National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Anxiety (1)
- (-) Cancer (21)
- Cancer: Colorectal Cancer (2)
- (-) Cancer: Prostate Cancer (21)
- Comparative Effectiveness (5)
- Decision Making (1)
- Depression (1)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (8)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Promotion (1)
- Imaging (1)
- Medicare (1)
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- Men's Health (7)
- Mortality (2)
- Outcomes (4)
- Patient-Centered Outcomes Research (8)
- Patient Adherence/Compliance (1)
- Practice Patterns (1)
- Prevention (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Screening (2)
- Surgery (4)
- Transitions of Care (1)
- Treatments (4)
- Workforce (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 DisplayedChhatre S, Malkowicz SB, Jayadevappa R
Continuity of care in acute survivorship phase, and short and long-term outcomes in prostate cancer patients.
This study examined the association between continuity of care and outcomes in Medicare beneficiaries with localized prostate cancer, and the moderating effect of race using SEER – Medicare data between 2000 and 2016. Continuity of care was defined as visits dispersion and density in the acute survivorship phase. Outcomes measured were emergency room visits, hospitalizations, and cost during the acute survivorship phase and mortality over the follow-up phase. Higher continuity of care was associated with improved outcomes. The interaction between race and continuity of care was significant.
AHRQ-funded; HS024106.
Citation: Chhatre S, Malkowicz SB, Jayadevappa R .
Continuity of care in acute survivorship phase, and short and long-term outcomes in prostate cancer patients.
Prostate 2021 Dec;81(16):1310-19. doi: 10.1002/pros.24228..
Keywords: Cancer: Prostate Cancer, Cancer, Transitions of Care
Lai LY, Shahinian VB, Oerline MK
Understanding active surveillance for prostate cancer.
Understanding active surveillance for prostate cancer.
AHRQ-funded; HS025707.
Citation: Lai LY, Shahinian VB, Oerline MK .
Understanding active surveillance for prostate cancer.
JCO Oncol Pract 2021 Nov;17(11):e1678-e87. doi: 10.1200/op.20.00929..
Keywords: Cancer: Prostate Cancer, Cancer
Erim DO, Bennett AV, Gaynes BN
Mapping the Memorial Anxiety Scale for Prostate Cancer to the SF-6D.
The purpose of this study was to create a crosswalk that predicts Short Form 6D (SF-6D) utilities from Memorial Anxiety Scale for Prostate Cancer (MAX-PC) scores. Findings showed that this study provided a crosswalk that converts MAX-PC scores to SF-6D utilities for economic evaluation of clinically significant prostate cancer-related anxiety treatment options for prostate cancer survivors.
AHRQ-funded; 29020050040I.
Citation: Erim DO, Bennett AV, Gaynes BN .
Mapping the Memorial Anxiety Scale for Prostate Cancer to the SF-6D.
Qual Life Res 2021 Oct;30(10):2919-28. doi: 10.1007/s11136-021-02871-9..
Keywords: Cancer: Prostate Cancer, Cancer, Research Methodologies
Moazzezi M, Rose B, Kisling K
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
This study’s objective was to assess the new online adaptive radiation therapy technology called Ethos for treating prostate cancer. Twenty-five prostate patients previously treated at the author’s clinic were re-planed using an Ethos emulator. Clinical margins of 3 mm posterior, 5 mm left/right/anterior, and 7 mm superior/inferior were used. Dose metrics were compared to unadapted plans to evaluate clinical target volumes (CTV) and online adaptive radiation (OAR) dose changes. Overall, 96% of fractions required auto-segmentation edits, although they were mostly minor. Adaptation improved CTV 98% for the 24 patients with minor auto-segmentation corrections. However, for one in 25 patients, large contour edits were required.
AHRQ-funded; HS025440.
Citation: Moazzezi M, Rose B, Kisling K .
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
J Appl Clin Med Phys 2021 Oct;22(10):82-93. doi: 10.1002/acm2.13399..
Keywords: Cancer: Prostate Cancer, Cancer, Treatments, Imaging
Marchetti KA, Oerline M, Hollenbeck BK
Urology workforce changes and implications for prostate cancer care among Medicare enrollees.
The purpose of this study was to characterize national trends in urologist workforce, practice organization, and management of incident prostate cancer. The investigators characterized shifts in urologist membership from smaller, independent groups to larger, multispecialty or hospital-owned practices. They indicated that this trend coincided with higher utilization of observation and surgical treatment for prostate cancer.
AHRQ-funded; HS025707.
Citation: Marchetti KA, Oerline M, Hollenbeck BK .
Urology workforce changes and implications for prostate cancer care among Medicare enrollees.
Urology 2021 Sep;155:77-82. doi: 10.1016/j.urology.2020.12.051..
Keywords: Cancer: Prostate Cancer, Cancer, Workforce, Practice Patterns
Caram MEV, Burns J, Kumbier K
Factors influencing treatment of veterans with advanced prostate cancer.
This study examined factors influencing treatment of veterans with metastatic castration-resistant prostate cancer (CRPC). Clinician and nonclinical factors associated with the first-line treatment for CPRC using data from the Veterans Health Administration was used. Almost 5000 patients who received abiraterone, enzalutamide, docetaxel, or ketoconazole from 2010 through 2017 were identified. Increasing age was associated with receipt of abiraterone or enzalutamide versus docetaxel. Greater preexisting comorbidity was associated with enzalutamide versus abiraterone. Patients with higher PSA values at the start of treatment were more likely to receive docetaxel than the other three treatments. African American men were more likely to receive ketoconazole.
AHRQ-funded; HS025707.
Citation: Caram MEV, Burns J, Kumbier K .
Factors influencing treatment of veterans with advanced prostate cancer.
Cancer 2021 Jul 1;127(13):2311-18. doi: 10.1002/cncr.33485..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Treatments
Pasalic D, Barocas DA, Huang LC
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
This retrospective cohort study’s objective was to determine if there were differences in treatment-related regret or survival between prostate cancer patients who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), over a 5-year period. The cohort included 695 men who met inclusion criteria and received either EBRT (n=583) or EBRT-LDR (n=112). Men who received either treatment reported clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate- to-big problems with urinary function bother and frequent urination at 5 years. There was no difference in treatment-related regret or survival between patients who received either treatment.
AHRQ-funded; HS019356; HS022640.
Citation: Pasalic D, Barocas DA, Huang LC .
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
Cancer 2021 Jun 1;127(11):1912-25. doi: 10.1002/cncr.33388..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Treatments
Danan ER, White KM, Wilt TJ
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
This study looked at differences in attitudes about recommendations and evidence on prostate cancer screening among White and Black male veterans. The authors provided a draft educational pamphlet about the benefits and harms of Prostate Specific Antigen (PSA) screening to 44 men, ages 55-81 at a midwestern VA medical center in 2013 and 2015. The groups were divided into four White and two Black focus groups. Three universal themes were low baseline familiarity with prostate cancer, surprise and resistance to the guidelines not to test routinely, and negative emotions in response to ambiguity. Discussions in the White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Discussions in Black groups devoted almost no time to benefits, considered harms significant, and emphasized personal and collective responsibility for cancer prevention through diet, exercise, and alternative medicine. Discussion in Black groups also emphasized the history of racism and discrimination in healthcare and medical research.
AHRQ-funded; HS026379.
Citation: Danan ER, White KM, Wilt TJ .
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
Am J Mens Health 2021 May-Jun;15(3):15579883211022110. doi: 10.1177/15579883211022110..
Keywords: Cancer: Prostate Cancer, Cancer, Screening, Prevention, Racial and Ethnic Minorities, Evidence-Based Practice, Health Promotion, Education: Patient and Caregiver
Wilt TJ, Ullman KE, Linskens EJ
Therapies for clinically localized prostate cancer: a comparative effectiveness review.
In this study, the investigators sought to identify new information evaluating clinically localized prostate cancer therapies. The investigators concluded that radical prostatectomy reduced mortality vs watchful waiting in clinically detected localized prostate cancer but caused more harms. Effectiveness may be limited to younger men and those with intermediate risk disease. Active monitoring resulted in little to no mortality difference vs radical prostatectomy or external beam radiation plus androgen deprivation.
AHRQ-funded; 290201500008I.
Citation: Wilt TJ, Ullman KE, Linskens EJ .
Therapies for clinically localized prostate cancer: a comparative effectiveness review.
J Urol 2021 Apr;205(4):967-76. doi: 10.1097/ju.0000000000001578..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Men's Health
Stone BV, Laviana AA, Luckenbaugh AN
Patient-reported financial toxicity associated with contemporary treatment for localized prostate cancer.
Contemporary treatment modalities for localized prostate cancer provide comparable overall and cancer-specific survival. However, the degree of financial burden imposed by treatment, the factors contributing to that burden, and how different treatments compare with regard to financial toxicity remain poorly understood. The investigators sought to explore these factors. They concluded that external beam radiotherapy was associated with the highest financial burden, even when controlling for age, education and income.
AHRQ-funded; HS019356; HS022640.
Citation: Stone BV, Laviana AA, Luckenbaugh AN .
Patient-reported financial toxicity associated with contemporary treatment for localized prostate cancer.
J Urol 2021 Mar;205(3):761-68. doi: 10.1097/ju.0000000000001423..
Keywords: Cancer: Prostate Cancer, Cancer, Healthcare Costs
Caram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Reisz PA, Laviana AA, Zhao Z
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
Prior studies suggest that nationally endorsed quality measures for prostate cancer care are not linked closely with outcomes. Using a prospective, population based cohort the investigators measured clinically relevant variation in structure, process and outcome measures in men undergoing radical prostatectomy. The authors did not identify and meaningful variation in quality of care across racial groups, age groups and surgeon volume strata, in this cohort, suggesting that men were receiving comparable quality of care across these strata.
AHRQ-funded; HS019356.
Citation: Reisz PA, Laviana AA, Zhao Z .
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
J Urol 2020 Dec;204(6):1236-41. doi: 10.1097/ju.0000000000001198..
Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Quality of Care, Quality of Life, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Huelster Huelster, Laviana AA, Joyce DD
Radiotherapy after radical prostatectomy: effect of timing of postprostatectomy radiation on functional outcomes.
This study sought to compare patient-reported functional outcomes after radical prostatectomy (RP) and postprostatectomy radiation as well as elucidate the timing of radiation to allow optimal recovery of function. Findings showed that, in men with localized prostate cancer, post-RP radiotherapy was associated with significantly worse sexual, urinary, and bowel function domain scores at 5 years compared to RP alone. Radiation delayed for approximately 24 months after RP may be optimal for preserving erectile function compared to radiation administered closer to the time of RP.
AHRQ-funded; HS019356; HS022640.
Citation: Huelster Huelster, Laviana AA, Joyce DD .
Radiotherapy after radical prostatectomy: effect of timing of postprostatectomy radiation on functional outcomes.
Urol Oncol 2020 Dec;38(12):930.e23-30.e32. doi: 10.1016/j.urolonc.2020.06.022..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness
Erim DO, Bennett AV, Gaynes BN
Associations between prostate cancer-related anxiety and health-related quality of life.
This study followed prostate cancer patients who were enrolled in the cohort study North Cancer Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCess) from January 2011 and June 2013. A 1-year follow-up survey was done to assess prostate cancer-related anxiety (PCRA) in the cohort. The researchers were interested in the association between PCRA and health-related quality of life (HRQOL). The risk of probable depression was significantly higher in participants with clinically significant PCRA compared with those without it.
AHRQ-funded; 29020050040I.
Citation: Erim DO, Bennett AV, Gaynes BN .
Associations between prostate cancer-related anxiety and health-related quality of life.
Cancer Med 2020 Jun;9(12):4467-73. doi: 10.1002/cam4.3069..
Keywords: Cancer: Prostate Cancer, Cancer, Anxiety, Quality of Life, Men's Health, Patient-Centered Outcomes Research, Depression, Evidence-Based Practice
Kierkegaard P, Vale MD, Garrison S
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
The purpose of this study was to identify and examine the underlying mechanisms that uniquely shape preoperative surgical decision-making strategies concerning older adult prostate cancer patients. Results showed that surgeons’ personal experiences had a significant impact on the decision-making processes during preoperative assessments. However, non-patient factors such as institutional microcultures passively and actively influenced the decision-making process during preoperative assessment.
AHRQ-funded; HS025707.
Citation: Kierkegaard P, Vale MD, Garrison S .
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
J Surg Oncol 2020 Mar;121(3):561-69. doi: 10.1002/jso.25819..
Keywords: Decision Making, Cancer: Prostate Cancer, Cancer, Surgery, Men's Health
Oswald LB, Kasimer R, Rappazzo K
Patient expectations of benefit from systemic treatments for metastatic prostate cancer.
Metastatic prostate cancer is incurable, but systemic therapies can improve quality of life and prolong survival. Accurate perceptions of treatment risks and benefits are vital as patients with metastatic disease make treatment decisions. In this study, the investigators assessed treatment-related expectations for benefit among patients with metastatic prostate cancer and explored associated sociodemographic characteristics.
AHRQ-funded; HS022990.
Citation: Oswald LB, Kasimer R, Rappazzo K .
Patient expectations of benefit from systemic treatments for metastatic prostate cancer.
Cancer Med 2020 Feb;9(3):980-87. doi: 10.1002/cam4.2783..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research
Lange JM, Laviana AA, Penson DF
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
This study projected the comparative benefits of different active surveillance (AS) schedules in men diagnosed with prostate cancer who had Gleason score (GS) </=6 disease and risk profiles similar to those in North American AS cohorts. Results showed that, among men diagnosed with GS </=6 prostate cancer, obtaining a biopsy every 3 or 4 years appeared to be an acceptable alternative to more frequent biopsies. Reducing surveillance intensity for those who have a low risk of progression reduces the number of biopsies while preserving the benefit of more frequent schedules.
AHRQ-funded; HS022990.
Citation: Lange JM, Laviana AA, Penson DF .
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
Cancer 2020 Feb 1;126(3):583-92. doi: 10.1002/cncr.32557..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Men's Health
Hoffman KE, Penson DF, Zhao Z
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
This study compared different treatment of men with favorable-risk prostate cancer and those with unfavorable-risk disease and their functional outcomes 5 years post-treatment. Treatment options for favorable-risk disease include active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy with prostatectomy being the most common. Treatment options for men with unfavorable-risk disease is prostatectomy or EBRT with androgen deprivation therapy (ADT). The cohort analyzed included men diagnosed with prostate cancer in 2011 through 2012, accrued from 5 Surveillance, Epidemiology and End Results Program sites and a US prostate cancer registry, using surveys through September 2017. A total of 2005 men met inclusion criteria. For men with favorable-risk disease low-dose-rate brachytherapy was associated with worse urinary irritative, and sexual and bowel function at 1 year compared with active surveillance. Nerve-sparing prostatectomy was associated with worse urinary incontinence at 5 years and sexual function at 3 years compared with active surveillance. EBRT was not associated with clinically different function changes from active surveillance at any point during the 5 years. For men with unfavorable-risk disease, EBRT with ADT was associated with lower hormonal function at 6 months, bowel function at 1 year, but better sexual function and incontinence than prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Hoffman KE, Penson DF, Zhao Z .
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
JAMA 2020 Jan 14;323(2):149-63. doi: 10.1001/jama.2019.20675..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Treatments, Men's Health, Adverse Events, Surgery
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery
Feuer EJ, Rabin BA, Zou Z
The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.
The researchers externally validate the nomograms for prostate and colorectal cancer using data from Kaiser Permanente Colorado. Their results indicated that the colorectal and prostate cancer nomograms are reliable tools for physicians and patients to use to obtain information on prognosis and assist in establishing priorities for both treatment of the cancer and other conditions, particularly when a patient is elderly and/or has significant comorbidities.
AHRQ-funded; HS019520.
Citation: Feuer EJ, Rabin BA, Zou Z .
The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):265-74. doi: 10.1093/jncimonographs/lgu021.
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Keywords: Cancer: Colorectal Cancer, Cancer: Prostate Cancer, Cancer, Mortality
Cobran EK, Wutoh AK, Lee E
Perceptions of prostate cancer fatalism and screening behavior between United States-born and Caribbean-born Black males.
The purpose of this study was to compare perceptions of prostate cancer (CaP) fatalism and predictors of CaP screening with Prostate Specific Antigen (PSA) testing between U.S.-born and Caribbean-born African-American males. In their study of 211 U.S.-born and Caribbean-born Black males between ages 39–75, the researchers found that nativity was not a significant predictor of CaP screening with PSA testing within the last year.
AHRQ-funded; HS011673.
Citation: Cobran EK, Wutoh AK, Lee E .
Perceptions of prostate cancer fatalism and screening behavior between United States-born and Caribbean-born Black males.
J Immigr Minor Health 2014 Jun;16(3):394-400. doi: 10.1007/s10903-013-9825-5..
Keywords: Cancer: Prostate Cancer, Screening, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Cancer