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Wheldon CW, Polter EJ, Simon Rosser BR, Kapoor A, Talley KMC, Haggart R, Kohli N, Konety BR, Mitteldorf D, Ross MW, West W, Wright M. Pain and Loss of Pleasure in Receptive Anal Sex for Gay and Bisexual Men following Prostate Cancer Treatment: Results from the Restore-1 Study. JOURNAL OF SEX RESEARCH 2022; 59:826-833. [PMID: 34219559 PMCID: PMC8720903 DOI: 10.1080/00224499.2021.1939846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Prostate cancer treatments disrupt receptive anal intercourse (RAI) for gay and bisexual men (GBM). Sexual dysfunction following prostate cancer treatment may include severe pain in the anorectum during RAI (i.e., anodyspareunia). The purpose of this study was to explore the impact of prostate cancer and its treatments on RAI among GBM. Data were from a cross-sectional online survey of 100 GBM prostate cancer survivors who reported pleasurable RAI prior to treatment. Approximately 47% of the sample reported recent RAI, which was more common among GBM in long-term relationships. RAI was also associated with engagement in other sexual behaviors (e.g., oral and insertive anal sex). Anodyspareunia was reported by 23% of the men who had attempted recent RAI. Anodyspareunia was negatively associated with mental health, performing oral sex on a partner, and bowel function. The overwhelming majority received no information from their healthcare providers about loss of RAI function prior to prostate cancer treatment. Culturally responsive cancer survivorship care may need to address the loss of RAI function for GBM prostate cancer survivors.
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Affiliation(s)
- Christopher W. Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA USA
| | - Elizabeth J. Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Aditya Kapoor
- Department of Radiology, Trinity Teleradiology Services, Vancouver, BC, Canada
| | - Kristine M. C. Talley
- Adult and Gerontological Health, University of Minnesota School of Nursing School, Minneapolis, Minnesota, USA
| | - Ryan Haggart
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - Michael W. Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota, USA
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Sibert NT, Pfaff H, Breidenbach C, Wesselmann S, Roth R, Feick G, Carl G, Dieng S, Gaber AA, Blana A, Darr C, Distler F, Kunath F, Bedke J, Erdmann J, Minner J, Simon J, Kwiatkowski M, Burchardt M, Harz N, Conrad S, Höfner T, Knoll T, Beyer B, Hammerer P, Kowalski C. Variation across operating sites in urinary and sexual outcomes after radical prostatectomy in localized and locally advanced prostate cancer. World J Urol 2022; 40:1437-1446. [PMID: 35347412 DOI: 10.1007/s00345-022-03985-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The extent of variation in urinary and sexual functional outcomes after radical prostatectomy (RPE) between prostate cancer (PC) operating sites remains unknown. Therefore, this analysis aims to compare casemix-adjusted functional outcomes (EPIC-26 scores incontinence, irritative/obstructive function and sexual function) between operating sites 12 months after RPE. MATERIALS AND METHODS Analysis of a cohort of 7065 men treated with RPE at 88 operating sites (prostate cancer centers, "PCCs") between 2016 and 2019. Patients completed EPIC-26 and sociodemographic information surveys at baseline and 12 months after RPE. Survey data were linked to clinical data. EPIC-26 domain scores at 12 months after RPE were adjusted for relevant confounders (including baseline domain score, clinical and sociodemographic information) using regression analysis. Differences between sites were described using minimal important differences (MIDs) and interquartile ranges (IQR). The effects of casemix adjustment on the score results were described using Cohen's d and MIDs. RESULTS Adjusted domain scores at 12 months varied between sites, with IQRs of 66-78 (incontinence), 89-92 (irritative/obstructive function), and 20-29 (sexual function). Changes in domain scores after casemix adjustment for sites ≥ 1 MID were noted for the incontinence domain (six sites). Cohen's d ranged between - 0.07 (incontinence) and - 0.2 (sexual function), indicating a small to medium effect of casemix adjustment. CONCLUSIONS Variation between sites was greatest in the incontinence and sexual function domains for RPE patients. Future research will need to identify the factors contributing to this variation. TRIAL REGISTRY The study is registered at the German Clinical Trial Registry ( https://www.drks.de/drks_web/ ) with the following ID: DRKS00010774.
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Affiliation(s)
- Nora Tabea Sibert
- German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany.
| | - Holger Pfaff
- Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Clara Breidenbach
- German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany
| | - Simone Wesselmann
- German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany
| | - Rebecca Roth
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany
| | - Günther Feick
- Federal Association of German Prostate Cancer Patient Support Groups, Bonn, Germany
| | - Günter Carl
- Federal Association of German Prostate Cancer Patient Support Groups, Bonn, Germany
| | | | - Amr A Gaber
- Urologische Klinik, Carl-Thiem-Klinikum Cottbus, Thiemstr. 111, 03048, Cottbus, Germany
| | - Andreas Blana
- Klinik für Urologie und Kinderurologie, Klinikum Fürth, Jakob-Henle-Strasse 1, 90766, Fürth, Germany
| | - Christopher Darr
- Klinik für Urologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Florian Distler
- Klinik für Urologie, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Standort Klinikum Nürnberg, Prof.-Ernst-Nathan-Straße 1 (Haus 22), 90419, Nuremberg, Germany
| | - Frank Kunath
- Department of Urology and Pediatric Urology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany
| | - Jens Bedke
- Klinik für Urologie, Universität Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Jörg Erdmann
- Prostatakarzinomzentrum Tauber-Franken, Uhlandstr. 7, 97980, Bad Mergentheim, Germany
| | - Jörg Minner
- Hegau-Bodensee-Klinikum GmbH, Virchowstraße 10, 78224, Singen, Germany
| | - Jörg Simon
- Klinik für Urologie und Kinderurologie, Ortenau Klinikum, Ebertplatz 12, 77654, Offenburg, Germany
| | - Maciej Kwiatkowski
- Kantonsspital Aarau AG, Onkologiezentrum Mittelland, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Martin Burchardt
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Nino Harz
- Klinikum Dortmund, Münsterstraße 240, 44145, Dortmund, Germany
| | - Stefan Conrad
- DIAKOVERE Friederikenstift, Humboldtstraße 5, 30169, Hannover, Germany
| | - Thomas Höfner
- Klinik und Poliklinik für Urologie und Kinderurologie, UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Thomas Knoll
- Kliniken Sindelfingen, Arthur-Gruber-Str. 70, 71065, Sindelfingen, Germany
| | - Burkhard Beyer
- Martini-Klinik Prostate Cancer Center Hamburg, Martinistraße 52, 20246, Hamburg, Germany
| | - Peter Hammerer
- Städtisches Klinikum Braunschweig, Freisestraße 9/10, 38118, Braunschweig, Germany
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Implementation of patient-reported outcome measures into health care for men with localized prostate cancer. Nat Rev Urol 2022; 19:263-279. [PMID: 35260844 DOI: 10.1038/s41585-022-00575-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 11/12/2022]
Abstract
Measuring treatment-related quality of life (QOL) has become an increasingly requisite component of delivering high-quality care for patients with prostate cancer. Patient-reported outcome measures (PROMs) have, therefore, become an important tool for understanding the adverse effects of radical prostate cancer treatment and have been widely integrated into clinical practice. By providing real-time symptom monitoring and improved clinical feedback to patients and providers, PRO assessment has led to meaningful gains in prostate cancer care delivery and quality improvement worldwide. By providing an avenue for benchmarking, collaboration and population health monitoring, PROMs have delivered substantial improvements beyond providing individual symptom feedback. However, multilevel barriers exist that need to be addressed before the routine implementation of PROMs is achieved. Improvements in collection, interpretation, standardization and reporting will be crucial for the continued implementation of PROM instruments in prostate cancer pathways.
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Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures. Soc Psychiatry Psychiatr Epidemiol 2022; 57:435-460. [PMID: 34145463 PMCID: PMC8934327 DOI: 10.1007/s00127-021-02120-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 06/02/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs). OBJECTIVE To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs. METHODS We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population. RESULTS We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation. CONCLUSIONS Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.
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Fukuda K, Muto S, China T, Koyasu H, Noma Y, Ashizawa T, Hirano H, Kitamura K, Shimizu F, Nagata M, Isotani S, Horie S. Clinical use of expanded prostate cancer index composite-based health-related quality of life outcomes after robot-assisted radical prostatectomy for localized prostate cancer. Prostate Int 2021; 10:62-67. [PMID: 35510095 PMCID: PMC9042679 DOI: 10.1016/j.prnil.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/11/2021] [Accepted: 08/22/2021] [Indexed: 11/19/2022] Open
Abstract
Background This study aimed to assess the longitudinal health-related quality of life (HRQOL) using the Expanded Prostate Cancer Index Composite (EPIC) and HRQOL change between the nerve-sparing technique in Japanese men treated with robot-assisted radical prostatectomy (RARP). Methods A total of 573 patients who received RARP were included in this study. EPIC questionnaire was administered before treatment and up to 36 months after RARP. Clinical recovery was defined as half of the standard deviation of the baseline score for each domain. We divided all patients into recovery group or nonrecovery group. The time from survey to each domain recovery was calculated using the Kaplan–Meier method. We compared the sexual and urinary score change between groups using analysis of variance to confirm the effect of nerve-sparing technique. Results The median age was 67 years (interquartile range, 62–71 years). The mean score of all urinary domains worsened noticeably after 1 month. All postoperative urinary summary, function, and incontinence scores were significantly lower than preoperative scores up to 3 years post-RARP. Postoperative sexual summary and functional scores were significantly lower than preoperative score at all follow-up times throughout the 36 months. The recovery rate for the urinary incontinence domain was the lowest (44.5%), whereas the recovery rate for the urinary irritative–obstructive domain was the highest (73.7%). In the sexual domain, the bother domain had a higher recovery rate (73.0%) than the functional domain (29.7%). Although the recovery of sexual domains was slower compared with other domains, by 36 months after RARP, almost all values had recovered. Compared with other technique groups, bilateral intrafascial nerve-sparing group showed significantly decreased change in subscale scores before and after RARP in several sexual and urinary domain. Conclusion The time course and extent of functional and bother domain recovery documented in this study may prove useful for RARP patient selection in Japan.
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6
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Dincer AN, Brunckhorst O, Genel O, Dasgupta P, Muneer A, Ahmed K. Quality of life, anxiety and depression patient-reported outcome measures in testicular cancer: A systematic review. Psychooncology 2021; 30:1420-1429. [PMID: 33934434 DOI: 10.1002/pon.5700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Several patient-reported outcome measures (PROMs) are available for the assessment of quality of life (QoL), anxiety and depression for testicular cancer (TCa); however, these PROMs have uncertain validation of their psychometric properties for TCa-only cohorts. This systematic review aims to critically analyse and evaluate the psychometric properties of these QoL, anxiety and depression PROMs. METHODS PubMed, EMBASE and PsycInfo were searched by two independent reviewers from inception to August 2020. Evaluative studies that assessed measurement properties of PROM(s) tools used for measuring QoL, anxiety and depression in TCa patients were included. The COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) updated criteria for good measurement properties were used in the evaluation of PROM psychometric quality. This systematic review was registered on the PROSPERO database (CRD42020160232). RESULTS Of 4,305 abstracts screened, a final eight full-text articles were included in this review. Five general and two TCa-specific PROMs were identified (depression, n = 1; anxiety and depression, n = 2; QoL, n = 4). All studies were incomplete in the validation of nine measurement properties and the modal methodological quality was 'indeterminate'. The European Organisation for Research and Treatment of Cancer Quality -Testicular Cancer 26 questionnaire and CAYA-T had the highest psychometric validation with three out of nine measurement properties being 'sufficient'. CONCLUSION This systematic review identifies a paucity of PROM-validation studies assessing anxiety, depression and QoL in TCa-only cohorts. We recommend further comprehensive and standardised psychometric validation studies of QoL, anxiety and depression PROMs in TCa-only study populations.
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Affiliation(s)
- Amine Nur Dincer
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Oktay Genel
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK
| | - Asif Muneer
- Division of Surgery and Interventional Science, University College London, London, UK.,Department of Urology, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK.,NIHR Biomedical Research Centre, University College London Hospital, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, UK.,Department of Urology, King's College Hospital, London, UK
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Odeo S, Degu A. Factors affecting health-related quality of life among prostate cancer patients: A systematic review. J Oncol Pharm Pract 2020; 26:1997-2010. [PMID: 32972301 DOI: 10.1177/1078155220959414] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Prostate cancer is recognized as the leading cause of malignancy-related incidence and mortality in the male population. The treatment regimens have long-term effects detrimental to the patient's quality of life. Hence, this review was aimed to determine the overall HRQOL and its associated among prostate cancer patients. METHODS The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The databases searched were PubMed, Embase, Google Scholar and Cumulative Index to the Nursing and Allied Literature (CINAHL), which provided articles that were critically examined, yielding 52 studies that met the inclusion criteria for the systematic review. RESULTS Out of 52 studies, 30 studies reported poor overall HRQOL in various domains after prostate cancer treatment. Contrastingly, 15 studies reported good overall quality of life after treatment. Among the various domains, sexual function was the most grossly affected functional score by the treatment modalities of prostate cancer. Nonetheless, seven studies showed that the absence of a significant change in the overall quality of life after treatment. According to the studies, older age, comorbidities, higher clinical stage, higher Gleason score, greater cancer severity, African American race, impaired mental health, neoadjuvant hormonal therapy and lower level of education were the major poor predictors of HRQOL among prostate cancer patients. CONCLUSION The overall HRQOL in prostate cancer patients was generally poor in various functional domains after treatment. Among the various domains, sexual function was the most grossly affected functional score by the treatment modalities of prostate cancer.
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Affiliation(s)
- Sharon Odeo
- School of Pharmacy and Health Sciences, United States International University-Africa, Nairobi, Kenya
| | - Amsalu Degu
- School of Pharmacy and Health Sciences, United States International University-Africa, Nairobi, Kenya
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Wong RL, Morgans AK. Integration of Patient Reported Outcomes in Drug Development in Genitourinary Cancers. Curr Oncol Rep 2020; 22:21. [PMID: 32036478 DOI: 10.1007/s11912-020-0890-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Patient reported outcomes (PROs) are increasingly utilized in cancer drug development, and are of particular importance in genitourinary cancers due to symptom burden, multiple treatment options with similar efficacy, and often prolonged duration of disease. Here we review current data and perspectives related to use of PROs in drug development for genitourinary cancers, including insights on the regulatory process for drug approval. RECENT FINDINGS The FDA is committed to incorporating PRO data into the regulatory process for development and approval of new cancer drugs, but challenges exist due to lack of standardization of PRO instrument choice and analytic approach, missing data, and difficulty isolating treatment effect from disease-related effects. We review guidance for standardization of PRO methodology that is nonetheless tailored to disease state and anticipated effects of treatment. PRO and efficacy data should be simultaneously analyzed and reported for best clinical practice. Multiple disease-specific PRO instruments exist for genitourinary cancers. While clinicians, researchers, and regulatory bodies alike recognize the importance of PROs in cancer drug development, challenges remain regarding implementation of best practices.
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Affiliation(s)
- Risa L Wong
- Department of Medicine, Division of Oncology, University of Washington, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Alicia K Morgans
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.
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Farnell DJJ, Staffurth J, Sivell S, Ahmedzai S, Andreyev J, Green J, Sanders DS, Ferguson CJ, Pickett S, Muls A, O'Shea R, Campbell SH, Taylor SE, Nelson A. The ALERT-B questionnaire: A screening tool for the detection of gastroenterological late effects after radiotherapy for prostate cancer. Clin Transl Radiat Oncol 2020; 21:98-103. [PMID: 32072031 PMCID: PMC7016329 DOI: 10.1016/j.ctro.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/02/2020] [Indexed: 01/03/2023] Open
Abstract
ALERT-B provides an effective screening tool for gastroenterological late effects. 84.4% and 95.7% of patients demonstrated complications at 6 and 12 months post-treatment. ROC curves at baseline indicated an AUC of 0.867 compared to the GSRS diarrhoea subscale. ROC curves at baseline indicated an AUC of 0.765 compared to the EPIC bowel subscale.
There is an increasing need to measure treatment-related side effects in normal tissues following cancer therapy. The ALERT-B (Assessment of Late Effects of RadioTherapy - Bowel) questionnaire is a screening tool that is composed of four items related specifically to bowel symptoms. Those patients that respond with a “yes” to any of these items are referred on to gastroenterologist in order to improve the long-term consequences of these side effects of radiological treatment. Here we wish to test the ability of this questionnaire to identify these subsequent gastroenterological complications by tracking prostate cancer patients that were positive with respect to ALERT-B. We also carry out receiver-operator curve (ROC) analysis for baseline data for an overall ALERT-B questionnaire score with respect to subscale data for the Gastrointestinal Symptom Rating Scale (GSRS) and the Expanded Prostate Cancer Index Composite (EPIC-26) questionnaire. 84.4% and 95.7% of patients identified by the ALERT-B questionnaire demonstrated complications diagnosed at 6 and 12 months post-treatment, respectively. ROC curve analysis of baseline data showed that ALERT-B detected clinically relevant levels of side effects established at baseline by the GSRS diarrhoea subscale (AUC = 0.867, 95% CI = 0.795 to 0.926) and at the minimally important level of side effects for the EPIC bowel subscale (AUC = 0.765, 95% CI = 0.617 to 0.913). These results show that ALERT-B provides a simple and effective screening tool for identifying gastroenterological complications after treatment for prostate cancer.
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Affiliation(s)
- D J J Farnell
- School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - J Staffurth
- Velindre Cancer Centre, Cardiff, United Kingdom.,Cardiff University, Cardiff, United Kingdom
| | - S Sivell
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - S Ahmedzai
- National Institute for Health Research, Clinical Research Network - Cancer Cluster Office, University of Leeds, Leeds, United Kingdom
| | - J Andreyev
- Department of Gastroenterology, Lincoln County Hospital, Lincoln, United Kingdom
| | - J Green
- Institute of Medical Education, School of Medicine, Cardiff University and Department of Gastroenterology, University Hospital Llandough, Cardiff and Vale UHB, Vale of Glamorgan, Cardiff, United Kingdom
| | - D S Sanders
- University of Sheffield Medical School, Sheffield, United Kingdom
| | - C J Ferguson
- University of Sheffield Medical School, Sheffield, United Kingdom
| | - S Pickett
- Swansea Centre for Health Economics, Swansea University, Swansea, United Kingdom
| | - A Muls
- Royal Marsden Hospital, Fulham Road, London, United Kingdom
| | - R O'Shea
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - S H Campbell
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - S E Taylor
- Macmillan Cancer Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - A Nelson
- Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Hathout L, Mahmoud O, Wang Y, Vergalasova I, Barkati M, Després P, Martin AG, Foster W, Lacroix F, Delouya G, Taussky D, Morton G, Vigneault E. A Phase 2 Randomized Pilot Study Comparing High-Dose-Rate Brachytherapy and Low-Dose-Rate Brachytherapy as Monotherapy in Localized Prostate Cancer. Adv Radiat Oncol 2019; 4:631-640. [PMID: 31673656 PMCID: PMC6817536 DOI: 10.1016/j.adro.2019.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 01/30/2023] Open
Abstract
Purpose To compare health-related quality of life (HRQOL) of high-dose-rate brachytherapy (HDRB) versus low dose-rate brachytherapy (LDRB) for localized prostate cancer in a multi-institutional phase 2 randomized trial. Methods and Materials Men with favorable-risk prostate cancer were randomized between monotherapy brachytherapy with either Iodine-125 LDRB to 144 Gy or single-fraction Iridium-192 HDRB to 19 Gy. HRQOL and urinary toxicity were recorded at baseline and at 1, 3, 6, and 12 months using the Expanded Prostate Cancer Index Composite (EPIC)-26 scoring and the International Prostate Symptom Score (IPSS). Independent samples t test and mixed effects modeling were performed for continuous variables. Time to IPSS resolution, defined as return to its baseline score ±5 points, was calculated using Kaplan-Meier estimator curves with the log-rank test. A multiple-comparison adjusted P value of ≤.05 was considered significant. Results LDRB and HDRB were performed in 15 and 16 patients, respectively, for a total of 31 patients. At 3 months, patients treated with LDRB had a higher IPSS score (mean, 15.5 vs 6.0, respectively; P = .003) and lower EPIC urinary irritative score (mean, 69.2 vs 85.3, respectively; P = .037) compared with those who received HDRB. On repeated measures at 1, 3, 6, and 12 months, the IPSS (P = .003) and EPIC urinary irritative scores (P = .019) were significantly better in the HDR arm, translating into a lower urinary toxicity profile. There were no significant differences in the EPIC urinary incontinence, sexual, or bowel habit scores between the 2 groups at any measured time point. Time to IPSS resolution was significantly shorter in the HDRB group (mean, 2.0 months) compared with the LDRB group (mean, 6.0 months; P = .028). Conclusions HDRB monotherapy is a promising modality associated with a lower urinary toxicity profile and higher HRQOL in the first 12 months compared with LDRB.
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Affiliation(s)
- Lara Hathout
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Omar Mahmoud
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Yaqun Wang
- Department of Biostatistics, School of Public Health, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Irina Vergalasova
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Maroie Barkati
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Philippe Després
- Department of Radiation Oncology and Research Centre CHU de Québec-Université Laval, Québec City, QC, Canada
| | - André-Guy Martin
- Department of Radiation Oncology and Research Centre CHU de Québec-Université Laval, Québec City, QC, Canada
| | - William Foster
- Department of Radiation Oncology and Research Centre CHU de Québec-Université Laval, Québec City, QC, Canada
| | - Frédéric Lacroix
- Department of Radiation Oncology and Research Centre CHU de Québec-Université Laval, Québec City, QC, Canada
| | - Guila Delouya
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Daniel Taussky
- Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Gerard Morton
- Department of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada
| | - Eric Vigneault
- Department of Radiation Oncology and Research Centre CHU de Québec-Université Laval, Québec City, QC, Canada
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11
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Detailed analysis of patient-reported lower urinary tract symptoms and effect on quality of life after robotic radical prostatectomy. Urol Oncol 2018; 36:364.e15-364.e22. [PMID: 29891407 DOI: 10.1016/j.urolonc.2018.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/24/2018] [Accepted: 05/14/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To prospectively evaluate short- to medium-term patient-reported lower urinary tract symptoms (LUTS) and their effect on health-related quality of life (HRQoL) using validated questionnaires in a large cohort of patients following robotic-assisted radical prostatectomy (RARP) for prostate cancer. MATERIALS AND METHODS HRQoL and LUTS outcomes were prospectively assessed in 357 consecutive men undergoing RARP at a single center from 2012 to 2015 using the functional assessment of cancer therapy-prostate (FACT-P) and the international consultation on incontinence modular questionnaire-male LUTS (ICIQ-MLUTS). Questionnaires were administered at baseline, 6, 12, and 18 months. Data were analyzed using paired t-tests and ANOVA. RESULTS Questionnaire completion rates were high (over 60% of eligible men completed 18-month follow-up). Mean Total FACT-P did not significantly change after RARP: 125.95 (standard deviation [SD] = 19.82) at baseline and 125.86 (SD = 21.14) at 18-months (P = 0.55). Mean total ICIQ-MLUTS also remained unchanged: 18.69 (SD = 10.70) at baseline and 18.76 (SD = 11.33) at 18-months (P = 0.11). Mean voiding score significantly reduced from 10.34 (SD = 5.78) at baseline to 6.33 (SD = 3.99) at 6 months after RARP (P<0.001). A reciprocal significant increase in storage score was observed: 5.34 (SD = 4.26) at baseline, 9.65 (SD = 5.71) at 6 months (P<0.001). Subanalyses of ICIQ-MLUTS scores revealed increases in storage symptoms were exclusively within urinary incontinence domains and included significant increases in both urge and stress urinary incontinence scores. CONCLUSION Overall, patient-reported outcome measures evaluating HRQoL and LUTS do not significantly change after RARP. Detailed analysis reveals significant changes within LUTS domains do occur after surgery which could be overlooked if only total LUTS scores are reported.
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12
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Axcrona K, Nilsson R, Brennhovd B, Sørebø Ø, Fosså SD, Dahl AA. Psychometric properties of the expanded prostate cancer index composite - 26 instrument in a cohort of radical prostatectomy patients: theoretical and practical examinations. BMC Urol 2017; 17:111. [PMID: 29197360 PMCID: PMC5712157 DOI: 10.1186/s12894-017-0302-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/17/2017] [Indexed: 03/21/2023] Open
Abstract
Background Recently, the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) was recommended for the assessment of adverse effects after the treatment of prostate cancer without clear reasons. This decision encouraged us to review the questionnaire development from the UCLA Prostate Cancer Index (UCLA-PCI) to the EPIC-16 CP with a focus on psychometric properties. We also reviewed PubMed for papers concerning such properties of the EPIC-26 since 2012 (latest review in 2011). Finally, we examined the psychometric properties of the EPIC-26 in a sample of Norwegian males treated with robot-assisted laparoscopic prostatectomy (RALP). Methods This study used three methods: (1) Comparison of the content of the UCLA-PCI, EPIC-50, EPIC-26, and EPIC-16 CP; (2) Review of EPIC-26 and EPIC-16 CP papers in PubMed from 2012 to 2016, identifying papers reporting on the psychometric properties of these questionnaires; and (3) Psychometric examination of the EPIC-26 rating in 651 Norwegian men treated with RALP at a mean of 3.2 years post-surgery. Results The questionnaire development showed a significant increase in bother versus function items, and the EPIC-26 contains eight function and 18 bother items. Twelve papers concerning the EPIC-26 available on PubMed since 2012 support the psychometric properties of the EPIC-26. The Norwegian EPIC-26 findings supported the psychometric properties of the EPIC-26, but suggested six subdomains both by exploratory and confirmatory factor analyses. Conclusions In general our examinations supported the adequate psychometric properties of the EPIC-26, although the factor structure, construct and predictive validity of the instrument should be examined further.
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Affiliation(s)
- Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | | | - Bjørn Brennhovd
- Department of Urology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - Øystein Sørebø
- School of Business and Social Sciences, University College of Southeast Norway, Hønefoss, Norway
| | - Sophie D Fosså
- National Resource Center for Late Effects after Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, P.O. Box 4453, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Alv A Dahl
- National Resource Center for Late Effects after Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, P.O. Box 4453, Nydalen, 0424, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
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13
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Vigneault É, Savard J, Savard MH, Ivers H, Després P, Foster W, Martin AG, Fradet V. Validation of the French-Canadian version of the Expanded Prostate Cancer Index Composite (EPIC) in a French-Canadian population. Can Urol Assoc J 2017; 11:404-410. [PMID: 29106365 DOI: 10.5489/cuaj.4428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aims to empirically validate the French-Canadian version of the Expanded Prostate Cancer Index Composite (EPIC), a measure of health-related quality of life for prostate cancer patients. METHODS Two hundred fifty-one participants completed a battery of self-report scales, including the French-Canadian version of the EPIC, after having received radiation therapy or radical prostatectomy for prostate cancer. RESULTS The internal consistency for the urinary incontinence, bowel, and sexual domains of the EPIC-26 was high (Cronbach's alpha coefficients from 0.80-0.92), while coefficients for the urinary irritation/obstruction (0.59) and hormonal (0.67) domains were lower. Item-total correlations (rs=0.15-0.85), and temporal stability (rs=0.72-0.93) generally supported the reliability of the instrument. The five-factor structure of the EPIC-26 was confirmed for the most part. The construct validity of the instrument was also supported by high correlations obtained between each domain and measures assessing similar constructs (rs=-0.56-0.83). The EPIC also showed an excellent sensitivity to change with significant differences obtained on EPIC scores (all p<0.05) between pre- and post-prostate cancer treatment. CONCLUSIONS The psychometric qualities of the French-Canadian version of the EPIC are well-supported, thus providing a valid tool to assess health-related quality of life in prostate cancer patients.
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Affiliation(s)
- Éric Vigneault
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Department of Radiation Oncology, CHU de Québec-Université Laval; Quebec City, QC, Canada
| | - Josée Savard
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Université Laval Cancer Research Centre; Quebec City, QC, Canada.,School of Psychology, Université Laval; Quebec City, QC, Canada
| | - Marie-Hélène Savard
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Université Laval Cancer Research Centre; Quebec City, QC, Canada
| | - Hans Ivers
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Université Laval Cancer Research Centre; Quebec City, QC, Canada.,School of Psychology, Université Laval; Quebec City, QC, Canada
| | - Philippe Després
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Department of Radiation Oncology, CHU de Québec-Université Laval; Quebec City, QC, Canada.,Université Laval Cancer Research Centre; Quebec City, QC, Canada.,Département de Physique, de Génie Physique et d'Optique, Université Laval; Quebec City, QC, Canada
| | - William Foster
- Department of Radiation Oncology, CHU de Québec-Université Laval; Quebec City, QC, Canada
| | - André-Guy Martin
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Department of Radiation Oncology, CHU de Québec-Université Laval; Quebec City, QC, Canada
| | - Vincent Fradet
- CHU de Québec-Université Laval Research Centre; Quebec City, QC, Canada.,Université Laval Cancer Research Centre; Quebec City, QC, Canada.,Department of Surgery, Université Laval; Quebec City, QC, Canada
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14
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Tomaszewski EL, Moise P, Krupnick RN, Downing J, Meyer M, Naidoo S, Holmstrom S. Symptoms and Impacts in Non-Metastatic Castration-Resistant Prostate Cancer: Qualitative Study Findings. THE PATIENT 2017; 10:567-578. [PMID: 28285412 PMCID: PMC5605614 DOI: 10.1007/s40271-017-0227-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES We developed a conceptual model to define key concepts associated with patients' experiences with the signs, symptoms, and impacts of non-metastatic castration-resistant prostate cancer (M0-CRPC). METHODS A targeted review of peer-reviewed literature, and other publicly available information, identified and categorized symptoms and impacts related to early-stage prostate cancer. Semi-structured interviews with five clinical experts helped determine the most relevant and important concepts for patients with M0-CRPC. Qualitative interviews with 17 patients with M0-CRPC identified the most frequently experienced symptoms and impacts, and their degree of interference with patients' lives. The findings from these three lines of evidence were summarized in a conceptual model. RESULTS Literature searches identified mainly urinary, intestinal, and sexual symptoms. Experts noted the symptoms most frequently mentioned by patients include erectile dysfunction, loss of sexual desire or interest, incontinence/leaking, urgency, and hot flashes. Patient interviews confirmed the high frequency of erectile dysfunction, loss of libido, urinary urgency, and incontinence. The most frequently mentioned impacts expressed by patients were the need to monitor/plan for urinary frequency, interference with/restriction of daily activities, and frustration or anxiety over diagnosis, symptoms, or treatment. Symptoms and impacts most frequently experienced by patients were typically not those with the greatest effects on their lives; rather, those with the greatest consequences were related to treatment. CONCLUSIONS The leading concerns associated with M0-CRPC were related to voiding and sexual dysfunction. The most relevant symptoms and impacts expressed by patients may be a consequence of therapy rather than of the disease.
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Affiliation(s)
| | - Pierre Moise
- QuintilesIMS Inc., 3-5 rue Maurice Ravel, Levallois-Perret, 92594, Paris, France.
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15
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Protopapa E, van der Meulen J, Moore CM, Smith SC. Patient-reported outcome (PRO) questionnaires for men who have radical surgery for prostate cancer: a conceptual review of existing instruments. BJU Int 2017; 120:468-481. [PMID: 28437031 DOI: 10.1111/bju.13896] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To critically review conceptual frameworks for available patient-reported outcome (PRO) questionnaires in men having radical prostatectomy (RP), psychometrically evaluate each questionnaire, and identify whether each is appropriate for use at the level of the individual patient. We searched PubMed, the Reports and Publications database of the University of Oxford Patient-Reported Outcomes Measurement Group and the website of the International Consortium for Health Outcomes Measurement (ICHOM) for psychometric reviews of prostate cancer-specific PRO questionnaires. From these we identified relevant questionnaires and critically appraised the conceptual content, guided by the Wilson and Cleary framework and psychometric properties, using well established criteria. The searches found four reviews and one recommendation paper. We identified seven prostate cancer-specific PROs: the Expanded Prostate Cancer Index Composite-26 (EPIC-26), Expanded Prostate Cancer Index Composite-50 (EPIC-50), University of California-Los Angeles Prostate Cancer Index (UCLA-PCI), Functional Assessment of Cancer Therapy - Prostate Cancer Subscale (FACT-P PCS), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - prostate specific 25-item (EORTC QLQ-PR25), Prostate Cancer - Quality of Life (PC-QoL), and Symptom Tracking and Reporting (STAR). Six out of seven measures purported to measure health-related quality of life (HRQL), but items focused strongly on urinary and sexual symptoms/functioning. The remaining questionnaire (STAR) claimed to assess functional recovery after RP. The psychometric evidence for these questionnaires was incomplete and variable in quality; none had evidence that they were appropriate for use with individual patients. Several questionnaires provide the basis of measures of urinary and/or sexual symptoms/functioning. Further work should explore other aspects of HRQL that are important for men having RP. Further psychometric work is also needed to determine whether they can be used at the individual level.
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Affiliation(s)
- Evangelia Protopapa
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Caroline M Moore
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Sarah C Smith
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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16
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Msaouel P, Gralla RJ, Jones RA, Hollen PJ. Key issues affecting quality of life and patient-reported outcomes in prostate cancer: an analysis conducted in 2128 patients with initial psychometric assessment of the prostate cancer symptom scale (PCSS). BMJ Support Palliat Care 2017; 7:308-315. [PMID: 28167656 DOI: 10.1136/bmjspcare-2016-001146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 12/19/2016] [Accepted: 01/19/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Evidence-based quality of life (QL) questionnaires require the identification of issues of importance to patients. The primary aim of this study was to inform providers on patient-expressed issues while enhancing the content validity of instruments assessing QL and patient-reported outcomes (PROs) in prostate cancer. The study provided additional psychometric properties for the new PRO and QL instrument, the Prostate Cancer Symptom Scale (PCSS). METHODS An anonymous web-based survey of 2128 patients with prostate cancer was conducted with patients rating 18 QL items on a five-point scale. RESULTS Most respondents (74%) were aged 55-74 years, had early stage disease at diagnosis (81%) and were diagnosed within 2 years of the survey (81%). The top five-rated issues were: overall QL, ability to perform normal activities, maintaining independence, ability to sleep and not being a burden. These items were ranked as either 'very important' or 'important' by at least 88% of patients. None of the most highly ranked issues were symptoms. Instead, the highest ranked items were global issues reflecting the impact of symptoms on patients. In addition to the enhanced content validity findings, good reliability results and initial support for construct validity are reported for the PCSS. CONCLUSIONS This is the largest survey providing patient-expressed background for content validity for QL and PRO measures. The findings of this study should aid development of newer practical questionnaires, such as the PCSS, which can be adapted to electronic platforms enhancing rapid and accurate PRO and QL evaluation.
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Affiliation(s)
- Pavlos Msaouel
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard J Gralla
- Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA
| | - Randy A Jones
- University of Virginia, Charlottesville, Virginia, USA
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17
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Downing A, Wright P, Wagland R, Watson E, Kearney T, Mottram R, Allen M, Cairnduff V, McSorley O, Butcher H, Hounsome L, Donnelly C, Selby P, Kind P, Cross W, Catto JWH, Huws D, Brewster DH, McNair E, Matheson L, Rivas C, Nayoan J, Horton M, Corner J, Verne J, Gavin A, Glaser AW. Life after prostate cancer diagnosis: protocol for a UK-wide patient-reported outcomes study. BMJ Open 2016; 6:e013555. [PMID: 27927667 PMCID: PMC5168696 DOI: 10.1136/bmjopen-2016-013555] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prostate cancer and its treatment may impact physically, psychologically and socially; affecting the health-related quality of life of men and their partners/spouses. The Life After Prostate Cancer Diagnosis (LAPCD) study is a UK-wide patient-reported outcomes study which will generate information to improve the health and well-being of men with prostate cancer. METHODS AND ANALYSIS Postal surveys will be sent to prostate cancer survivors (18-42 months postdiagnosis) in all 4 UK countries (n=∼70 000). Eligible men will be identified and/or verified through cancer registration systems. Men will be surveyed twice, 12 months apart, to explore changes in outcomes over time. Second, separate cohorts will be surveyed once and the design will include evaluation of the acceptability of online survey tools. A comprehensive patient-reported outcome measure has been developed using generic and specific instruments with proven psychometric properties and relevance in national and international studies. The outcome data will be linked with administrative health data (eg, treatment information from hospital data). To ensure detailed understanding of issues of importance, qualitative interviews will be undertaken with a sample of men who complete the survey across the UK (n=∼150) along with a small number of partners/spouses (n=∼30). ETHICS AND DISSEMINATION The study has received the following approvals: Newcastle and North Tyneside 1 Research Ethics Committee (15/NE/0036), Health Research Authority Confidentiality Advisory Group (15/CAG/0110), NHS Scotland Public Benefit and Privacy Panel (0516-0364), Office of Research Ethics Northern Ireland (16/NI/0073) and NHS R&D approval from Wales, Scotland and Northern Ireland. Using traditional and innovative methods, the results will be made available to men and their partners/spouses, the funders, the NHS, social care, voluntary sector organisations and other researchers.
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Affiliation(s)
- Amy Downing
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Penny Wright
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - Therese Kearney
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Rebecca Mottram
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Majorie Allen
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Victoria Cairnduff
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Oonagh McSorley
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Hugh Butcher
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
- Yorkshire Cancer Patient Forum, c/o Strategic Clinical Network and Senate, Yorkshire and The Humber, Harrogate, UK
| | - Luke Hounsome
- National Cancer Registration and Analysis Service, Public Health England, Bristol, UK
| | - Conan Donnelly
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Peter Selby
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Paul Kind
- Academic Unit of Health Economics, Institute of Health Sciences, University of Leeds, Leeds, UK
| | - William Cross
- Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
| | - James W H Catto
- Academic Urology Unit, University of Sheffield, Medical School, Sheffield, UK
| | - Dyfed Huws
- Welsh Cancer Intelligence and Surveillance Unit, Cardiff, UK
| | - David H Brewster
- Public Health and Intelligence (NHS National Services Scotland), Edinburgh, UK
| | - Emma McNair
- Public Health and Intelligence (NHS National Services Scotland), Edinburgh, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Johana Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Mike Horton
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
| | - Jessica Corner
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Julia Verne
- Knowledge and Intelligence Directorate, Public Health England, Bristol, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, UK
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18
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From QOL to QALYs: Comparing nononcologic outcomes in prostate cancer survivors across treatments. Urol Oncol 2016; 35:69-75. [PMID: 27575917 DOI: 10.1016/j.urolonc.2016.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/24/2016] [Accepted: 07/25/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We aim to highlight the progression from the early definition of nononcologic outcomes in prostate cancer (PC) to measurement and use of preferences to ensure appropriate treatment decisions in men with localized disease. METHODS We review the assessment of nononcologic outcomes after PC treatment and ways to use the outcomes to augment patient care. RESULTS PC treatments may have similar oncologic efficacy in men with certain clinical features, but they differ in their nononcologic outcomes. Tools to assess these outcomes have been developed and are useful in areas from treatment reimbursement to shared decision-making. CONCLUSIONS The ability to measure and make useful data on nononcologic outcomes evolved substantially over the past 20 years. Current work suggests that individual preference assessment for nononcologic outcomes is a promising means of matching patients with appropriate treatment.
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19
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Thaker NG, Pugh TJ, Mahmood U, Choi S, Spinks TE, Martin NE, Sio TT, Kudchadker RJ, Kaplan RS, Kuban DA, Swanson DA, Orio PF, Zelefsky MJ, Cox BW, Potters L, Buchholz TA, Feeley TW, Frank SJ. Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing. Brachytherapy 2016; 15:274-282. [PMID: 26916105 PMCID: PMC5502102 DOI: 10.1016/j.brachy.2016.01.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. METHODS AND MATERIALS Patients with low-risk PCa treated with low-dose-rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to 1 year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. RESULTS A total of 238 men were eligible for analysis. Median age was 64 (range, 46-81). Median followup was 5 years (0.5-12.1). There were no acute Grade 3-5 complications. Expanded Prostate Cancer Index Composite 50 scores were favorable, with no clinically significant changes from baseline to last followup at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. CONCLUSIONS We successfully created a visual framework to define the value of PBT using the International Consortium for Health Outcomes Measurement standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities.
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Affiliation(s)
- Nikhil G Thaker
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; The Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Thomas J Pugh
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Usama Mahmood
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Seungtaek Choi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tracy E Spinks
- Office of the SVP/Hospitals & Clinics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Neil E Martin
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Terence T Sio
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ
| | - Rajat J Kudchadker
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Deborah A Kuban
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David A Swanson
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Peter F Orio
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Centers, Boston, MA
| | - Michael J Zelefsky
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Brett W Cox
- Department of Radiation Oncology, North Shore-LIJ Health System, New York, NY
| | - Louis Potters
- Department of Radiation Oncology, North Shore-LIJ Health System, New York, NY
| | - Thomas A Buchholz
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Thomas W Feeley
- The Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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20
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Fosså SD, Storås AH, Steinsvik EA, Myklebust TA, Eri LM, Loge JH, Dahl AA. Psychometric testing of the Norwegian version of the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26). Scand J Urol 2016; 50:280-5. [DOI: 10.3109/21681805.2016.1163617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sophie D. Fosså
- National Advisory Unit on Late Effects after Cancer Treatment, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Cancer Registry of Norway, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Holck Storås
- National Advisory Unit on Late Effects after Cancer Treatment, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Eivind A. Steinsvik
- Division of Surgery, Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway
| | | | - Lars M. Eri
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Urology, Oslo University Hospital, Oslo, Norway
| | - Jon H. Loge
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway
| | - Alv A. Dahl
- National Advisory Unit on Late Effects after Cancer Treatment, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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Choi EPH, Wong CKH, Wan EYF, Tsu JHL, Chin WY, Kung K, Yiu MK. The internal and external responsiveness of Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Short Form-12 Health Survey version 2 (SF-12 v2) in patients with prostate cancer. Qual Life Res 2016; 25:2379-93. [PMID: 26908258 DOI: 10.1007/s11136-016-1254-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the responsiveness of Functional Assessment of Cancer Therapy-Prostate (FACT-P) and Short Form-12 Health Survey version 2 (SF-12 v2) in prostate cancer patients because there is a lack of evidence to support their responsiveness in this patient population. METHODS One hundred sixty-eight subjects with prostate cancer were surveyed at baseline and at 6 months using the SF-12 v2 and FACT-P version 4. Internal responsiveness was assessed using paired t test and generalized estimating equation. External responsiveness was evaluated using receiver operating characteristic curve analysis. RESULTS The internal responsiveness of the FACT-P and SF-12 v2 to detect positive change was satisfactory. The FACT-P and SF-12 v2 could not detect negative change. The FACT-P and the SF-12 v2 performed the best in distinguishing between improved general health and worsened general health. The FACT-P performed better in distinguishing between unchanged general health and worsened general health. The SF-12 v2 performed better in distinguishing between unchanged general health and improved general health. CONCLUSIONS Positive change detected by these measures should be interpreted with caution as they might be too responsive to detect "noise," which is not clinically significant. The ability of the FACT-P and the SF-12 v2 to detect negative change was disappointing. The internal and external responsiveness of the social well-being of the FACT-P cannot be supported, suggesting that it is not suitable to longitudinally monitor the social component of HRQOL in prostate cancer patients. The study suggested that generic and disease-specific measures should be used together to complement each other.
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Affiliation(s)
- Edmond P H Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pok Fu Lam, Hong Kong.
| | - Carlos K H Wong
- Department of Family Medicine and Primary Care, University of Hong Kong, Ap Lei Chau, Hong Kong
| | - Eric Y F Wan
- Department of Family Medicine and Primary Care, University of Hong Kong, Ap Lei Chau, Hong Kong
| | - James H L Tsu
- Division of Urology, Department of Surgery, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - W Y Chin
- Department of Family Medicine and Primary Care, University of Hong Kong, Ap Lei Chau, Hong Kong
| | - Kenny Kung
- Department of Family Medicine and Primary Care, University of Hong Kong, Ap Lei Chau, Hong Kong
| | - M K Yiu
- Division of Urology, Department of Surgery, University of Hong Kong, Pok Fu Lam, Hong Kong
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Evans SM, Nag N, Roder D, Brooks A, L Millar J, Moretti KL, Pryor D, Skala M, J. McNeil J. Development of an International Prostate Cancer Outcomes Registry. BJU Int 2016; 117 Suppl 4:60-7. [DOI: 10.1111/bju.13258] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Sue M. Evans
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - Nupur Nag
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - David Roder
- Centre for Population Health Research; University of South Australia; Adelaide SA Australia
| | - Andrew Brooks
- Department of Urology Westmead Hospital; Westmead NSW Australia
| | | | - Kim L Moretti
- Centre for Population Health Research; University of South Australia; Adelaide SA Australia
| | - David Pryor
- Department of Radiation Oncology; Princess Alexandra Hospital; Wooloongabba Qld Australia
| | | | - John J. McNeil
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
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Sampurno F, Ruseckaite R, Millar JL, Evans SM. Comparison of Patient-Reported Quality-of-Life and Complications in Men With Prostate Cancer, Between Two Modes of Administration. Clin Genitourin Cancer 2016; 14:284-9. [PMID: 26794390 DOI: 10.1016/j.clgc.2015.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Our purpose was to: (1) assess the level of consistency between the quality-of-life (QOL) scores of men with prostate cancer for urinary/bowel/sexual bother, collected via telephone versus self-administered survey; (2) determine factors associated with variation in level of agreement; and (3) assess the efficacy of telephone interview as a mode of administration against the "gold standard" tool, EPIC-26. METHODS Cohen's Kappa coefficients were calculated to investigate test-retest reliability across modes of administration. Logistic regression models explored patients' characteristics associated with the magnitude of urinary/bowel/sexual problem. Sensitivities and specificities of the telephone mode in reference to "gold standard" were further measured. RESULTS From 221 men who agreed to participate in the study, 168 (76.0%) returned completed surveys. Kappa-linear model resulted in a moderate agreement across the urinary/bowel/sexual bother scores for both modes of administration; with greatest concordance recorded for bowel bother (90%). Patient's age (<75 years), disease risk, and active treatment type determined a moderate-to-good level of agreement between administration modalities with a Kappa varying between 0.44 and 0.73; χ(2), 8.18; P = .042. Sensitivity tests revealed that 68% of men with a moderate/big problem during the phone interviews would respond to suffering from a moderate/big sexual problem. CONCLUSION Results of this pilot study revealed that QOL outcomes from this registry will likely underestimate the true bother experienced by men. More research is required to determine the differences between self-administered and telephone interviews in men with prostate cancer.
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Affiliation(s)
- Fanny Sampurno
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Jeremy L Millar
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia; William Buckland Radiation Oncology Department, The Alfred, Melbourne, VIC, Australia
| | - Sue M Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Contreras JA, Wilder RB, Mellon EA, Strom TJ, Fernandez DC, Biagioli MC. Quality of life after high-dose-rate brachytherapy monotherapy for prostate cancer. Int Braz J Urol 2015; 41:40-5. [PMID: 25928509 PMCID: PMC4752055 DOI: 10.1590/s1677-5538.ibju.2015.01.07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/22/2014] [Indexed: 11/28/2022] Open
Abstract
Purpose There is little information in the literature on health-related quality of life (HRQOL) changes due to high-dose-rate (HDR) brachytherapy monotherapy for prostate cancer. Materials and Methods We conducted a prospective study of HRQOL changes due to HDR brachytherapy monotherapy for low risk or favorable intermediate risk prostate cancer. Sixty-four of 84 (76%) patients who were treated between February 2011 and April 2013 completed 50 questions comprising the Expanded Prostate Cancer Index Composite (EPIC) before treatment and 6 and/or 12 months after treatment. Results Six months after treatment, there was a significant decrease (p<0.05) in EPIC urinary, bowel, and sexual scores, including urinary overall, urinary function, urinary bother, urinary irritative, bowel overall, bowel bother, sexual overall, and sexual bother scores. By one year after treatment, EPIC urinary, bowel, and sexual scores had increased and only the bowel overall and bowel bother scores remained significantly below baseline values. Conclusions HDR brachytherapy monotherapy is well-tolerated in patients with low and favorable intermediate risk prostate cancer. EPIC urinary and sexual domain scores returned to close to baseline 12 months after HDR brachytherapy.
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Affiliation(s)
| | - Richard B Wilder
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Eric A Mellon
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Tobin J Strom
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
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Drummond FJ, Kinnear H, Donnelly C, O'Leary E, O'Brien K, Burns RM, Gavin A, Sharp L. Establishing a population-based patient-reported outcomes study (PROMs) using national cancer registries across two jurisdictions: the Prostate Cancer Treatment, your experience (PiCTure) study. BMJ Open 2015; 5:e006851. [PMID: 25888474 PMCID: PMC4401862 DOI: 10.1136/bmjopen-2014-006851] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To establish an international patient-reported outcomes (PROMs) study among prostate cancer survivors, up to 18 years postdiagnosis, in two countries with different healthcare systems and ethical frameworks. DESIGN A cross-sectional, postal survey of prostate cancer survivors sampled and recruited via two population-based cancer registries. Healthcare professionals (HCPs) evaluated patients for eligibility to participate. Questionnaires contained validated instruments to assess health-related quality of life and psychological well-being, including QLQ-C30, QLQ-PR25, EQ-5D-5L, 21-question Depression, Anxiety and Stress Scale (DASS-21) and the Decisional Regret Scale. SETTING Republic of Ireland (RoI) and Northern Ireland (NI). PRIMARY OUTCOME MEASURES Registration completeness, predictors of eligibility and response, data missingness, unweighted and weighted PROMs. RESULTS Prostate cancer registration was 80% (95% CI 75% to 84%) and 91% (95% CI 89% to 93%) complete 2 years postdiagnosis in NI and RoI, respectively. Of 12,322 survivors sampled from registries, 53% (n=6559) were classified as eligible following HCP screening. In the multivariate analysis, significant predictors of eligibility were: being ≤59 years of age at diagnosis (p<0.001), short-term survivor (<5 years postdiagnosis; p<0.001) and from RoI (p<0.001). 3348 completed the questionnaire, yielding a 54% adjusted response rate. 13% of men or their families called the study freephone with queries for assistance with questionnaire completion or to talk about their experience. Significant predictors of response in multivariate analysis were: being ≤59 years at diagnosis (p<0.001) and from RoI (p=0.016). Mean number of missing questions in validated instruments ranged from 0.12 (SD 0.71; EQ-5D-5L) to 3.72 (SD 6.30; QLQ-PR25). Weighted and unweighted mean EQ-5D-5L, QLQ-C30 and QLQ-PR25 scores were similar, as were the weighted and unweighted prevalences of depression, anxiety and distress. CONCLUSIONS It was feasible to perform PROMs studies across jurisdictions, using cancer registries as sampling frames; we amassed one of the largest, international, population-based data set of prostate cancer survivors. We highlight improvements which could inform future PROMs studies, including utilising general practitioners to assess eligibility and providing a freephone service.
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Affiliation(s)
| | - H Kinnear
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - C Donnelly
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - E O'Leary
- National Cancer Registry Ireland, Cork, Ireland
| | - K O'Brien
- National Cancer Registry Ireland, Cork, Ireland
| | - R M Burns
- JE Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland
| | - A Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - L Sharp
- National Cancer Registry Ireland, Cork, Ireland
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O’Leary E, Drummond FJ, Gavin A, Kinnear H, Sharp L. Psychometric evaluation of the EORTC QLQ-PR25 questionnaire in assessing health-related quality of life in prostate cancer survivors: a curate’s egg. Qual Life Res 2015; 24:2219-30. [DOI: 10.1007/s11136-015-0958-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 11/29/2022]
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Miller SM. Editorial Comment. Urology 2015; 85:105-6. [DOI: 10.1016/j.urology.2014.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nicolaisen M, Müller S, Patel HRH, Hanssen TA. Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study. J Clin Nurs 2014; 23:3403-14. [DOI: 10.1111/jocn.12586] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Marianne Nicolaisen
- National Continence and Pelvic Floor Center of Norway; University Hospital of North Norway; Tromsø Norway
| | - Stig Müller
- Department of Urology; Akershus University Hospital; Lørenskog Norway
- Institute of Clinical Medicine; University of Oslo; Lørenskog Norway
| | - Hitendra RH Patel
- National Continence and Pelvic Floor Center of Norway; University Hospital of North Norway; Tromsø Norway
- Faculty of Health Sciences; University of Tromsø; Tromsø Norway
| | - Tove Aminda Hanssen
- Faculty of Health Sciences; University of Tromsø; Tromsø Norway
- Division of Cardiothoracic and Respiratory Medicine; University Hospital North Norway; Tromsø Norway
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Avila M, Pardo Y, Castells M, Ferrer F, Boladeras A, Pera J, Prada PJ, Guix B, de Paula B, Hernandez H, Pont A, Alonso J, Garin O, Bremner K, Krahn M, Ferrer M. Adaptation and validation of the Spanish version of the Patient-Oriented Prostate Utility Scale (PORPUS). Qual Life Res 2014; 23:2481-7. [PMID: 24789667 DOI: 10.1007/s11136-014-0701-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The Patient-Oriented Prostate Utility Scale (PORPUS) is a combined profile and utility-based quality of life measure for prostate cancer patients. Our objectives were to adapt the PORPUS into Spanish and to assess its acceptability, reliability, and validity. METHODS The PORPUS was adapted into Spanish using forward and back translations and cognitive debriefing. PORPUS was administered jointly with the SF-36 and the Expanded Prostate Index Composite (EPIC) to 480 Spanish prostate cancer patients treated with radical prostatectomy or radiotherapy. The Spanish PORPUS scores' distribution and reliability were examined and compared with the original instrument. To evaluate construct validity, relationships were assessed between PORPUS and other instruments (testing hypotheses of the original PORPUS study), and among known groups defined by side effect severity. RESULTS Reliability coefficient was 0.76 (similar to the original PORPUS' 0.81). Spanish PORPUS items presented correlations ranging 0.57-0.88 with the corresponding EPIC domains, as in the original PORPUS study (0.60-0.83). Both PORPUS-P and PORPUS-U showed significant differences and large effect sizes (0.94-1.90) when comparing severe versus no problem groups on urinary, bowel, sexual and hormonal side effects defined by EPIC. CONCLUSIONS A conceptually equivalent Spanish version was obtained, with high reliability and good construct validity, similar to the original Canadian PORPUS version. It can therefore be used to measure health-related quality of life and utilities in Spanish prostate cancer patients.
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Affiliation(s)
- Mónica Avila
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain
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Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res 2014; 23:2169-81. [PMID: 24748557 PMCID: PMC4155169 DOI: 10.1007/s11136-014-0678-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2014] [Indexed: 11/07/2022]
Abstract
Purpose The objective was to obtain a standardized evaluation of available prostate cancer-specific quality of life instruments used in patients with early-stage disease. Methods We carried out systematic literature reviews in the PubMed database to identify manuscripts which contained information regarding either the development process or metric properties of prostate cancer-specific quality of life instruments. Each instrument was evaluated by two experts, independently, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0–100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden and alternative forms. Results Eight instruments and 57 manuscripts (2–15 per instrument) were identified. The Expanded Prostate Cancer Index Composite (EPIC) was the best rated (overall EMPRO score 83.1 points). Good results were also obtained by University of California Los Angeles-Prostate Cancer Index (UCLA-PCI), Patient-Oriented Prostate Utility Scale (PORPUS) and Prostate Cancer Quality of Life Instrument (PC-QoL) with 77.3, 70.5 and 64.8 points, respectively. These four instruments passed with distinction the validity and responsiveness evaluation. Insufficient reliability results were observed for UCLA-PCI and PORPUS. Conclusions Current evidence supports the choice of EPIC, PORPUS or PC-QoL. Attribute-specific EMPRO results facilitate selecting the adequate instrument for every purpose. For longitudinal studies or clinical trials, where responsiveness is the priority, EPIC or PC-QoL should be considered. We recommend the PORPUS for economic evaluations because it allows cost-utility analysis, and EPIC short versions to minimize administration burden. Electronic supplementary material The online version of this article (doi:10.1007/s11136-014-0678-8) contains supplementary material, which is available to authorized users.
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Holm HV, Fosså SD, Hedlund H, Schultz A, Dahl AA. How should continence and incontinence after radical prostatectomy be evaluated? A prospective study of patient ratings and changes with time. J Urol 2014; 192:1155-61. [PMID: 24727062 DOI: 10.1016/j.juro.2014.03.113] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE We examined prevalence rates, and changes in continence and incontinence before and after radical prostatectomy for prostate cancer by comparing different definitions. We also studied the descriptive validity of the grading system of Ellison et al for post-prostatectomy incontinence and baseline predictors of post-prostatectomy incontinence at 12 months. MATERIALS AND METHODS This national prospective study included 844 patients treated with radical prostatectomy between 2005 and 2009. Adverse effects, including urinary dysfunction and bother, were reported by 735 patients (88%) using the EPIC-50 and UCLA-PCI validated questionnaires at baseline and 12-month followup. Linear regression analysis was done to examine baseline predictors and the degree of post-prostatectomy incontinence at followup. RESULTS At 12 months after radical prostatectomy 74% of patients reported post-prostatectomy incontinence, of whom 40% used pads daily, 34% reported occasional dribbling without pads and 26% had total urinary control. When defined as total incontinence/no urinary control, severe post-prostatectomy incontinence was reported by 3% of the men but 25% had severe post-prostatectomy incontinence according to the stratification of Ellison et al. Of patients with preoperative incontinence 14% improved postoperatively. Predictors of post-prostatectomy incontinence were age 65 years or greater, not working, sexual dysfunction and incontinence preoperatively. The latter 2 remained the strongest predictors on multivariate analysis. Prostate cancer related variables were not associated with post-prostatectomy incontinence. CONCLUSIONS The prevalence of post-prostatectomy incontinence varied considerably according to the definition applied. In our opinion incontinence may be reported as any leakage and not only as pad use with grading done on a symptom scale. Preoperative sexual dysfunction and urinary incontinence were the strongest predictors of post-prostatectomy incontinence at 12-month followup.
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Affiliation(s)
| | - Sophie D Fosså
- Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway; University of Oslo, Oslo, Norway
| | - Hans Hedlund
- Department of Urology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; University of Oslo, Oslo, Norway
| | - Alexander Schultz
- Department of Urology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Alv A Dahl
- Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway; University of Oslo, Oslo, Norway
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Hamoen EHJ, De Rooij M, Witjes JA, Barentsz JO, Rovers MM. Measuring health-related quality of life in men with prostate cancer: A systematic review of the most used questionnaires and their validity. Urol Oncol 2014; 33:69.e19-28. [PMID: 24433753 DOI: 10.1016/j.urolonc.2013.10.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/05/2013] [Accepted: 10/07/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To identify and study the psychometric properties of the most used health-related quality-of-life (HRQoL) instruments in men with prostate cancer. METHODS We performed a literature search using PubMed and EMBASE to identify all studies on prostate cancer using a HRQoL instrument. The most often used HRQoL instruments were investigated in detail by 2 independent reviewers. Data were extracted regarding the characteristics and psychometric values of the instruments, i.e., content validity, internal consistency, criterion validity, construct validity, reproducibility, responsiveness, floor and ceiling effects, and interpretability. Good psychometric outcomes indicate a high methodological quality of the instrument. RESULTS Our systematic search revealed 13,812 potential relevant articles, of which 2,258 appeared relevant after screening the titles and reading the abstracts. We studied the psychometric properties of the 20 most often used HRQoL instruments, the first 3 of which were the Expanded Prostate Index Composite, University of California-Los Angeles Prostate Cancer Index, and Short Form-36 (SF-36). Content validity, internal consistency (α>0.70), criterion validity, construct validity, and reproducibility were good in 60%, 90%, 10%, 35%, and 65% of the 20 instruments, respectively. Responsiveness was not reported for 12 of 20 instruments (60%). Floor and ceiling effects and the interpretability of the questionnaires were only reported in 3 (15%) and 6 (30%) instruments. CONCLUSIONS Considering the psychometric properties, we advise to use the SF-12 as a generic instrument, the Cancer Rehabilitation Evaluation System-SF or the Functional Assessment of Cancer Therapy-General as cancer-specific HRQoL instruments, and the University of California-Los Angeles Prostate Cancer Index, the QUFW94, or the Functional Assessment of Cancer Therapy-Prostate as prostate cancer-specific instruments.
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Affiliation(s)
- Esther H J Hamoen
- Department of Urology, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Radiology, Radboud University Nijmegen Medical Centre, The Netherlands.
| | - Maarten De Rooij
- Department of Radiology, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Operating Rooms, Radboud University Nijmegen Medical Centre, The Netherlands
| | - J Alfred Witjes
- Department of Urology, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Jelle O Barentsz
- Department of Radiology, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Maroeska M Rovers
- Department of Operating Rooms, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Health Evidence, Radboud University Nijmegen Medical Centre, The Netherlands
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Jones D, Zhao F, Fisch MJ, Wagner LI, Patrick-Miller LJ, Cleeland CS, Mendoza TR. The validity and utility of the MD Anderson Symptom Inventory in patients with prostate cancer: evidence from the Symptom Outcomes and Practice Patterns (SOAPP) data from the Eastern Cooperative Oncology Group. Clin Genitourin Cancer 2013; 12:41-9. [PMID: 24126238 DOI: 10.1016/j.clgc.2013.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/05/2013] [Accepted: 07/31/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The MD Anderson Symptom Inventory (MDASI) is a psychometrically validated patient-reported outcome measure that assesses the severity and impact of multiple symptoms related to cancer and its treatment and has the potential to guide treatment specific to patients with prostate cancer. Although the original MDASI validation study encompassed various cancer types, the instrument's psychometric properties have not been examined in a large homogeneous sample of patients with prostate cancer. PATIENTS AND METHODS This study involved secondary analysis of data from the nationwide multicenter Eastern Cooperative Oncology Group (ECOG) SOAPP (Symptom Outcomes and Practice Patterns) study, which enrolled patients from 38 ECOG-affiliated institutions, including 6 academic centers and 32 community clinics. Data were used to establish the psychometric properties of the MDASI in a subsample of 320 patients with prostate cancer. The instrument was administered twice, approximately 1 month apart. RESULTS The MDASI demonstrated good internal consistency and test-retest reliability (with Cronbach alphas of ≥ .84 and intraclass correlations of ≥ 0.76 for all subscales), strong ability to discriminate between clinically different patient groups (by performance status, tumor response, and disease stage), and high sensitivity in detecting symptom change (with respect to patient-reported quality of life [QOL] between the baseline and 1-month follow-up visits). CONCLUSION The MDASI is a valid, reliable, and sensitive symptom-assessment instrument that can be used with confidence in descriptive and clinical studies of symptom status in patients with prostate cancer.
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Affiliation(s)
- Desiree Jones
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Fengmin Zhao
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA
| | - Michael J Fisch
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lynne I Wagner
- Departments of Medical Social Sciences and Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL
| | - Linda J Patrick-Miller
- Department of Medicine and Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
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Chipman JJ, Sanda MG, Dunn RL, Wei JT, Litwin MS, Crociani CM, Regan MM, Chang P. Measuring and predicting prostate cancer related quality of life changes using EPIC for clinical practice. J Urol 2013; 191:638-45. [PMID: 24076307 DOI: 10.1016/j.juro.2013.09.040] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE We expanded the clinical usefulness of EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) by evaluating its responsiveness to health related quality of life changes, defining the minimally important differences for an individual patient change in each domain and applying it to a sexual outcome prediction model. MATERIALS AND METHODS In 1,201 subjects from a previously described multicenter longitudinal cohort we modeled the EPIC-CP domain scores of each treatment group before treatment, and at short-term and long-term followup. We considered a posttreatment domain score change from pretreatment of 0.5 SD or greater clinically significant and p ≤ 0.01 statistically significant. We determined the domain minimally important differences using the pooled 0.5 SD of the 2, 6, 12 and 24-month posttreatment changes from pretreatment values. We then recalibrated an EPIC-CP based nomogram model predicting 2-year post-prostatectomy functional erection from that developed using EPIC-26. RESULTS For each health related quality of life domain EPIC-CP was sensitive to similar posttreatment health related quality of life changes with time, as was observed using EPIC-26. The EPIC-CP minimally important differences in changes in the urinary incontinence, urinary irritation/obstruction, bowel, sexual and vitality/hormonal domains were 1.0, 1.3, 1.2, 1.6 and 1.0, respectively. The EPIC-CP based sexual prediction model performed well (AUC 0.76). It showed robust agreement with its EPIC-26 based counterpart with 10% or less predicted probability differences between models in 95% of individuals and a mean ± SD difference of 0.0 ± 0.05 across all individuals. CONCLUSIONS EPIC-CP is responsive to health related quality of life changes during convalescence and it can be used to predict 2-year post-prostatectomy sexual outcomes. It can facilitate shared medical decision making and patient centered care.
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Affiliation(s)
- Jonathan J Chipman
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Martin G Sanda
- Department of Urology, Emory University, Atlanta, Georgia
| | - Rodney L Dunn
- Department of Urology, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - John T Wei
- Department of Urology, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Mark S Litwin
- David Geffen School of Medicine and Fielding School of Public Health, University of California-Los Angeles, Los Angeles, California
| | - Catrina M Crociani
- Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Meredith M Regan
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Peter Chang
- Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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