In Reply We thank Dr Bianchi and colleagues for reiterating the importance of external validation for any prediction tool. Decision support tools such as clinical nomograms are important components of individualized decision making and patient care. Currently, many nomograms are available for different clinical scenarios. Decision making in the prebiopsy setting is of utmost importance because suboptimal decisions can lead to unnecessary biopsies and ultimately overtreatment. Patients with clinically significant prostate cancer, however, need to undergo a biopsy procedure and receive treatment according to their risk profile.
Mehralivand S, Shih J, Turkbey B. Magnetic Resonance Imaging–Based Prediction of Prostate Cancer Risk—Reply. JAMA Oncol. Published online September 20, 2018. doi:10.1001/jamaoncol.2018.4234
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