National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Cancer (15)
- (-) Cancer: Prostate Cancer (21)
- Care Management (3)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (6)
- Dementia (1)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Elderly (3)
- Evidence-Based Practice (4)
- Falls (1)
- Guidelines (2)
- Healthcare Costs (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (1)
- Imaging (2)
- Medication (2)
- Men's Health (8)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- Practice Patterns (4)
- Prevention (1)
- Primary Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Registries (1)
- Risk (2)
- Screening (2)
- Sexual Health (1)
- Shared Decision Making (3)
- Surgery (6)
- Treatments (2)
- 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 DisplayedChapman 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
Modi PK, Kaufman SR, Herrel LA
Practice-level adoption of conservative management for prostate cancer.
In this study, the authors describe the longitudinal adoption of conservative management (ie, the absence of treatment) for prostate cancer among urology group practices in the United States and identify group practice features that influence this adoption. The investigators found that there was increasing variation among group practices in the use of conservative management for prostate cancer. They indicated that this underscores the need for a better understanding of practice-level factors that influence prostate cancer management.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Herrel LA .
Practice-level adoption of conservative management for prostate cancer.
J Oncol Pract 2019 Oct;15(10):e863-e69. doi: 10.1200/jop.19.00088.
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Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Care Management
Caram MEV, Kaufman SR, Modi PK
Adoption of abiraterone and enzalutamide by urologists.
The purpose of this study was to investigate the adoption of abiraterone and enzalutamide by urologists. Abiraterone and enzalutamide are oral therapies approved for the treatment of metastatic castration-resistant prostate cancer, a disease most commonly treated by medical oncologists. The investigators found that urologists are increasingly prescribing oral therapies for metastatic castration-resistant prostate cancer. They suggest that understanding the distribution of urologists specializing in castration-resistant prostate cancer therapeutics will help guide future interventions to optimize the care for this important patient population.
AHRQ-funded; HS025707.
Citation: Caram MEV, Kaufman SR, Modi PK .
Adoption of abiraterone and enzalutamide by urologists.
Urology 2019 Sep;131:176-83. doi: 10.1016/j.urology.2019.05.012..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Medication, Men's Health
Cedars B, Lisker S, Borno HT
An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.
The goal of this study was to assess the efficacy and feasibility of a health information technology registry for men on active surveillance at a safety-net hospital to ensure patients receive guideline-recommended care. Use of a customized electronic approach for monitoring men on active surveillance could improve patient outcomes. It may help reduce the number of men lost to follow-up and improve adherence to timely follow-up testing.
AHRQ-funded; HS023558.
Citation: Cedars B, Lisker S, Borno HT .
An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.
Pilot Feasibility Stud 2019 Aug 14;5:101. doi: 10.1186/s40814-019-0482-x..
Keywords: Cancer, Cancer: Prostate Cancer, Health Information Technology (HIT), Men's Health, Registries
Ankerst DP, Goros M, Tomlins SA
Incorporation of urinary prostate cancer antigen 3 and TMPRSS2:ERG into Prostate Cancer Prevention Trial Risk Calculator.
The objective of this study was to determine whether the incorporation of two urinary markers, prostate cancer antigen 3 (PCA3) and TMPRSS2:ERG (T2:ERG), into the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) tool improves its discrimination, accuracy, and clinical net benefit. A Bayesian modeling approach was used to combine data where the markers were measured in a Michigan cohort with the PCPTRC as prior probabilities to create an updated PCPTRC; this update was compared to the existing PCPTRC in terms of discrimination, calibration, and decision curve analysis. Net benefit was improved for the updated PCPTRC, but calibration was not. The authors note that, the updated PCPTRC is limited since it was based on two separate cohorts, and further validation is required. The updated tool is available online.
AHRQ-funded; HS024810.
Citation: Ankerst DP, Goros M, Tomlins SA .
Incorporation of urinary prostate cancer antigen 3 and TMPRSS2:ERG into Prostate Cancer Prevention Trial Risk Calculator.
Eur Urol Focus 2019 Jan;5(1):54-61. doi: 10.1016/j.euf.2018.01.010..
Keywords: Cancer, Cancer: Prostate Cancer, Men's Health, Risk
Modi PK, Herrel LA, Kaufman SR
Urologist practice structure and spending for prostate cancer care.
This study examined the impact of urologist practice structure on health care spending for men being treated for prostate cancer. Their hypothesis that spending would be lower for urologists in multispecialty group practices and higher for practices with intensity-modulated radiation therapy (IMRT) ownership. A sample of 35.929 men with newly diagnosed prostate cancer being treated by 6381 urologists was identified. The sample came from fee-for-service Medicare beneficiaries between 2011 and 2014. Their hypothesis was proven true with the lowest costs for men going to MSGs and significantly higher among practices with IMRT ownership.
AHRQ-funded; HS025707.
Citation: Modi PK, Herrel LA, Kaufman SR .
Urologist practice structure and spending for prostate cancer care.
Urology 2019 Aug;130:65-71. doi: 10.1016/j.urology.2019.03.029.
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Keywords: Cancer: Prostate Cancer, Cancer, Healthcare Costs, Men's Health
Jayadevappa R, Chhatre S, Malkowicz SB
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer.
The purpose of this study was to analyze the association between androgen deprivation therapy (ADT) exposure and diagnosis of Alzheimer disease or dementia among elderly men with prostate cancer. Results showed that, among elderly patients with prostate cancer, ADT exposure was associated with subsequent diagnosis of Alzheimer disease or dementia over a follow-up period of at least 10 years.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Malkowicz SB .
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer.
JAMA Netw Open 2019 Jul 3;2(7):e196562. doi: 10.1001/jamanetworkopen.2019.6562..
Keywords: Cancer, Cancer: Prostate Cancer, Dementia, Elderly, Men's Health, Risk
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
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Shared Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Crawford ED, Koo PJ, Shore N
A clinician's guide to next generation imaging in patients with advanced prostate cancer (RADAR III).
This paper reports on the convening of the Radiographic Assessments for Detection of Advanced Recurrence (RADAR III) Group to offer guidance on the use of next generation imaging to stage prostate cancer based on available data and clinical experience. The RADAR III Group recommends next generation imaging techniques in select patients in whom disease progression is suspected based on biomarker values, comorbidities and symptoms.
AHRQ-funded.
Citation: Crawford ED, Koo PJ, Shore N .
A clinician's guide to next generation imaging in patients with advanced prostate cancer (RADAR III).
J Urol 2019 Apr;201(4):682-92. doi: 10.1016/j.juro.2018.05.164..
Keywords: Men's Health, Cancer: Prostate Cancer, Cancer, Diagnostic Safety and Quality, Imaging, Evidence-Based Practice, Guidelines
Schmidt B, Eapen RS, Cowan JE
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
This study investigated usage of external-beam radiation therapy (EBRT), with or without neoadjuvant androgen deprivation therapy (ADT), using data from a community-based prospective disease registry (CaPSURE). Data on 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment was compared. The authors conclude that use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990, and that men who received ADT have higher risk characteristics than those who receive EBRT alone.
AHRQ-funded; HS019356.
Citation: Schmidt B, Eapen RS, Cowan JE .
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
Prostate Cancer Prostatic Dis 2019 Mar;22(1):117-24. doi: 10.1038/s41391-018-0084-3..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Practice Patterns, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Treatments
Misra-Hebert AD, Hu B, Klein EA
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
The researchers assessed prostate cancer screening practices in primary care since the initial United States Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA) testing for older men. Prostate cancer screening declined from 2007 to 2014 even in higher-risk groups and follow-up screening rates were not related to previous PSA level.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Klein EA .
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
BJU Int 2017 Aug;120(2):257-64. doi: 10.1111/bju.13793.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Primary Care, Practice Patterns
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Winters-Stone KM, Moe E, Graff JN
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
This study compared the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). It concluded that current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment.
AHRQ-funded; HS022981.
Citation: Winters-Stone KM, Moe E, Graff JN .
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
J Am Geriatr Soc 2017 Jul;65(7):1414-19. doi: 10.1111/jgs.14795.
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Keywords: Cancer: Prostate Cancer, Cancer, Falls, Medication, Elderly
Jayadevappa R, Chhatre S, Wong YN
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
This review analyzed the comparative effectiveness of prostate cancer (PCa) treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting and radiation therapy.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Wong YN .
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
Medicine 2017 May;96(18):e6790. doi: 10.1097/md.0000000000006790.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer
Chen RC, Basak R, Meyer AM
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
This study compared quality of life after radical prostatectomy, external beam radiotherapy, and brachytherapy vs active surveillance. By 24 months, mean scores between treatment groups vs active surveillance were not significantly different in most domains. However, each treatment strategy was associated with distinct patterns of adverse effects over 2 years.
AHRQ-funded; AHRQ contract (no number given).
Citation: Chen RC, Basak R, Meyer AM .
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
JAMA 2017 Mar 21;317(11):1141-50. doi: 10.1001/jama.2017.1652.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Quality of Life
Barocas DA, Alvarez J, Resnick MJ
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
This study compares functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. It concluded that radical prostatectomy was associated with a greater decrease in sexual function and urinary incontinence than either EBRT or active surveillance after 3 years and was associated with fewer urinary irritative symptoms than active surveillance.
AHRQ-funded; HS019356; HS022640.
Citation: Barocas DA, Alvarez J, Resnick MJ .
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
JAMA 2017 Mar 21;317(11):1126-40. doi: 10.1001/jama.2017.1704.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Adverse Events, Cancer: Prostate Cancer, Surgery
Eifler JB, Alvarez J, Koyama T
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
Urologists have been criticized for overtreating men with low risk prostate cancer and for passively observing older men with higher risk disease. Proponents of active surveillance for low risk disease and critics of watchful waiting for higher risk disease have advocated for more judicious use of observation. In this study, the investigator compared 2 population based cohorts to determine how expectant management has evolved during the last 2 decades.
AHRQ-funded; HS019356; HS022640.
Citation: Eifler JB, Alvarez J, Koyama T .
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
J Urol 2017 Mar;197(3 Pt 1):614-20. doi: 10.1016/j.juro.2016.10.067..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Diagnostic Safety and Quality, Men's Health
Tsai HT, Philips G, Taylor KL
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Researchers assessed the use and predictors of expectant management (EM) to understand its uptake in U.S. practice. In U.S. practice, the utilization of EM steadily increased in low-risk prostate cancer and remained low in the intermediate-risk group over time. While patients with advanced age or comorbidities were more likely to receive EM, its use varied substantially by geographic region.
AHRQ-funded; HS022915.
Citation: Tsai HT, Philips G, Taylor KL .
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Urol Pract 2017 Mar;4(2):132-39. doi: 10.1016/j.urpr.2016.05.005.
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Keywords: Shared Decision Making, Elderly, Healthcare Utilization, Cancer: Prostate Cancer, Practice Patterns
Scherr KA, Fagerlin A, Hofer T
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
This study assessed the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. It found that patients' initial treatment preferences did not predict receipt of active treatment versus surveillance. Instead, receipt of active treatment was predicted primarily by urologists' recommendations.
AHRQ-funded; HS021764.
Citation: Scherr KA, Fagerlin A, Hofer T .
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
Med Decis Making 2017 Jan;37(1):56-69. doi: 10.1177/0272989x16662841.
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Keywords: Cancer: Prostate Cancer, Shared Decision Making, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication