National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Cancer (7)
- Cancer: Colorectal Cancer (3)
- Cancer: Lung Cancer (1)
- (-) Cancer: Prostate Cancer (25)
- Case Study (1)
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- Comparative Effectiveness (3)
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- Diagnostic Safety and Quality (1)
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- Men's Health (3)
- Mortality (1)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (6)
- Patient and Family Engagement (1)
- Payment (1)
- Practice Patterns (2)
- Prevention (1)
- Primary Care (2)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Life (3)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Risk (1)
- Screening (7)
- Sexual Health (2)
- Shared Decision Making (4)
- Substance Abuse (1)
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- 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 25 of 25 Research Studies DisplayedReeve BB, Wang M, Weinfurt K
Psychometric evaluation of PROMIS sexual function and satisfaction measures in a longitudinal population-based cohort of men with localized prostate cancer.
The purpose of this study was to evaluate the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction (SexFS) measures. A population-based cohort of men with localized prostate cancer who were living in North Carolina and who could self-report their health-related quality of life in English completed surveys via phone interviews prior to treatment and at 3, 12, and 24 months after cancer treatment initiation. The researchers’ hypothesis was that men undergoing prostatectomy surgery would report the poorest sexual function at the 3-month survey. The study concludes that use of the PROMIS SexFS measures to assess sexual interest, erectile function, and satisfaction is strongly supported, and that these measures may be useful to identify effective interventions to treat sexual dysfunction and monitor sexual functioning in men with localized prostate cancer over time.
AHRQ-funded; 29020050040ITO6.
Citation: Reeve BB, Wang M, Weinfurt K .
Psychometric evaluation of PROMIS sexual function and satisfaction measures in a longitudinal population-based cohort of men with localized prostate cancer.
J Sex Med 2018 Dec;15(12):1792-810. doi: 10.1016/j.jsxm.2018.09.015..
Keywords: Cancer: Prostate Cancer, Men's Health, Sexual Health
Skolarus TA, Caram ME, Chapman CH
Castration remains despite decreasing definitive treatment of localized prostate cancer in the elderly: a case for de-implementation.
In this editorial, the authors discuss a study by Yang, et al., published in 2017 in Cancer, in which they used the National Cancer Data Base to examine definitive therapy (prostatectomy or radiotherapy) among 400,000 patients who were diagnosed with intermediate-risk or high-risk prostate cancer between 2004 and 2012.
AHRQ-funded; HS025707.
Citation: Skolarus TA, Caram ME, Chapman CH .
Castration remains despite decreasing definitive treatment of localized prostate cancer in the elderly: a case for de-implementation.
Cancer 2018 Oct 15;124(20):3971-74. doi: 10.1002/cncr.31665..
Keywords: Cancer: Prostate Cancer, Elderly, Men's Health
Wolff T, Jadotte YJ
AHRQ Author: Wolff T
Screening for prostate cancer.
This case study describes a 57-year-old black man, non-smoker, who has a history of diabetes mellitus, currently well-controlled. He would like to discuss the prostate-specific antigen (PSA) test even though he has no family history of prostate cancer. The case study questions are based on USPSTF recommendations for prostate cancer screening.
AHRQ-authored.
Citation: Wolff T, Jadotte YJ .
Screening for prostate cancer.
Am Fam Physician 2018 Oct 15;98(8):537-38..
Keywords: Cancer: Prostate Cancer, Case Study, Guidelines, Prevention, Screening
Modi PK, Kaufman SR, Qi J
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
This study analyzed the use of active surveillance of low-risk prostate cancer among a wide variety of health care practices. Researchers identified men with prostate cancer from 2012-2014 using a 100% sample of Michigan Medicare data and linked them with the Michigan Urologic Surgery Improvement Collaborative (MUSIC) registry. They analyzed the performance of 8 claims-based algorithms that were used and selected 3 of them to apply to a 20% national Medicare sample. The 3 algorithms were determined to be either the most sensitive, the most specific, and a balanced algorithm incorporating age and comorbidity. They found that use of surveillance for men increased from 2007 to 2014 but there was a large decrease in the rate of prostate cancer diagnosis. The rate of active surveillance either increased or remained stable depending on the algorithm used.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Qi J .
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
Urology 2018 Oct;120:96-102. doi: 10.1016/j.urology.2018.06.037..
Keywords: Cancer, Cancer: Prostate Cancer, Medicare, Men's Health, Payment
Lee DJ, Zhao Z, Huang LC
Racial variation in receipt of quality radiation therapy for prostate cancer.
Racial disparities are apparent in the management and outcomes for prostate cancer; however, disparities in compliance to quality measures for radiation therapy for prostate cancer have not been previously studied. The goal of this study was to characterize disparities in the compliance rates with quality measures. The investigators suggest that addressing disparities in access to providers that meet quality guidelines, and improving adherence to evidence-based processes of care may decrease racial/ethnic disparities in prostate cancer outcomes.
AHRQ-funded; HS019356; HS022640.
Citation: Lee DJ, Zhao Z, Huang LC .
Racial variation in receipt of quality radiation therapy for prostate cancer.
Cancer Causes Control 2018 Oct;29(10):895-99. doi: 10.1007/s10552-018-1065-5..
Keywords: Cancer: Prostate Cancer, Disparities, Quality Measures, Racial and Ethnic Minorities
Lee DJ, Barocas DA, Zhao Z
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
This study measured compliance with quality measures for radiation therapy treatment of prostate cancer. The Comparative Effectiveness Analysis of Surgery and Radiation Study enrolled men who were treated for localized prostate cancer from 2011 and 2012. Medical records were reviewed, and patients completed surveys. Researchers concluded that men who received external beam radiation therapy (EBRT) were treated more appropriately than those treated with brachytherapy (BT). White men were also more likely to receive appropriate treatment than African-American and other minorities.
AHRQ-funded; HS019356; HS022640.
Citation: Lee DJ, Barocas DA, Zhao Z .
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
Pract Radiat Oncol 2018 Sep-Oct;8(5):307-16. doi: 10.1016/j.prro.2018.04.009..
Keywords: Cancer, Cancer: Prostate Cancer, Comparative Effectiveness, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Practice Patterns, Quality Measures
Modi PK, Kaufman SR, Borza T
Variation in prostate cancer treatment and spending among Medicare shared savings program accountable care organizations.
This study assessed whether the level of engagement in accountable care organizations (ACOs) by urologists affected rates of treatment, overtreatment, and spending. The investigators found that ACOs vary widely in treatment, potential overtreatment, and spending for prostate cancer. ACOs with stronger urologist engagement were less likely to treat men with a high risk of noncancer mortality, and this suggests that organizations that better engage specialists may be able to improve the value of specialty care.
AHRQ-funded; HS024728; HS025707; HS024525.
Citation: Modi PK, Kaufman SR, Borza T .
Variation in prostate cancer treatment and spending among Medicare shared savings program accountable care organizations.
Cancer 2018 Aug;124(16):3364-71. doi: 10.1002/cncr.31573..
Keywords: Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Medicare
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
Misra-Hebert AD, Hom G, Klein EA
Testing of a tool for prostate cancer screening discussions in primary care.
As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed. This paper discusses a previously-created 9-item tool to aid (PCa) screening discussions. The study found that the brief conversation tool was well received in busy primary-care settings and improved patients' knowledge about the screening decision.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hom G, Klein EA .
Testing of a tool for prostate cancer screening discussions in primary care.
Front Oncol 2018 Jun 28;8:238. doi: 10.3389/fonc.2018.00238..
Keywords: Cancer: Prostate Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Primary Care, Screening
Luckenbaugh AN, Holllenbeck BK, Kaufman SR
Impact of accountable care organizations on diagnostic testing for prostate cancer.
The researchers sought to determine if Accountable Care Organizations (ACOs) have the potential to accelerate the impact of prostate cancer screening recommendations. They concluded that the rate of PSA testing was not differentially affected by ACO participation. Conversely, there was an increase in the rate of prostate biopsy among patients of ACO-aligned physicians.
AHRQ-funded; HS024728; HS025707; HS024525.
Citation: Luckenbaugh AN, Holllenbeck BK, Kaufman SR .
Impact of accountable care organizations on diagnostic testing for prostate cancer.
Urology 2018 Jun;116:68-75. doi: 10.1016/j.urology.2018.01.056.
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Keywords: Cancer: Prostate Cancer, Health Services Research (HSR), Screening
Kistler CE, Vu M, Sutkowi-Hemstreet A
Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.
This study sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request.
AHRQ-funded; HS019468; HS021133.
Citation: Kistler CE, Vu M, Sutkowi-Hemstreet A .
Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.
Int J Gen Med 2018 May 17;11:179-90. doi: 10.2147/ijgm.s153887..
Keywords: Cancer: Colorectal Cancer, Cancer: Prostate Cancer, Primary Care, Practice Patterns, Screening
Chhatre S, Jayadevappa R
Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients.
This study used Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data to identify prevalence of substance use among patients with advanced-stage prostate cancer. There are racial and ethnic disparities between substance use and outcomes. A multidisciplinary coordinated care approach is recommended to address these disparities.
AHRQ-funded; HS024106.
Citation: Chhatre S, Jayadevappa R .
Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients.
J Ethn Subst Abuse 2018 Apr-Jun;17(2):135-49. doi: 10.1080/15332640.2016.1160019..
Keywords: Cancer: Prostate Cancer, Disparities, Elderly, Outcomes, Racial and Ethnic Minorities, Substance Abuse
Holmes-Rovner M, Srikanth A, Henry SG
Decision aid use during post-biopsy consultations for localized prostate cancer.
The purpose of this study was to characterize the content and communicative function of high-quality decision aids during diagnostic clinic visits for prostate cancer. Results showed that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.
AHRQ-funded; HS021764.
Citation: Holmes-Rovner M, Srikanth A, Henry SG .
Decision aid use during post-biopsy consultations for localized prostate cancer.
Health Expect 2018 Feb;21(1):279-87. doi: 10.1111/hex.12613..
Keywords: Cancer: Prostate Cancer, Shared Decision Making, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Borza T, Kaufman SR, Yan P
Early effect of Medicare Shared Savings Program accountable care organization participation on prostate cancer care.
The purpose of this study was to understand the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on prostate cancer care. The authors found that the treatment of prostate cancer and annual payments decreased significantly between 2010 and 2013, but ACO participation did not appear to impact these trends. Among men least likely to benefit, Medicare Shared Savings Program ACO alignment was associated with a significant decline in prostate cancer treatment.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Kaufman SR, Yan P .
Early effect of Medicare Shared Savings Program accountable care organization participation on prostate cancer care.
Cancer 2018 Feb 1;124(3):563-70. doi: 10.1002/cncr.31081..
Keywords: Cancer: Prostate Cancer, Healthcare Costs, Medicare
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