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14 Subsequently, the appropriateness outcomes were correlated with the actual PBx outcome (negative vs positive; Gleason sum?selleck chemicals llc respectively. For the first 2 scenarios, a PBx was considered unnecessary for cases rated as ��inappropriate�� according to the expert recommendations. For the third scenario, PBx was considered unnecessary for all cases with a PCA3 score?PRDX4 all outcomes, where applicable and possible, were also calculated for a cutoff of?25. The BCJ was applied to the REDUCE patient data on the basis of unique profiles (combinations of the values of relevant patient characteristics). The last variable values and corresponding last PBx results for a given subject were used for all analyses. The diagnostic properties (sensitivity, specificity, positive predictive value, and negative predictive value [NPV]) were calculated for the BCJ without and with the inclusion of the PCA3 score and the scenario with the PCA3 score alone. All confidence interval calculations were 2-sided with an �� of 0.05. All statistical analyses were performed using PASW Statistics, release 18.0. A subset of 1140 subjects from the placebo arm of the REDUCE study cohort provided urine samples for PCA3 analysis before the 2- and/or 4-year PBx (not study mandated). The samples from 1072 patients provided sufficient messenger RNA for PCA3 analysis. Data allowing appropriateness calculations were complete for 1024 of these men; thus, apart from the PCA3 score, age, PSA level, DRE findings, and prostate volume data were also available. The baseline characteristics of this population are listed in Table?1. Figure?1 shows the flow diagrams for BCJ without and Bleomycin with PCA3 and for the PCA3 score alone. According to the BCJ, a repeat PBx was inappropriate for 26% of the men when the PCA3 score was not included in the model and in 64% of the men when the PCA3 score was included (Fig.?1A,B). If only the PCA3 score (cutoff score 20) was considered, PBx was judged inappropriate in 52% of men (Fig.?1C). For a cutoff score of 25, this was 63%. A strong relationship was found between the BCJ and actual PBx outcome, particularly when the PCA3 score was included in the model (Fig.?1B). Of the men for whom a PBx was considered inappropriate when taking into account the PCA3 score (n?= 656), 90% had negative PBx findings.