stuff.
You'd think the nhc would dig up the numbers to put PEB in the best light! Ah well..

The test you are referring to though Andy is not the one NewGuy was asking about (or am I misreading you somehow?).

E.g. both documents show the same results for UroVysion. I.e. Sensitivity of 77% and Specificity of 98%. It seems the point still stands that on the face of it UroVysion appears a little better based on those numbers. That being said, sensitivity and specificity values trade off against one another. When one goes up the other goes down, so as Miner says both need to be looked at as a pair, not compared across tests individually - the later would be a big mistake. Eg NewGuy saying "CX bladder has neither the best sensitivity nor specificity" does not mean you can infer that CxBladder is not the best test.... There are various ways to look at both sensitivity and specificity simultaneously: area under the ROC curve is the one I like to use, but likelihood ratios (positive/negative) are also ofter used.

The other point is that the NHC report indicates the focus for further research should be on tests with high sensitivity (pg 30) so on that count CxBladder is preferable to UroVysion. Presumably that suggests a preference for tests which limit the number of negative test results for patients who in reality do actually have cancer.

[AndyLP]

The test you are referring to though Andy is not the one NewGuy was asking about (or am I misreading you somehow?).

E.g. both documents show the same results for UroVysion. I.e. Sensitivity of 77% and Specificity of 98%. It seems the point still stands that on the face of it UroVysion appears a little better based on those numbers. That being said, sensitivity and specificity values trade off against one another. When one goes up the other goes down, so as Miner says both need to be looked at as a pair, not compared across tests individually - the later would be a big mistake. Eg NewGuy saying "CX bladder has neither the best sensitivity nor specificity" does not mean you can infer that CxBladder is not the best test.... There are various ways to look at both sensitivity and specificity simultaneously: area under the ROC curve is the one I like to use, but likelihood ratios (positive/negative) are also ofter used.

The other point is that the NHC report indicates the focus for further research should be on tests with high sensitivity (pg 30) so on that count CxBladder is preferable to UroVysion. Presumably that suggests a preference for tests which limit the number of negative test results for patients who in reality do actually have cancer.

Quite right there twotic. I got distracted by the higher reported sensitivity of immunocyt because as you say that's what's immediately pertinent to patient health.

[twotic]

The point still remains, does it not, that CX bladder has neither the best sensitivity nor specificity, which I'm sure contradicts how others have portrayed it in this thread historically???

I can't speak for how things have been portrayed on here, what I can say is that anyone that would make comments such as that does not understand how specificity and sensitivity are calculated or what they mean. So on that count, no, IMO the point does not remain - you simply can't look at each of these numbers in isolation and compare across different tests.

Put it this way - I could create a test that guarantees 100% sensitivity - does that make it a good test? Perhaps, it would certainly make it the highest ranking of the different tests found in table 11 IF you were to rank them by sensitivity values alone. BUT, you actually don't have any idea how good my test is until you at least see what the specificity value is. All I could have done is create a test which always results in a positive result thereby producing 100% sensitivity. The downside is that my specificity value would be 0%.

Remembering of course that Sensitivity = the number of true positives/the number of sick individuals in the population (a true positive being a test which correctly indicates a positive result). And specificity = the number of true negatives/the number of well individuals in the population (a true negative being a test which correctly indicates a negative result).

Also remember that Pacific Edge purposefully fixes specificity at 85%. If they wanted to improve their specificity value they could always do so at the expense of sensitivity.

I hope there are no typos in my post, regardless I think you should get the idea.

[Tsuba]

How many times does this topic have to be debated? Time to feed the chooks.