National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Cancer (11)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (3)
- Cancer: Lung Cancer (1)
- (-) Cancer: Prostate Cancer (26)
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- Comparative Effectiveness (3)
- Diabetes (2)
- Diagnostic Safety and Quality (2)
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- Elderly (10)
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- Men's Health (3)
- Mortality (2)
- Outcomes (2)
- Palliative Care (1)
- Patient-Centered Outcomes Research (6)
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- Prevention (1)
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- Quality Indicators (QIs) (1)
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- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (1)
- Screening (7)
- Sexual Health (1)
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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 25 of 26 Research Studies DisplayedRaval AD, Mattes MD, Madhavan S
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
The researchers examined the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. They found a significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7 percent versus 6.7 percent.
AHRQ-funded; HS018622.
Citation: Raval AD, Mattes MD, Madhavan S .
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
J Diabetes Res 2016;2016:2656814. doi: 10.1155/2016/2656814.
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Keywords: Cancer: Prostate Cancer, Medication, Elderly, Diabetes, Medicare
Raval AD, Madhavan S, Mattes MD
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer. It found that those with none of the 3 types of chronic conditions (cardiometabolic, mental health, and respiratory) were 44 percent more likely to be diagnosed with advanced prostate cancer compared to men with all 3 types of chronic conditions.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
Popul Health Manag 2016 Dec;19(6):445-53. doi: 10.1089/pop.2015.0141.
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Keywords: Cancer, Cancer: Prostate Cancer, Elderly, Medicare
Jayadevappa R, Chhatre S
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
The authors analyzed the association between age, substance use, and outcomes in fee-for-service Medicare enrollees with advanced prostate cancer. As they found age-specific results, they recommend an integrated and multidisciplinary approach to screen, refer, and treat substance use in patients with prostate cancer to improve outcomes and reduce costs.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S .
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
J Geriatr Oncol 2016 Nov;7(6):444-52. doi: 10.1016/j.jgo.2016.06.007.
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Keywords: Elderly, Medicare, Outcomes, Cancer: Prostate Cancer, Substance Abuse
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Sohn W, Resnick MJ, Greenfield S
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Given the small number of narrowly focused measures in prostate cancer care, the researchers sought to determine whether adherence to any of the available payer-driven quality measures influences patient-centered outcomes, including health-related quality of life (HRQOL), patient satisfaction, and treatment-related complications. They concluded that compliance with available nationally endorsed quality indicators was not associated with clinically important changes in patient-centered outcomes (HRQOL, satisfaction, or complications) within 1-year.
AHRQ-funded; HS019356; HS022640.
Citation: Sohn W, Resnick MJ, Greenfield S .
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Med Care 2016 Aug;54(8):738-44. doi: 10.1097/mlr.0000000000000562.
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Keywords: Cancer, Cancer: Prostate Cancer, Quality of Life, Comparative Effectiveness, Patient Experience
Roth JA, Gulati R, Gore JL
Economic analysis of prostate-specific antigen screening and selective treatment strategies.
The researchers evaluated the potential cost-effectiveness of plausible prostate-specific antigen (PSA) screening strategies and assessed the value added by increased use of conservative management among low-risk, screen-detected cases. They found that, with contemporary treatment, only strategies with biopsy referral for PSA levels higher than 10.0 ng/mL or age-dependent thresholds were associated with increased quality-adjusted life-years (QALYs), and only quadrennial screening of patients aged 55 to 69 years was potentially cost-effective in terms of cost per QALY. They concluded that, for PSA screening to be cost-effective, it needs to be used conservatively and ideally in combination with a conservative management approach for low-risk disease.
AHRQ-funded; HS022982.
Citation: Roth JA, Gulati R, Gore JL .
Economic analysis of prostate-specific antigen screening and selective treatment strategies.
JAMA Oncol 2016 Jul;2(7):890-8. doi: 10.1001/jamaoncol.2015.6275.
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Keywords: Healthcare Costs, Prevention, Cancer: Prostate Cancer, Quality of Life, Screening
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health
Bhatia N, Santos M, Jones LW
Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer.
Since cardiovascular disease risk may be increased by the use of androgen deprivation therapy (ADT), the researchers have adapted the five-step "ABCDE" algorithm for prostate cancer survivors. Its treatment recommendations come under the following headings: awareness and aspirin, blood pressure, cholesterol and cigarettes, diet and diabetes, and exercise. The algorithm is illustrated by a hypothetical case study.
AHRQ-funded; HS022990.
Citation: Bhatia N, Santos M, Jones LW .
Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer.
Circulation 2016 Feb 2;133(5):537-41. doi: 10.1161/circulationaha.115.012519.
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Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Medication, Patient-Centered Outcomes Research
Raval AD, Madhavan S, Mattes MD
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
The authors analyzed the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods. They found that the rate of NCHs was higher during the postcancer period compared with the precancer period. They suggested that their study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
J Natl Compr Canc Netw 2016 Feb;14(2):186-94.
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Keywords: Elderly, Hospitalization, Medicare, Cancer: Prostate Cancer
Dinan MA, Li Y, Zhang Y
Resource use in the last year of life among patients who died with versus of prostate cancer.
The researchers conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Patients who died of prostate cancer rather than from other causes had more hospice and outpatient use, less inpatient and ICU use, and lower overall costs. Efforts to shift care toward outpatient settings might provide more efficient and judicious care for patients during the end of life.
AHRQ-funded; HS022189.
Citation: Dinan MA, Li Y, Zhang Y .
Resource use in the last year of life among patients who died with versus of prostate cancer.
Clin Genitourin Cancer 2016 Feb;14(1):28-37.e2. doi: 10.1016/j.clgc.2015.07.006.
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Keywords: Cancer, Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Men's Health, Mortality, Palliative Care, Patient-Centered Outcomes Research
O'Neil B, Koyama T, Alvarez J
The comparative harms of open and robotic prostatectomy in population based samples.
Using population cohort data,the researchers examined sexual and urinary function in men undergoing open radical prostatectomy vs those undergoing robotic assisted radical prostatectomy. They found that men undergoing robotic assisted radical prostatectomy likely experience less decline in early urinary continence and sexual function than those undergoing open radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: O'Neil B, Koyama T, Alvarez J .
The comparative harms of open and robotic prostatectomy in population based samples.
J Urol 2016 Feb;195(2):321-9. doi: 10.1016/j.juro.2015.08.092.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Adverse Events
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
Zanwar P, Lin YL, Kuo YF
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
The investigators assessed the tests, treatments, and payments for prostate cancer care in men aged 75 or older who have primary care physicians (PCPs) with high or low prostate specific antigen (PSA) testing rates. They found that older men seeing PCPs with high rates of PSA testing undergo more testing and treatments for prostate cancer, with higher Medicare insurance payments.
AHRQ-funded; HS022134.
Citation: Zanwar P, Lin YL, Kuo YF .
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
BMC Health Serv Res 2016 Jan 15;16:17. doi: 10.1186/s12913-016-1265-1.
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Keywords: Elderly, Medicare, Primary Care, Cancer: Prostate Cancer, Screening
Garcia-Albeniz X, Hsu J, Lipsitch M
Infective endocarditis and cancer in the elderly.
The researchers investigated the magnitude of the association between infective endocarditis and cancer, and the natural history of cancer patients with concomitant diagnosis of infective endocarditis. They found that in this elderly population, the incidence of infective endocarditis around a colorectal cancer diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Lipsitch M .
Infective endocarditis and cancer in the elderly.
Eur J Epidemiol 2016 Jan;31(1):41-9. doi: 10.1007/s10654-015-0111-9.
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Keywords: Cancer, Cancer: Colorectal Cancer, Cardiovascular Conditions, Elderly, Cancer: Prostate Cancer
Rezaee ME, Ward CE, Odom BD
Prostate cancer screening practices and diagnoses in patients age 50 and older, Southeastern Michigan, pre/post 2012.
This study investigated the regional impact of the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation against the use of prostate specific antigen (PSA) screening for prostate cancer. PSA utilization significantly increased during the pre-period, but significantly decreased in the post-period. Prostate biopsies decreased before the 2012 recommendation and did not change afterwards.
AHRQ-funded; HS000084.
Citation: Rezaee ME, Ward CE, Odom BD .
Prostate cancer screening practices and diagnoses in patients age 50 and older, Southeastern Michigan, pre/post 2012.
Prev Med 2016 Jan;82:73-6. doi: 10.1016/j.ypmed.2015.11.017.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Elderly, Healthcare Utilization
Risko R, Merdan S, Womble PR
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
This study identified clinical variables associated with a positive computed tomography (CT) scan and estimated the performance of imaging recommendations in patients with newly diagnosed prostate cancer. It found that implementation of criterion for CT imaging that includes PSA levels greater than 20, a Gleason score of 8 or higher, or locally advanced disease (interpreted as cT3/4) would ensure that CT scans are performed for almost all men who would test positive for metastases.
AHRQ-funded; HS018346
Citation: Risko R, Merdan S, Womble PR .
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
Urology. 2014 Dec;84(6):1329-34. doi: 10.1016/j.urology.2014.07.051..
Keywords: Cancer: Prostate Cancer, Imaging
Roth JA, Ramsey SD, Carlson JJ
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
A novel 8-protein prognostic assay generates a risk score at time of biopsy that is predictive of prostate cancer aggressiveness and can inform treatment decisions. The objective of this study was to evaluate the cost-effectiveness of using the assay to inform treatment decisions compared with usual care. The 8-protein assay strategy resulted in 0.04 more quality-adjusted life years and $700 less in costs compared with usual care.
AHRQ-funded; HS022982.
Citation: Roth JA, Ramsey SD, Carlson JJ .
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
Oncologist 2015 Dec;20(12):1355-64. doi: 10.1634/theoncologist.2015-0214.
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Keywords: Cancer, Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Healthcare Costs, Shared Decision Making
Morgans AK, van Bommel AC, Stowell C
Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach.
The International Consortium for Health Outcomes Measurement assembled a multidisciplinary working group to develop a standard set of outcomes relevant to men with advanced prostate cancer to follow during routine clinical care. The international multidisciplinary group identified clinical data and patient-reported outcome measures that serve as a basis for international health outcome comparisons and quality-of-care assessments. The set will be revised annually.
AHRQ-funded; HS022990.
Citation: Morgans AK, van Bommel AC, Stowell C .
Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach.
Eur Urol 2015 Nov;68(5):891-8. doi: 10.1016/j.eururo.2015.06.007.
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Keywords: Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Quality of Life, Adverse Events, Quality Indicators (QIs)
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Cantor SB, Deshmukh AA, Krahn MD
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
The researchers sought to determine whether the forecasted assessment of how someone would feel in a future health state can be predictive of utilities (e.g. as elicited by the time-trade-off method) and also predictive of optimal decisions as determined by a decision-analytic model. They concluded that anticipated difficulty adjusting to adverse health effects were highly related to preferences and could be used as a proxy measure of utility.
AHRQ-funded; HS08992.
Citation: Cantor SB, Deshmukh AA, Krahn MD .
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
Health Expect 2015 Oct;18(5):1610-20. doi: 10.1111/hex.12150.
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Keywords: Shared Decision Making, Cancer: Prostate Cancer, Elderly, Quality of Life, Screening
Chhatre S, Malkowicz SB, Schwartz JS
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
The aims of the study were to understand the racial/ethnic differences in cost of care and mortality in Medicare elderly with advanced stage prostate cancer. It found that relationship between race/ethnicity, cost of care, and mortality is intricate. For non-Hispanic black men, disparity in mortality can be attributed to treatment differences.
AHRQ-funded; HS024106.
Citation: Chhatre S, Malkowicz SB, Schwartz JS .
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
Med Health 2015 Aug;94(32):e1353. doi: 10.1097/md.0000000000001353..
Keywords: Cancer: Prostate Cancer, Mortality, Racial and Ethnic Minorities, Elderly, Disparities
Tsai HT, Keating NL, Van Den Eeden SK
Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer.
The researchers sought to determine if primary androgen deprivation therapy increases the risk of diabetes and to determine the susceptibility factors. They found that primary androgen deprivation therapy may increase diabetes risk by 60% and recommended using caution when managing localized prostate cancer. They further recommended routine screening and lifestyle interventions to reduce the risk of diabetes in men receiving androgen deprivation therapy.
AHRQ-funded; HS022915.
Citation: Tsai HT, Keating NL, Van Den Eeden SK .
Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer.
J Urol 2015 Jun;193(6):1956-62. doi: 10.1016/j.juro.2014.12.027.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Cancer: Prostate Cancer, Risk
Resnick MJ, Barocas DA, Morgans AK
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
This study evaluated differences in pretreatment urinary and sexual function in two population-based cohorts of men with prostate cancer enrolled nearly 20 yrs. apart. It concluded that reporting of pretreatment urinary incontinence and erectile dysfunction has increased over the past two decades. These findings may reflect sociological changes including heightened media attention and direct-to-consumer marketing, among other potential explanations.
AHRQ-funded; HS019356; HS022640; HS022990.
Citation: Resnick MJ, Barocas DA, Morgans AK .
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
Eur Urol 2015 Jun;67(6):1019-25. doi: 10.1016/j.eururo.2014.08.035..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer, Sexual Health
Elstad EA, Sutkowi-Hemstreet A, Sheridan SL
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
The researchers sought to understand clinicians’ perceptions of the benefits and harms of two screening tests (colonoscopy and prostate-specific antigen (PSA) testing) that differ in their balance of potential benefits and harms. Clinicians perceived PSA testing to have a greater likelihood of harm as well as a lower likelihood of lengthening life relative to colonoscopy.
AHRQ-funded; HS000032; HS021133
Citation: Elstad EA, Sutkowi-Hemstreet A, Sheridan SL .
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
Med Decis Making. 2015 May;35(4):467-76. doi: 10.1177/0272989x15569780..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening
Gilbert SM, Dunn RL, Wittmann D
Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic.
The researchers integrated quality of lifer (QOL) assessments into a prostate cancer survivorship clinic and compared recovery and satisfaction among men managed in the survivorship clinic with those followed with more routine care. They concluded that patient QOL and satisfaction were higher among men managed in a survivorship program.
AHRQ-funded; HS020927.
Citation: Gilbert SM, Dunn RL, Wittmann D .
Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic.
Cancer 2015 May 1;121(9):1484-91. doi: 10.1002/cncr.29215..
Keywords: Cancer: Prostate Cancer, Quality of Life, Outcomes, Cancer