National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Anxiety (1)
- (-) Cancer (28)
- Cancer: Breast Cancer (6)
- Cancer: Colorectal Cancer (2)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (9)
- Cancer: Skin Cancer (2)
- Children/Adolescents (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (10)
- Decision Making (2)
- Depression (1)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (3)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (18)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Imaging (1)
- Medication (2)
- Men's Health (6)
- Mortality (1)
- Nutrition (1)
- Outcomes (9)
- Palliative Care (2)
- Patient-Centered Healthcare (3)
- (-) Patient-Centered Outcomes Research (28)
- Patient Adherence/Compliance (2)
- Prevention (2)
- Quality Improvement (1)
- Quality of Care (2)
- Quality of Life (4)
- Risk (2)
- Screening (2)
- Surgery (6)
- Treatments (6)
- Women (5)
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 28 Research Studies DisplayedKim HS, Hernaez R, Sansgiry S
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
The purpose of this study was to determine the comparative effectiveness of varying colonoscopy intervals on colorectal cancer (CRC) outcomes among patients with inflammatory bowel disease (IBD). Data was from the National Veterans Health Administration. Findings showed that, in a national cohort of patients with CRC-IBD, colonoscopy within 3 years prior to CRC diagnosis was associated with early tumor stage at diagnosis, and colonoscopy within 1 year was associated with a reduced all-cause mortality compared with no colonoscopy, supporting colonoscopy intervals of 1 to 3 years in patients with IBD in order to reduce late-stage CRC and all-cause mortality.
AHRQ-funded; HS024122.
Citation: Kim HS, Hernaez R, Sansgiry S .
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol 2022 Dec;20(12):2848-57.e2. doi: 10.1016/j.cgh.2022.02.048..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health, Imaging, Screening, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research
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.
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
Wernli KJ, Smith RE, Henderson LM
Decision quality and regret with treatment decisions in women with breast cancer: pre-operative breast MRI and breast density.
The authors evaluated self-report of decision quality and regret with breast cancer surgical treatment by pre-operative breast MRI use in women recently diagnosed with breast cancer. They found that breast MRI use in the diagnostic work-up of breast cancer does not negatively alter women's perceptions of surgical treatment decisions in early survivorship.
AHRQ-funded; HS018366.
Citation: Wernli KJ, Smith RE, Henderson LM .
Decision quality and regret with treatment decisions in women with breast cancer: pre-operative breast MRI and breast density.
Breast Cancer Res Treat 2022 Aug;194(3):607-16. doi: 10.1007/s10549-022-06648-7..
Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Women, Patient-Centered Outcomes Research
Loo S, Mullikin K, Robbins C
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study.
This study’s goal was to assess the implementation of the 2018 Translating Research Into Practice (TRIP), an evidence-based patient navigation intervention aimed at addressing breast cancer care disparities, across six Boston hospitals. Patient navigator team member perspectives regarding implementation barriers and facilitators one-year post-study implementation were assessed. Seventeen interviews were conducted with patient navigators, patient navigator supervisors, and designated clinical champions. The following benefits were identified by participants: 1) increased networking and connections for navigators across clinical sites (Cosmopolitanism), 2) formalization of the patient navigation process (Goals and Purpose, Access to Knowledge and Information, and Relative Advantage), and 3) flexibility within the TRIP intervention that allowed for diversity in implementation and use of TRIP components across sites (Adaptability). Barriers included documentation requirements and the structured patient follow up guidelines that did not always align with the timeline of existing site navigation processes.
AHRQ-funded; HS022242.
Citation: Loo S, Mullikin K, Robbins C .
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study.
BMC Health Serv Res 2022 May 21;22(1):683. doi: 10.1186/s12913-022-08090-3..
Keywords: Patient-Centered Healthcare, Cancer: Breast Cancer, Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice
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
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
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
Onaitis MW, Furnary AP, Kosinski AS
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
This study compared the effectiveness of lobectomy and segmentectomy for treatment of clinical stage IA (T1N0) lung cancer patients. The Society of Thoracic Surgeons General Thoracic Surgery Database was linked to Medicare data in 14,286 lung cancer patients who underwent segmentectomy (n = 1654) or lobectomy (n = 12,632) from 2002 to 2015. Survival rates were found to be similar.
AHRQ-funded; HS022279.
Citation: Onaitis MW, Furnary AP, Kosinski AS .
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
Ann Thorac Surg 2020 Dec;110(6):1882-91. doi: 10.1016/j.athoracsur.2020.01.020..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
AHRQ-funded; HS024914.
Citation: Friese CR, Fauer AJ, Kuisell C .
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
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
Shah SC, Dai Zhu, X
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Gastric cancer remains a leading cause of cancer-related mortality. Identifying dietary and other modifiable disease determinants has important implications for risk attenuation in susceptible individuals. The primary aim of the investigators was to estimate the association between dietary and supplemental intakes of calcium and magnesium and the risk of incident gastric cancer. They conducted a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons Diet and Health Study.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Zhu, X .
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Int J Cancer 2020 Jun 1;146(11):2999-3010. doi: 10.1002/ijc.32659..
Keywords: Cancer, Digestive Disease and Health, Risk, Prevention, Nutrition, Patient-Centered Outcomes Research, Evidence-Based Practice
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
Sauder CAM, Bateni SB, Davidson AJ
Breast conserving surgery compared with mastectomy in male breast cancer: a brief systematic review.
The surgical guidelines for male breast cancer (MBC) have been largely guided by female-predominant clinical trials. Because no clinical trial has been conducted to examine the surgical treatment of MBC, the investigators performed a systematic review comparing the survival of patients with MBC who had undergone breast conserving surgery (BCS) and those who had undergone mastectomy and evaluated the patients' radiotherapy compliance after BCS.
AHRQ-funded; HS022236.
Citation: Sauder CAM, Bateni SB, Davidson AJ .
Breast conserving surgery compared with mastectomy in male breast cancer: a brief systematic review.
Clin Breast Cancer 2020 Jun;20(3):e309-e14. doi: 10.1016/j.clbc.2019.12.004..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Dominici LS, Rosenberg SM
Ductal carcinoma in situ (DCIS): the importance of patient-reported outcomes (PRO).
This review summarizes patient-reported outcomes (PROs) frequently assessed in the setting of a ductal carcinoma in situ (DCIS) diagnosis. Findings indicated that PROs provide critical information regarding the experiences of women following a DCIS diagnosis. Continued inclusion of PROs in clinical trials is warranted, further informing treatment decisions and adequately preparing patients for what to expect following treatment.
AHRQ-funded; HS023680.
Citation: Dominici LS, Rosenberg SM .
Ductal carcinoma in situ (DCIS): the importance of patient-reported outcomes (PRO).
Curr Breast Cancer Rep 2020 Jun;12(2):90-97. doi: 10.1007/s12609-020-00363-2..
Keywords: Cancer: Breast Cancer, Cancer, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Women, Quality of Life
Heneghan MB, Hussain T, Barrera L
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
This study examined parent- and patient-reported barriers to oral chemotherapy adherence with children with pediatric acute lymphoblastic leukemia (ALL). The medicine most often used was 6-mercaptopurine (6-MP). Forty-nine parents and 15 patients were surveyed and most reported at least one adherence barrier. Most of the barriers were about meeting other patients with ALL or meeting other parents. Patients also reported difficulty in finding out what their medications are, and what 6-MP does. These barriers can lead to relapse if they are not addressed.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
Pediatr Blood Cancer 2020 May;67(5):e28216. doi: 10.1002/pbc.28216..
Keywords: Children/Adolescents, Treatments, Cancer, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Hernandez-Boussard T, Blayney DW, Brooks JD
Leveraging digital data to inform and improve quality cancer care.
Efficient capture of routine clinical care and patient outcomes is needed at a population-level, as is evidence on important treatment-related side effects and their effect on well-being and clinical outcomes. The increasing availability of electronic health records (EHR) offers new opportunities to generate population-level patient-centered evidence on oncologic care that can better guide treatment decisions and patient-valued care. This study discussed how to leverage digital data to inform and improve quality cancer care.
AHRQ-funded; R01 HS024096.
Citation: Hernandez-Boussard T, Blayney DW, Brooks JD .
Leveraging digital data to inform and improve quality cancer care.
Cancer Epidemiol Biomarkers Prev 2020 Apr;29(4):816-22. doi: 10.1158/1055-9965.Epi-19-0873..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Kamal AH, Bausewein C, Casarett DJ
Standards, guidelines, and quality measures for successful specialty palliative care integration into oncology: current approaches and future directions.
This review paper discusses the need to integrate specialty palliative care into oncology and that there is robust evidence that it improves patient and health system outcomes. Three of the most cited standards/guidelines are discussed as well as quality measures related to integrated palliative and oncology care. They also recommend changes to the quality measurement framework for palliative care and a new way to match palliative care services to patients with advanced cancer.
AHRQ-funded; HS023681.
Citation: Kamal AH, Bausewein C, Casarett DJ .
Standards, guidelines, and quality measures for successful specialty palliative care integration into oncology: current approaches and future directions.
J Clin Oncol 2020 Mar 20;38(9):987-94. doi: 10.1200/jco.18.02440..
Keywords: Palliative Care, Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Murphy CC, Sen A, Watson B
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
This systematic review examined the prevalence of repeat fecal occult blood tests (FOBT) for colorectal cancer screening. MEDLINE, Embase, and the Cochrane Library were searched for studies published from 1997 to 2017 and reported repeat FOBT over 2 and more screening rounds. Thirty-five articles (n=27) were identified which measured repeat FOBT as 1) proportion of Round 1 participants completing repeat FOBT in Round 2; 2) proportion completing two, consecutive FOBTs; or 3) proportion completing 3 or more rounds. The number of participants completing Round 1 ranged from 24.6% to 89.6%. Those who completed Round 2 ranged from 16.4% to 80%; and completion of 3 or more rounds ranged from 0.8% to 64.1%. Repeat FOBT was higher in mailed outreach than opportunistic screening.
AHRQ-funded; HS022418.
Citation: Murphy CC, Sen A, Watson B .
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2020 Feb;29(2):278-87. doi: 10.1158/1055-9965.Epi-19-0775..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Diagnostic Safety and Quality, Prevention, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Evidence-Based Practice
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Decision Making
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
Drucker AM, Adam GP, Rofeberg V
Treatments for primary squamous cell carcinoma and squamous cell carcinoma in situ of the skin: a systematic review and network meta-analysis summary of an Agency for Healthcare Research and Quality comparative effectiveness review.
This article discusses the results of a systematic review and network meta-analysis summary of treatments for primary squamous cell carcinoma (SCC) and squamous cell carcinoma in situ (SCCi) AHRQ comparative effective review. The authors included English-language randomized controlled trials (RCTs) with information on recurrence, histologic clearance, clinical clearance, cosmesis, and quality of life. They excluded studies enrolling less than 10 body lesions total or arms that had 5 or less lesions. They included 7 RCTs with a total of 418 participants. While they found some evidence of the best treatment options, there was little evidence to guide treatment of SC. There were no RCTs found on surgical modalities which is the first line of treatment for SCC.
AHRQ-funded; 290201500002I.
Citation: Drucker AM, Adam GP, Rofeberg V .
Treatments for primary squamous cell carcinoma and squamous cell carcinoma in situ of the skin: a systematic review and network meta-analysis summary of an Agency for Healthcare Research and Quality comparative effectiveness review.
J Am Acad Dermatol 2020 Feb;82(2):479-82. doi: 10.1016/j.jaad.2019.06.030..
Keywords: Cancer: Skin Cancer, Cancer, Comparative Effectiveness, Treatments, Evidence-Based Practice, Patient-Centered Outcomes Research
Khorfan R, Schlick CJR, Yang AD
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
This study compared outcomes of patients with T3 or greater and/or N+ gastric carcinoma who had minimally invasive surgery (MIS) or traditional open surgery. Patients who received MIS had a greater likelihood of receiving postoperative chemotherapy. Patients from the National Cancer Database (21,872) from 2010 to 2015 were identified. The majority (72.2%) received open surgery although MIS rates went up during that time period. Predictors of MIS were Asian race, any insurance coverage and treatment at high-volume centers. Survival rates were higher for MIS patients although that could be explained by their increased likelihood of receiving adjuvant chemotherapy.
AHRQ-funded; HS026385.
Citation: Khorfan R, Schlick CJR, Yang AD .
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
J Gastrointest Surg 2020 Feb;24(2):243-52. doi: 10.1007/s11605-019-04410-x.
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Keywords: Surgery, Treatments, Cancer, Digestive Disease and Health, Healthcare Utilization, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
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