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Cancer. 1993 Nov 15;72(10):3131-5.

The American Joint Committee on Cancer. Criteria for prognostic factors and for an enhanced prognostic system.

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Department of Medicine, School of Medicine, University of Nevada, Reno 89520.


The American Joint Committee on Cancer proposes the following criteria for evaluating putative prognostic factors: they must be (1) significant, (2) independent, and (3) clinically important. Furthermore, we suggest the criteria for selecting a prognostic system that includes TNM and new prognostic factors. These criteria are: (1) easy for physicians to use; (2) provides predictions for all types of cancer; (3) provides the most accurate relapse and survival predictions at diagnosis and for every year lived for each patient; (4) provides group survival curves, where the grouping can be by any variable including outcome and therapy; (5) accommodates missing data and censored patients and is tolerant of noisy and biased data; (6) makes no a priori assumptions regarding the type of data, the distribution of the variables, or the relationships among the variables; (7) can test putative prognostic factors for significance, independence, and clinical importance; (8) accommodates treatment information in the evaluation of prognostic factors; (9) accommodates new putative prognostic factors without changing the model; (10) accommodates emerging diagnostic techniques; (11) provides information regarding the importance of each predictive variable; and (12) is automatic.

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