OBJECTIVE: The WSG-PRIMe Study prospectively evaluated the impact of the 70-gene signature MammaPrint® (MP) and the 80-gene molecular subtyping assay BluePrint® on clinical therapy decisions in luminal early breast cancer.
METHODS: 452 hormone receptor (HR)-positive and HER2-negative patients were recruited (N0, N1). Physicians provided initial therapy recommendations based on clinicopathological factors. After prospective risk classification by MammaPrint/BluePrint was revealed, post-test treatment recommendations and actual treatment were recorded. Decisional Conflict and anxiety were measured by questionnaires.
RESULTS: Post-test switch (in chemotherapy (CT) recommendation) occurred in 29.1% of cases. Overall, physician adherence to MP risk assessment was 92.3% for low-risk and 94.3% for high-risk MP scores. Adherence was remarkably high in \"discordant\" groups: 74.7% of physicians initially recommending CT switched to CT omission following low-risk MP scores; conversely, 88.9% of physicians initially recommending CT omission switched to CT recommendations following high-risk MP scores. Most patients (99.2%) recommended to forgo CT post-test and 21.3% of patients with post-test CT recommendations did not undergo CT; among MP low-risk patients with pre-test and post-test CT recommendations, 40% did not actually undergo CT. Luminal subtype assessment by BluePrint was discordant with IHC assessment in 34% of patients. Patients\' State Anxiety scores improved significantly overall, particularly in MP low-risk patients. Trait Anxiety scores increased slightly in MP high risk and decreased slightly in MP low-risk patients.
CONCLUSIONS: MammaPrint and BluePrint test results strongly impacted physicians\' therapy decisions in luminal EBC with up to three involved lymph nodes. The high adherence to genetically determined risk assessment represents a key prerequisite for achieving a personalized cost-effective approach to disease management of early breast cancer.

UNASSIGNED: Exam blueprinting achieves valid assessment of students by defining exactly what is intended to be measured in which learning domain and defines what level of competence is required. We aimed to detect the impact of newly applied method for blueprinting that depends on total course credit hours and relate the results with item analysis reports for students\' performance.
UNASSIGNED: A new method for blueprint construction was created. This method utilizes course credit hours for blueprint creation. Survey analysis was conducted for two groups of students (n=80); one utilized our new method (credit hours based) for blueprinting and the other used traditional method depending on exam duration and time for individual test items.
UNASSIGNED: Results of both methods were related to item analysis of students\' achievements. No significant difference was found between both groups in terms related to test difficulty, discrimination, or reliability indices. Both achieved close degrees of test validity and reliability measures.
UNASSIGNED: We concluded that our method using credit hours system for blueprinting could be considered easy and feasible and may eventually be utilized for blueprint construction and implementation.