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- Adverse Events (1)
- (-) Cancer (9)
- (-) Cancer: Prostate Cancer (9)
- Comparative Effectiveness (5)
- Evidence-Based Practice (6)
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- Healthcare Utilization (1)
- Imaging (1)
- Men's Health (3)
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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 9 of 9 Research Studies DisplayedReisz 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
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
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
Chapman CH, Caram MEV, Radhakrishnan A
Association between PSA values and surveillance quality after prostate cancer surgery.
This study examined the association between PSA values and posttreatment surveillance after prostate cancer surgery. Normally the treatment cutoff rate is 0.2 ng/mL but 4.0 ng/mL may be more appropriate. Data from the US Veterans Health Administration was used to perform a retrospective longitudinal cohort study for men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. Guideline concordance was high at year 1 (95%) but decreased to 79% in year 7. After adjustment, guideline concordance was lowered for the youngest and oldest, Black, and unmarried men.
AHRQ-funded; HS018726.
Citation: Chapman CH, Caram MEV, Radhakrishnan A .
Association between PSA values and surveillance quality after prostate cancer surgery.
Cancer Med 2019 Dec;8(18):7903-12. doi: 10.1002/cam4.2663..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Screening, Guidelines, Prevention, Evidence-Based Practice
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Kirk PS, Borza T, Caram MEV
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
The authors characterized bone scan use after radical prostatectomy (RP) using data from a large, national integrated delivery system. They found a substantial rate of bone scan utilization after RP. The majority were performed for prostate-specific antigen levels in which the likelihood of a positive test was low. They recommended more judicious use of imaging in the post-RP setting.
AHRQ-funded; HS025707.
Citation: Kirk PS, Borza T, Caram MEV .
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
BJU Int 2019 Jul;124(1):55-61. doi: 10.1111/bju.14551..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Imaging, Healthcare Utilization
Tyson MD, Koyama T, Lee D
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
The purpose of this study was to determine whether differences in predicted function over time between radical prostatectomy (RP) or external beam radiotherapy (EBRT) for localized cancer varied by risk group. Patient-reported, disease-specific function was measured using the Expanded Prostate Index Composite and predicted function was estimated using regression models, compared by disease risk. The study found that sexual function was similar between surgery and radiation for patients with high-risk disease, and the authors conclude that high-risk patients undergoing radiation therapy should be counseled that their sexual function may not be as good as low-risk patients also undergoing radiation.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Koyama T, Lee D .
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
Eur Urol 2018 Jul;74(1):26-33. doi: 10.1016/j.eururo.2018.02.012..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Treatments, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments