National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Behavioral Health (1)
- Cancer (14)
- Cancer: Colorectal Cancer (2)
- Cancer: Lung Cancer (1)
- (-) Cancer: Prostate Cancer (21)
- Cardiovascular Conditions (1)
- Colonoscopy (1)
- Comparative Effectiveness (3)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Imaging (1)
- Medication (2)
- Medication: Safety (1)
- Men's Health (4)
- Mortality (1)
- Nutrition (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (6)
- Patient Safety (1)
- Practice Patterns (1)
- Provider: Physician (2)
- Quality Indicators (QIs) (1)
- Quality of Life (5)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (2)
- Screening (3)
- Sexual Health (3)
- Shared Decision Making (2)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
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 21 of 21 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
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
DeFrank JT, Barclay C, Sheridan S
The psychological harms of screening: the evidence we have versus the evidence we need.
The study’s purpose was to understand the extent of evidence on psychological harms. The researchers reviewed 68 studies and developed an evidence map that quantifies the distribution of evidence on psychological harms for five adult screening services. They found that the evidence for psychological harms of screening is inadequate in number of studies and in research design and measures.
AHRQ-funded; HS021133.
Citation: DeFrank JT, Barclay C, Sheridan S .
The psychological harms of screening: the evidence we have versus the evidence we need.
J Gen Intern Med 2015 Feb;30(2):242-8. doi: 10.1007/s11606-014-2996-5..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Cancer: Prostate Cancer, Evidence-Based Practice, Research Methodologies