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Andrew Vickers

@vickersbiostats.bsky.social
1K followers 46 following 676 posts

Biostatistician at Memorial Sloan Kettering Cancer Center. Special interest in prostate cancer, risk prediction, patient-reported outcomes, decision-making.

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Andrew Vickers @vickersbiostats.bsky.social · 17/09/2026
Netto et al published an argument against relabeling pattern 3 prostate disease as pre-cancerous: pattern 3 but not benign shares “canonical molecular alterations” with pattern 4. A literature review shows this to be false @uroegg @dr_coops bjui-journals.onlinelibrary.wiley.com/doi/10.1111/...
bjui-journals.onlinelibrary.wiley.com
Is Gleason pattern 3 cancer? Molecular features do not distinguish pattern 3 from benign tissue
Click on the article title to read more.
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Andrew Vickers @vickersbiostats.bsky.social · 25/08/2026
Can anyone at AMA please explain to be the rationale of insisting on two significant figures for high p values but one significant figure for lower p values? The 4 in p=0.34 tells us nothing; truncating the 4 so p=0.034 is changed to 0.03 is losing information.
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Andrew Vickers @vickersbiostats.bsky.social · 22/08/2026
On the left, Robin meets his hero, Jimmy Mickle, at frisbee summer camp, 2018. On the right, Robin and Jimmy after Robin's team, San Francisco Revolver, defeats Jimmy's (New York Pony) in the World Ultimate Club Championship final.
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Andrew Vickers @vickersbiostats.bsky.social · 12/08/2026
Almost all high-income countries have a national policy recommending shared decision-making before PSA screening. We show: a) this recommendation never justified by evidence; b) best evidence is PSA screening not a preference-sensitive decision. journals.sagepub.com/eprint/UP9VV...
journals.sagepub.com
Should there be informed decision-making for prostate cancer screening? An analysis of preference sensitivity - Andrew Vickers, Sigrid Carlsson, 2026
Background Almost all national guidelines groups recommend that individual men make an informed personal decision about whether to be screened for prostate canc...
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Andrew Vickers @vickersbiostats.bsky.social · 10/08/2026
Generally assumed population-based PSA screening = increased overdiagnosis. But already lots of PS testing going on. In a modeling study, we show organized screening would reduce PSA tests, overdiagnsosis compared to current disorganized approach onlinelibrary.wiley.com/doi/10.1002/...
onlinelibrary.wiley.com
Effect of Implementing Population‐Based Prostate‐Specific Antigen Screening on Testing Rates and Prostate Cancer Overdiagnosis in England: A Statistical Modelling Study
We undertook a statistical modeling study to determine the effect of implementing population-based prostate-specific antigen (PSA) screening in England on overdiagnosis and PSA testing rates in compa...
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Andrew Vickers @vickersbiostats.bsky.social · 07/08/2026
Can everyone stop using the term "real world data" and just be precise about setting, participants and interventions? grandroundsinurology.com/the-reality-...
grandroundsinurology.com
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Andrew Vickers @vickersbiostats.bsky.social · 21/07/2026
I've long been suspicious of "regret" as an endpoint. This is principally because decisional regret is predicated on the (improbable) understanding of outcome under the counterfactual. New paper shows regret is basically explained by "I had a bad outcome". pubmed.ncbi.nlm.nih.gov/42429300/
pubmed.ncbi.nlm.nih.gov
Function drives 1-year decision regret in radical prostatectomy: a multicentre prospective study - PubMed
Surgical decision regret after RP is primarily driven by postoperative functional outcomes rather than oncological results or surgical approach. Optimising functional recovery and managing patient exp...
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Andrew Vickers @vickersbiostats.bsky.social · 21/07/2026
Hiring right now and the surnames on our shortlist have the following origins: Jewish, Chinese, Irish, West African, East European, English, South Asian, Spanish. What a joy to live in a country where we get so many different histories and perspectives.
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Andrew Vickers @vickersbiostats.bsky.social · 16/07/2026
Hasn’t it been amazing to see teams from the minor footballing countries doing so well at the world cup, even if they come up short? I refer to Morocco, Egypt, Cape Verde and, of course, England.
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Andrew Vickers @vickersbiostats.bsky.social · 09/07/2026
When I report that I am doing a randomized trial, this is in distinction to a study with non-randomized or historical controls. But when a researcher claims to be analyzing "real world data", this is in distinction to what exactly?
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Andrew Vickers @vickersbiostats.bsky.social · 23/06/2026
Looking for the best papers on the positive and negative likelihood ratio for prostate MRI. What is LR+ and LR- separately for PIRADS 3, 4 and 5? Problem is, this can only be derived from a study where everyone had a biopsy or long-term follow-up.
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Andrew Vickers @vickersbiostats.bsky.social · 17/06/2026
Has anyone been noticing folks are starting to say "numerically superior" to describe results that are not statistically significant?
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Andrew Vickers @vickersbiostats.bsky.social · 12/06/2026
Can someone explain to be how, in meta-analysis, leave-one-out methodology, has anything to do with exploring the sources of heterogeneity?
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Andrew Vickers @vickersbiostats.bsky.social · 10/06/2026
One of my true heroes. She managed to find a work around to a catch-22 that male doctors had created to prevent women becoming doctors.
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Andrew Vickers @vickersbiostats.bsky.social · 26/05/2026
Lots of interesting arguments against removing "cancer" label from pattern 3 prostate disease. For instance, pattern 3 involves basal cells & often has PTEN loss. Question now is whether these are a hill worth other people dying on. jamanetwork.com/journals/jam...
jamanetwork.com
Prostate Cancer Mortality After Relabeling Low-Grade Prostate Cancer as Precancerous
This decision analytical model study evaluates the effects of relabeling grade group 1 prostate cancer on prostate cancer mortality in the US.
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Andrew Vickers @vickersbiostats.bsky.social · 04/05/2026
"Due to low sensitivity, PSMA-PET/CT without evidence of nodal disease does not obviate the need for PLND" BUT "PSMA-avid nodal disease portends ... nearly inevitable ... recurrence / progression, supporting treatment intensification." bjui-journals.onlinelibrary.wiley.com/doi/10.1111/...
bjui-journals.onlinelibrary.wiley.com
Diagnostic and prognostic utility of PSMA‐PET/CT in node‐metastatic prostate cancer
Objective To measure the sensitivity of prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT) for detecting lymph node involvement (LNI) in patients under.....
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Andrew Vickers @vickersbiostats.bsky.social · 30/04/2026
PSA screening reduces cancer-specific mortality (PCSM). Questions remain about effect on all-cause (OS). PSA could reduce PCSM not OS only with deaths from other causes, eg complications of surgery. Please reply with list of screening-induced causes of death.
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Reposted by Andrew Vickers
Stuart McDonald @actuarybyday.bsky.social · 24/04/2026
If the UK were a US state, how would it rank? It depends entirely on what you measure! Fascinating table showing a startlingly different picture depending on the choice of metric. Source: www.linkedin.com/posts/diogo-...
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Andrew Vickers @vickersbiostats.bsky.social · 22/04/2026
Analysis of the CAP randomized trials demonstrates prostate cancer overdiagnosis is highly age dependent. Opportunistic screening policies have led to most PSA tests being in older men. These policies should be revaluated. onlinelibrary.wiley.com/doi/10.1002/ijc.70492
onlinelibrary.wiley.com
Evaluating the Impact of Age on Prostate Cancer Overdiagnosis Using Long‐Term Follow‐Up From the CAP Randomised Trial
Uncertainty persists over whether the benefits of prostate-specific antigen (PSA) screening outweigh harms from overdiagnosis, a key barrier to population-wide adoption. Here, English male mortality ....
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Andrew Vickers @vickersbiostats.bsky.social · 16/04/2026
Accrual to cancer RCTs is very poor. Keeping the product (ie the trial) the same but changing the advertising has a very small effect doi.org/10.1002/cam4.... Alternatively , change the product pubmed.ncbi.nlm.nih.gov/39410769/: it is possible to rapidly accrue to large, single-center RCTs
doi.org
Strategies for increasing accrual in cancer clinical trials: What is the evidence?
Introduction Despite the importance of clinical trial participation among cancer patients, few participate—and even fewer patients from ethnic and racial minoritized groups. It is unclear whether su.....
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Andrew Vickers @vickersbiostats.bsky.social · 16/04/2026
Time to bring back a classic! I asked a journal editor for a date. She declined, but said I could date her sister if I paid $4,000.
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Andrew Vickers @vickersbiostats.bsky.social · 13/04/2026
Just saw geology undergraduate final presentations @carleton.edu Way better presentational, statistical and causal reasoning skills than at typical medical conferences. Why we aren’t teaching our fellows and residents better, given that, you know, lives are at stake?
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Andrew Vickers @vickersbiostats.bsky.social · 02/04/2026
Doing statistics well is hard. Avoiding egregious errors in analysis, reporting and interpretation isn't. Just read, understand and follow the guidelines. pubmed.ncbi.nlm.nih.gov/32451178/ pubmed.ncbi.nlm.nih.gov/37286459/ pubmed.ncbi.nlm.nih.gov/40914655/ pubmed.ncbi.nlm.nih.gov/30580902/
pubmed.ncbi.nlm.nih.gov
Guidelines for Reporting of Figures and Tables for Clinical Research in Urology - PubMed
In an effort to improve the presentation of and information within tables and figures in clinical urology research, we propose a set of appropriate guidelines. We introduce six principles: (1) include graphs only if they improve the reader's ability to understand the study findings; (2) think throug …
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Andrew Vickers @vickersbiostats.bsky.social · 27/03/2026
Just submitted a paper to "Diabetes & Metabolic Syndrome: Clinical Research & Reviews". Was asked by editor *before* they would peer review: my h-index ; all publications in past 12 months, along with impact factor of each journal in which they were published". #RealScience
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Andrew Vickers @vickersbiostats.bsky.social · 11/03/2026
pubmed.ncbi.nlm.nih.gov/29404569/
pubmed.ncbi.nlm.nih.gov
Statistical Code for Clinical Research Papers in a High-Impact Specialist Medical Journal - PubMed
Statistical Code for Clinical Research Papers in a High-Impact Specialist Medical Journal
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Andrew Vickers @vickersbiostats.bsky.social · 03/03/2026
If only AI / ML had been around when I was training, I wouldn’t have had to learn about things like causal inference, how to evaluate prediction models or even, say, the importance of data quality. What a waste of time all that was!
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Andrew Vickers @vickersbiostats.bsky.social · 28/02/2026
Any suggestions as to great resources (lectures on YouTube, short didactic papers etc), to teach novice researchers about RCTs? Design, endpoints, consent, eligibility criteria, IRB etc etc any and all of it.
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Andrew Vickers @vickersbiostats.bsky.social · 21/02/2026
COULD EVERYONE PLEASE STOP USING RANDOM EFFECTS META-ANALYSIS WHEN COMBINING 3 OR 4 TRIALS? AND COULD REVIEWERS STOP DEMANDING IT?
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Andrew Vickers @vickersbiostats.bsky.social · 10/02/2026
today.yougov.com/politics/art...
today.yougov.com
​​From millionaires to Muslims, small subgroups of the population seem much larger to many Americans | YouGov
When it comes to estimating the size of demographic groups, Americans rarely get it right. In two recent YouGov polls, we asked respondents to guess the percentage (ranging from 0% to 100%) of America...
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Andrew Vickers @vickersbiostats.bsky.social · 10/02/2026
www.auajournals.org/doi/10.1097/... Lymph node dissection (LND) for radical prostatectomy: controversy about RCT, complication rate. Decision analysis puts numerical estimates on benefit, harm, uncertainty. Expected utility of LND was higher vs. no PLND across broad range of scenarios.
auajournals.org
Decision Analysis of Pelvic Lymph Node Dissection During Radical Prostatectomy | Journal of Urology
Purpose:There is controversy about the decision of whether to perform a pelvic lymph node dissection (PLND) during radical prostatectomy for prostate cancer. While a recent randomized trial reported a...
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Andrew Vickers @vickersbiostats.bsky.social · 27/01/2026
Yet again, PRS do not differentially distinguish aggressive from indolent cancer. & BARCODE RCT showed poor results compared to MRI etc. Yet the authors give a thumbs up to genomics in prostate cancer screening. When is the PRS fever going to break? www.nature.com/articles/s43...
nature.com
Genomic risk model to implement precision prostate cancer screening in clinical care: the ProGRESS study - Nature Cancer
Vassy, Dornisch and colleagues developed a genomics-based prostate cancer risk model to support a randomized clinical trial of precision screening in a national healthcare system.
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Andrew Vickers @vickersbiostats.bsky.social · 26/01/2026
Too many meta-analyses have findings equivalent to: “If you average the cost of a loaf of bread, car insurance for a year and a movie ticket, you get $752.36”
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Reposted by Andrew Vickers
Stephen Senn @stephensenn.bsky.social · 14/01/2026
1) A covariate that is predictive of outcome should be in the model even if unpredictive of assignment (eg matched pairs design). 2) A covariate that is not predictive of outcome should not be in the model, even if predictive of assignment. 3) The propensity score is stupid.
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Andrew Vickers @vickersbiostats.bsky.social · 14/01/2026
When discussing PSA screening policy, we often contrast two options as opportunistic vs. population-based PSA screening. Would suggest a name change to disorganized vs. organized PSA screening.
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Andrew Vickers @vickersbiostats.bsky.social · 06/01/2026
Number of papers on PubMed using the term "real world data" in 2000: 6. Number in 2025: ~5000. Number of papers for which "real world data" would be a meaningful scientific term: 0.
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Andrew Vickers @vickersbiostats.bsky.social · 05/01/2026
@amit_sud PRS-based prostate cancer screening has worse properties than contemporary approaches: "BARCODE1 biopsied more men, diagnosed more low-grade PCs & detected fewer high-grade PCs versus Göteborg-2 and ProScreen." authors.elsevier.com/sd/article/S...
authors.elsevier.com
ScienceDirect.com | Science, health and medical journals, full text articles and books.
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Andrew Vickers @vickersbiostats.bsky.social · 18/12/2025
ProQuant collaboration: >100 urologists, radiation oncologists, pathologists, radiologists, biostatisticians, & ML experts from 34 institutions worldwide evaluating whether & how tumor quantification offers superior risk stratification to Gleason score. www.sciencedirect.com/science/arti...
sciencedirect.com
Evaluating Tumor Quantification in Place of Proportions in Prostate Cancer: Principles of the ProQuant Group
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Andrew Vickers @vickersbiostats.bsky.social · 18/12/2025
Lysenko is a bit of a bogeyman in science. But I have to say, rereading his story, hard not to draw parallels with Prasad, Makary, Bhattacharya and Hoeg. en.wikipedia.org/wiki/Trofim_...
en.wikipedia.org
Trofim Lysenko - Wikipedia
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Reposted by Andrew Vickers
Ben Van Calster @benvancalster.bsky.social · 13/12/2025
Our guidance regarding performance measures for medical AI models is finally out! - Stop bashing AUROC, although it does not settle things - Calibration and clinical utility are key - Show risk distributions - Classification statistics (e.g. F1) are improper www.thelancet.com/journals/lan...
thelancet.com
Evaluation of performance measures in predictive artificial intelligence models to support medical decisions: overview and guidance
Numerous measures have been proposed to illustrate the performance of predictive artificial intelligence (AI) models. Selecting appropriate performance measures is essential for predictive AI models i...
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Andrew Vickers @vickersbiostats.bsky.social · 09/12/2025
Working on a paper on informed decision making for PSA screening. Looking for any literature demonstrating that PSA screening is a preference sensitive decision and / or any data that these preferences can be accurately elicited in primary care. Please advise.
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Andrew Vickers @vickersbiostats.bsky.social · 08/12/2025
Machine learning has developed remarkable new ideas about how to develop prediction algorithms. But always baffled me why the field had to reinvent how to evaluate models. Here we show F score should not be used to evaluate medical prediction models link.springer.com/epdf/10.1186...
link.springer.com
The F score ranks diagnostic tests and prediction models inconsistently with their clinical utility
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Andrew Vickers @vickersbiostats.bsky.social · 05/12/2025
Five things you need to know about prostate cancer diagnostic tests www.sciencedirect.com/science/arti...
sciencedirect.com
Five things you need to know about prostate cancer diagnostic tests
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Andrew Vickers @vickersbiostats.bsky.social · 04/12/2025
For those who complained about the recent RCT on PSA not looking at overall mortality, note that Gil Welch, the well-respected screening skeptic, concluded "It is not feasible to test all-cause mortality when screening for an individual cancer" pubmed.ncbi.nlm.nih.gov/37639251/
pubmed.ncbi.nlm.nih.gov
Testing Whether Cancer Screening Saves Lives: Implications for Randomized Clinical Trials of Multicancer Screening - PubMed
It is not feasible to test all-cause mortality when screening for an individual cancer. However, it is feasible to test all-cause mortality for multicancer screening because cancer deaths are such a large component of deaths in general. Observational data on the effects of cancer screening are misle …
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Andrew Vickers @vickersbiostats.bsky.social · 24/11/2025
MRI is a great tool in prostate cancer. The problem is, quality in practice might not be quality we see in studies. Nice study from @dr_coops showing that in the VA, MRI not good enough to rule out biopsy. jamanetwork.com/journals/jam...
jamanetwork.com
Magnetic Resonance Imaging or Confirmatory Biopsy for Patients With Prostate Cancer Receiving Active Surveillance
This cohort study compares magnetic resonance imaging with confirmatory biopsy for patients with favorable-risk prostate cancer undergoing active surveilance.
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Andrew Vickers @vickersbiostats.bsky.social · 10/11/2025
RCT n= ~1500. >90% of patients walking through the door with target indication were randomized. Zero funding. Clinical integration and rethinking informed consent transformational. journals.lww.com/anesthesiolo...
journals.lww.com
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Reposted by Andrew Vickers
Prof Gavin Yamey MD MPH @gavinyamey.bsky.social · 31/10/2025
Gosh, who could have predicted that the men who complained that they were being "censored!" during the pandemic phase of Covid (Prasad, Bhattacharya) are now leading the nation's health agencies & CENSORING others? "staffers are terrified of pushing back on Prasad, lest they face retaliation"
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Andrew Vickers @vickersbiostats.bsky.social · 30/10/2025
Recently been debating "cancer screening skeptics" about endpoints in screening RCTs. They insist on overall survival (OS); when I point out feasibility issues, they say infeasibility of RCT on OS proves screening doesn't work. Prejudice masquerading as methodologic rigor.
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Reposted by Andrew Vickers
Aaron Schwartz @aschwartz.bsky.social · 30/10/2025
Appreciated this editorial on the long term results from the prostate cancer screening trial. It's hard to believe we are doing the best we can be when it comes to this screening tool. Screening effectiveness needs to be re-evaluated over time as practices change. www.nejm.org/doi/full/10....
nejm.org
Early Detection of Prostate Cancer — Time to Fish or Cut Bait | NEJM
Approaches to early detection of cancer often seem contentious, but the big-picture view is actually one of remarkable consensus. All major guideline groups recommend the Papanicolaou smear, mammog...
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Andrew Vickers @vickersbiostats.bsky.social · 29/10/2025
After my son’s team lost in semi-finals of frisbee nationals 2024, he wrote to team “I love you all. This is how we do better next year …”. 2025: national champions. Something for science to learn from the sporting world: respect and motivate your team and good things will happen.
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Andrew Vickers @vickersbiostats.bsky.social · 28/10/2025
Folks (Prasad etc) who say “cancer screening must improve overall survival”, let's take a real example, ovarian cancer. ~0.7% mortality; salpingectomy reduces risk by ≥50%. Trial could be powered on cancer mortality (n~20,000) vs. overall (n~750,000). Which would you recommend?
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