Operating Characteristics of Prostate-Specific Antigen and Verification Bias

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Abstract
To the Editor: In their study of the operating characteristics of prostate-specific antigen (PSA) in men with an initial PSA level of 3.0 ng/mL or lower, Dr Thompson and colleagues1 achieved a biopsy rate or verification rate of 65% from the participants in the Prostate Cancer Prevention Trial (PCPT), corresponding to 5587 prostate biopsies. The authors do note that verification bias was present in their study, as those men who underwent biopsy were more likely to have a positive family history, to be of white race, and to be older than men who did not undergo biopsy. Accordingly, the authors adjusted for verification bias in their reported results.