National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Anxiety (1)
- Behavioral Health (1)
- Cancer (18)
- (-) Cancer: Prostate Cancer (18)
- Cardiovascular Conditions (1)
- Comparative Effectiveness (5)
- Depression (1)
- Evidence-Based Practice (8)
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- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Men's Health (9)
- Nutrition (1)
- Outcomes (5)
- Patient-Centered Outcomes Research (9)
- Patient Adherence/Compliance (1)
- Patient Safety (1)
- Practice Patterns (1)
- Provider: Physician (2)
- Quality of Care (1)
- Quality of Life (4)
- Risk (1)
- Sexual Health (2)
- Shared Decision Making (1)
- Surgery (4)
- Treatments (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 18 of 18 Research Studies DisplayedDe B, Pasalic D, Barocas DA
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
The purpose of this study was to compare patient reported outcomes through 5 years following radical prostatectomy or external beam radiation therapy with low dose rate brachytherapy boost for localized prostate cancer. The researchers enrolled men 80 years of age or under who had localized prostate adenocarcinoma and followed them longitudinally from 2011 to 2012. The study found that when compared with radical prostatectomy, external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and better urinary incontinence function through 5 years. Urinary function bother was similar between groups. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with worse bowel function through 5 years compared to radical prostatectomy. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with better sexual function at 1 year compared to radical prostatectomy, but there was insufficient evidence to reject the supposition that no difference was seen at 3 or 5 years. The researcher concluded that external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and bowel functions but better urinary incontinence function through 5 years after treatment compared to radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: De B, Pasalic D, Barocas DA .
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
J Urol 2022 Dec;208(6):1226-39. doi: 10.1097/ju.0000000000002902..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Li R, Wittmann D, Nelson CJ
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
This study’s objective was to perform a qualitative study to identify unmet sexual needs of patients and female partners after prostate cancer diagnosis. The authors conducted a qualitative study of posts to the Inspire Us TOO Prostate Cancer Online Support and Discussion Community. They identified 6,192 posts in the Sexual Health & Intimacy forum of the community, of which 661 posts were from female authors. A random sample of 10% of posts from female partners and an equal number of randomly selected posts from male patients were analyzed. Multiple themes emerged that were unique to female partners of prostate cancer survivors including included expanding the sexual repertoire, feeling invisible, contextualizing sexual intimacy within the broader picture of survival, and addressing relationship concerns. Patients and their partners had common concerns, including not receiving sufficient information from healthcare providers regarding sexual side effects from prostate cancer and its treatment. A limitation may be that members of the online community may not be representative of all couples facing prostate cancer. This study also does not examine sexual health needs among gay and bisexual couples.
AHRQ-funded; HS026120.
Citation: Li R, Wittmann D, Nelson CJ .
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
J Sex Med 2022 Dec; 19(12):1797-803. doi: 10.1016/j.jsxm.2022.08.195..
Keywords: Sexual Health, Cancer: Prostate Cancer, Cancer
Gupta N, Patel HD, Taylor J
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
The objective of this study was to perform a systematic review of plant-based diets and prostate cancer. Findings showed that interventional studies displayed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Further, observational studies demonstrated either a lower risk of prostate cancer or no significant difference.
AHRQ-funded; HS026120.
Citation: Gupta N, Patel HD, Taylor J .
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
Prostate Cancer Prostatic Dis 2022 Sep;25(3):444-52. doi: 10.1038/s41391-022-00553-2..
Keywords: Cancer: Prostate Cancer, Cancer, Evidence-Based Practice, Nutrition, Outcomes
Mitchell JM, Gresenz CR
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Researchers examined the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. They found that physician practice structure attributes were significantly associated with type of treatment received but few studies controlled for such factors. Their findings - coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups - provided one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Med Care 2022 Sep;60(9):665-72. doi: 10.1097/mlr.0000000000001746..
Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Men's Health, Provider: Physician
Lai LY, Oerline MK, Caram MEV
Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
Investigators examined the association between the use of abiraterone or enzalutamide and the risk of metabolic or cardiovascular adverse events while on treatment for advanced prostate cancer. They found that, compared with men not receiving abiraterone, men receiving abiraterone were at increased risk of both a major composite adverse event and a minor composite adverse event. Compared with men not receiving enzalutamide, men receiving enzalutamide were at an increased risk of a major composite adverse event but not a minor composite adverse event. They recommended careful monitoring and management of men on abiraterone or enzalutamide through team-based approaches.
AHRQ-funded; HS027507.
Citation: Lai LY, Oerline MK, Caram MEV .
Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
J Natl Cancer Inst 2022 Aug 8;114(8):1127-34. doi: 10.1093/jnci/djac081..
Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Cancer, Risk, Adverse Events, Medication, Adverse Drug Events (ADE), Medication: Safety, Patient Safety
Luckenbaugh AN, Wallis CJD, Huang LC
Association between treatment for localized prostate cancer and mental health outcomes.
Researchers conducted a prospective population-based analysis using the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study to compare mental health outcomes for men undergoing treatment for localized prostate cancer. Results showed that there were no clinically important differences in mental health outcomes; however, the researchers identified a number of characteristics associated with worse mental health outcomes. These included: older age, poorer health, and being unmarried.
AHRQ-funded; HS019356; HS022640.
Citation: Luckenbaugh AN, Wallis CJD, Huang LC .
Association between treatment for localized prostate cancer and mental health outcomes.
J Urol 2022 May; 207(5):1029-37. doi: 10.1097/ju.0000000000002370..
Keywords: Cancer: Prostate Cancer, Cancer, Behavioral Health, Quality of Life
Wallis CJD, Huang LC, Zhao Z
Association between pelvic nodal radiotherapy and patient-reported functional outcomes through 5 years among men undergoing external-beam radiotherapy for prostate cancer: an assessment of the Comparative Effectiveness Analysis of Surgery and Radiation (C
In this study, the investigators sought to compare functional outcomes for men receiving prostate and pelvic versus prostate-only radiotherapy, longitudinally over 5 years. The investigators concluded that there were no clinically important differences in disease-specific or general health-related quality of life with the addition of pelvic irradiation to prostate radiotherapy, supporting the use of pelvic radiotherapy when it may be of clinical benefit, such as men with increased risk of nodal involvement.
AHRQ-funded; HS022640; HS019356.
Citation: Wallis CJD, Huang LC, Zhao Z .
Association between pelvic nodal radiotherapy and patient-reported functional outcomes through 5 years among men undergoing external-beam radiotherapy for prostate cancer: an assessment of the Comparative Effectiveness Analysis of Surgery and Radiation (C
Urol Oncol 2022 Feb;40(2):56.e1-56.e8. doi: 10.1016/j.urolonc.2021.04.035..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Comparative Effectiveness, Outcomes, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality of Life
Mitchell JM, Gresenz CR
Documenting horizontal integration among urologists who treat prostate cancer.
The purpose of this study was to create and employ a methodology to document changes in physician practice structure resulting from horizontal mergers among urology groups. To identify all urologists who treated men with prostate cancer, the researchers integrated cancer registry records from four large states with Medicare Part B claims. Information from SK & A surveys and extensive internet searches was added to assign a practice structure to each urologist-year from 2005-2014. The study found that horizontal merging among small urology groups resulted in a strong increase in the percentage of urologists who belong to large urology practices with ownership in anatomical pathology services and/or intensity modulated radiation therapy. By 2014, small percentages (7%-16%) of New Jersey, Florida and Texas urologists were employed by a health system, whereas more than half of New Jersey urologists and about 43% of urologists in Florida and Texas were members of large practices. This is compared to California urologists of which only 17.5% had ownership in intensity modulated radiation therapy and/or pathology services. The researchers highlighted that the study indicators of market share of urologists connected with each practice structure type were highly correlated with indicators of market share based on quantity of prostate cancer events treated by each type of practice structure.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
Documenting horizontal integration among urologists who treat prostate cancer.
Med Care Res Rev 2022 Feb;79(1):141-50. doi: 10.1177/1077558720980552..
Keywords: Cancer: Prostate Cancer, Cancer, Provider: Physician
Joyce DD, Wallis CJD, Luckenbaugh AN
Sexual function outcomes of radiation and androgen deprivation therapy for localized prostate cancer in men with good baseline function.
This retrospective review study sought to compare sexual function through 5 years for men undergoing radiation treatment for localized prostate cancer with and without systemic androgen deprivation therapy. Out of a cohort of 167 patients, 73 underwent radiation alone and 94 received androgen therapy deprivation therapy plus radiation. Androgen deprivation therapy was associated with worse sexual function through the first year regardless of disease risk. By 3 years the difference was no longer significant for the 51 patients with intermediate-risk disease. Worse sexual function for high-risk disease patients who received androgen deprivation therapy was shown at 3 years but not at 5 years.
AHRQ-funded; HS019356; HS022640.
Citation: Joyce DD, Wallis CJD, Luckenbaugh AN .
Sexual function outcomes of radiation and androgen deprivation therapy for localized prostate cancer in men with good baseline function.
Prostate Cancer Prostatic Dis 2022 Feb;25(2):238-47. doi: 10.1038/s41391-021-00405-5..
Keywords: Cancer: Prostate Cancer, Cancer, Sexual Health, Men's Health
Wallis CJD, Zhao Z, Huang LC
Association of treatment modality, functional outcomes, and baseline characteristics with treatment-related regret among men with localized prostate cancer.
Treatment-related regret is an integrative, patient-centered measure that accounts for morbidity, oncologic outcomes, and anxiety associated with prostate cancer diagnosis and treatment. The objective of this study was to assess the association between treatment approach, functional outcomes, and patient expectations and treatment-related regret among patients with localized prostate cancer. The investigators concluded that the findings of their cohort study suggested that more than 1 in 10 patients with localized prostate cancer experienced treatment-related regret.
AHRQ-funded; HS019356; HS022640.
Citation: Wallis CJD, Zhao Z, Huang LC .
Association of treatment modality, functional outcomes, and baseline characteristics with treatment-related regret among men with localized prostate cancer.
JAMA Oncol 2022 Jan;8(1):50-59. doi: 10.1001/jamaoncol.2021.5160..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Patient-Centered Outcomes Research
Caram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Reisz PA, Laviana AA, Zhao Z
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
Prior studies suggest that nationally endorsed quality measures for prostate cancer care are not linked closely with outcomes. Using a prospective, population based cohort the investigators measured clinically relevant variation in structure, process and outcome measures in men undergoing radical prostatectomy. The authors did not identify and meaningful variation in quality of care across racial groups, age groups and surgeon volume strata, in this cohort, suggesting that men were receiving comparable quality of care across these strata.
AHRQ-funded; HS019356.
Citation: Reisz PA, Laviana AA, Zhao Z .
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
J Urol 2020 Dec;204(6):1236-41. doi: 10.1097/ju.0000000000001198..
Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Quality of Care, Quality of Life, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Huelster Huelster, Laviana AA, Joyce DD
Radiotherapy after radical prostatectomy: effect of timing of postprostatectomy radiation on functional outcomes.
This study sought to compare patient-reported functional outcomes after radical prostatectomy (RP) and postprostatectomy radiation as well as elucidate the timing of radiation to allow optimal recovery of function. Findings showed that, in men with localized prostate cancer, post-RP radiotherapy was associated with significantly worse sexual, urinary, and bowel function domain scores at 5 years compared to RP alone. Radiation delayed for approximately 24 months after RP may be optimal for preserving erectile function compared to radiation administered closer to the time of RP.
AHRQ-funded; HS019356; HS022640.
Citation: Huelster Huelster, Laviana AA, Joyce DD .
Radiotherapy after radical prostatectomy: effect of timing of postprostatectomy radiation on functional outcomes.
Urol Oncol 2020 Dec;38(12):930.e23-30.e32. doi: 10.1016/j.urolonc.2020.06.022..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness
Erim DO, Bennett AV, Gaynes BN
Associations between prostate cancer-related anxiety and health-related quality of life.
This study followed prostate cancer patients who were enrolled in the cohort study North Cancer Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCess) from January 2011 and June 2013. A 1-year follow-up survey was done to assess prostate cancer-related anxiety (PCRA) in the cohort. The researchers were interested in the association between PCRA and health-related quality of life (HRQOL). The risk of probable depression was significantly higher in participants with clinically significant PCRA compared with those without it.
AHRQ-funded; 29020050040I.
Citation: Erim DO, Bennett AV, Gaynes BN .
Associations between prostate cancer-related anxiety and health-related quality of life.
Cancer Med 2020 Jun;9(12):4467-73. doi: 10.1002/cam4.3069..
Keywords: Cancer: Prostate Cancer, Cancer, Anxiety, Quality of Life, Men's Health, Patient-Centered Outcomes Research, Depression, Evidence-Based Practice
Kierkegaard P, Vale MD, Garrison S
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
The purpose of this study was to identify and examine the underlying mechanisms that uniquely shape preoperative surgical decision-making strategies concerning older adult prostate cancer patients. Results showed that surgeons’ personal experiences had a significant impact on the decision-making processes during preoperative assessments. However, non-patient factors such as institutional microcultures passively and actively influenced the decision-making process during preoperative assessment.
AHRQ-funded; HS025707.
Citation: Kierkegaard P, Vale MD, Garrison S .
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
J Surg Oncol 2020 Mar;121(3):561-69. doi: 10.1002/jso.25819..
Keywords: Shared Decision Making, Cancer: Prostate Cancer, Cancer, Surgery, Men's Health
Oswald LB, Kasimer R, Rappazzo K
Patient expectations of benefit from systemic treatments for metastatic prostate cancer.
Metastatic prostate cancer is incurable, but systemic therapies can improve quality of life and prolong survival. Accurate perceptions of treatment risks and benefits are vital as patients with metastatic disease make treatment decisions. In this study, the investigators assessed treatment-related expectations for benefit among patients with metastatic prostate cancer and explored associated sociodemographic characteristics.
AHRQ-funded; HS022990.
Citation: Oswald LB, Kasimer R, Rappazzo K .
Patient expectations of benefit from systemic treatments for metastatic prostate cancer.
Cancer Med 2020 Feb;9(3):980-87. doi: 10.1002/cam4.2783..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research
Lange JM, Laviana AA, Penson DF
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
This study projected the comparative benefits of different active surveillance (AS) schedules in men diagnosed with prostate cancer who had Gleason score (GS) </=6 disease and risk profiles similar to those in North American AS cohorts. Results showed that, among men diagnosed with GS </=6 prostate cancer, obtaining a biopsy every 3 or 4 years appeared to be an acceptable alternative to more frequent biopsies. Reducing surveillance intensity for those who have a low risk of progression reduces the number of biopsies while preserving the benefit of more frequent schedules.
AHRQ-funded; HS022990.
Citation: Lange JM, Laviana AA, Penson DF .
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
Cancer 2020 Feb 1;126(3):583-92. doi: 10.1002/cncr.32557..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Men's Health
Hoffman KE, Penson DF, Zhao Z
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
This study compared different treatment of men with favorable-risk prostate cancer and those with unfavorable-risk disease and their functional outcomes 5 years post-treatment. Treatment options for favorable-risk disease include active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy with prostatectomy being the most common. Treatment options for men with unfavorable-risk disease is prostatectomy or EBRT with androgen deprivation therapy (ADT). The cohort analyzed included men diagnosed with prostate cancer in 2011 through 2012, accrued from 5 Surveillance, Epidemiology and End Results Program sites and a US prostate cancer registry, using surveys through September 2017. A total of 2005 men met inclusion criteria. For men with favorable-risk disease low-dose-rate brachytherapy was associated with worse urinary irritative, and sexual and bowel function at 1 year compared with active surveillance. Nerve-sparing prostatectomy was associated with worse urinary incontinence at 5 years and sexual function at 3 years compared with active surveillance. EBRT was not associated with clinically different function changes from active surveillance at any point during the 5 years. For men with unfavorable-risk disease, EBRT with ADT was associated with lower hormonal function at 6 months, bowel function at 1 year, but better sexual function and incontinence than prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Hoffman KE, Penson DF, Zhao Z .
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
JAMA 2020 Jan 14;323(2):149-63. doi: 10.1001/jama.2019.20675..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Treatments, Men's Health, Adverse Events, Surgery