National Healthcare Quality and Disparities Report
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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
26 to 50 of 54 Research Studies DisplayedAnkerst 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
Sun CJ, Tobin K, Spikes P
Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention.
Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006-2009 identified individual and social network characteristics of Black MSM that were associated with disclosure that may be leveraged to increase disclosure.
AHRQ-funded; HS022981.
Citation: Sun CJ, Tobin K, Spikes P .
Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention.
AIDS Care 2019 Aug;31(8):1011-18. doi: 10.1080/09540121.2018.1548753..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Sexual Health, Men's Health, Prevention
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
Al-Lami RA, Graham JE, Deer RR
Testosterone replacement therapy and rehospitalization in older men with testosterone deficiency in a postacute care setting.
The goal of this study was to examine whether receipt of testosterone replacement therapy was associated with reduced 30-day rehospitalization after post-acute care among older men with testosterone deficiency, using a five-precent national sample of Medicare beneficiaries 66 years or older. Findings showed that testosterone replacement therapy was not associated with reduced rehospitalization after post-acute care discharge in older men with testosterone deficiency. Further research in this population should examine the effects of testosterone replacement therapy on functional recovery and community independence.
AHRQ-funded; HS022134.
Citation: Al-Lami RA, Graham JE, Deer RR .
Testosterone replacement therapy and rehospitalization in older men with testosterone deficiency in a postacute care setting.
Am J Phys Med Rehabil 2019 Jun;98(6):456-59. doi: .
Keywords: Men's Health, Elderly, Hospital Readmissions
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: 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
Spees LP, ledikwe JH, Kleinman NJ
Immediate motivators to seeking voluntary medical male circumcision among HIV-negative adult men in an urban setting in Botswana.
The goal of this study was to identify subpopulations of Botswanan men with high levels of voluntary medical male circumcision (VMMC) uptake. An observational cohort of men presenting for circumcision services at two high-volume clinics in Gabo-rone, Botswana's capital, were compared with a matched, population-based random sample of uncircumcised men with regard to factors that played a role in the men's decision to seek VMMC services. The results indicate that married men and highly educated men are more likely to undergo circumcision for personal hygiene reasons. The authors conclude that these findings have implications for activities designed to increase VMMC uptake in Botswana and reduce HIV acquisition risk in men.
AHRQ-funded; HS000032.
Citation: Spees LP, ledikwe JH, Kleinman NJ .
Immediate motivators to seeking voluntary medical male circumcision among HIV-negative adult men in an urban setting in Botswana.
AIDS Educ Prev 2019 Apr;31(2):136-51. doi: 10.1521/aeap.2019.31.2.136..
Keywords: Decision Making, Human Immunodeficiency Virus (HIV), Men's Health, Urban Health, Sexual Health
Morden NE, Woloshin S, Brooks CG
Trends in testosterone prescribing for age-related hypogonadism in men with and without heart disease.
A study in 2010 (Basaria et al) revealed more cardiovascular events in men randomized to take testosterone than among men receiving a placebo. By 2015 the FDA had revised testosterone labels to highlight lack of efficacy evidence and possible increased cardiovascular risk. This study examines trends in testosterone use among Medicare-insured men over the age of 50 with and without coronary artery disease (CAD). A random sample was used of Medicare fee-for-service recipients from January 1, 2007 to December 31, 2016 using prescription fills under Medicare Parts B and D. Results showed that testosterone use was consistently higher among men with CAD than for men without CAD. Prescription rates had lowered after the warnings in 2013 but has remained higher than in 2007 and was largely off-label.
AHRQ-funded; HS024075.
Citation: Morden NE, Woloshin S, Brooks CG .
Trends in testosterone prescribing for age-related hypogonadism in men with and without heart disease.
JAMA Intern Med 2019 Mar;179(3):446-48. doi: 10.1001/jamainternmed.2018.6505..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Practice Patterns, Men's Health, Medication
Adams LB, Gottfredson N, Lightfoot AF
Factor analysis of the CES-D 12 among a community sample of black men.
The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used measures for assessing depression in population-based research. This study assessed the dimensional structure of the CES-D 12-item scale using exploratory and confirmatory factor analysis in a community-based sample of Black men. Findings suggested that the "effort" item from the CES-D 12 should be interpreted with caution among Black men.
AHRQ-funded; HS000032.
Citation: Adams LB, Gottfredson N, Lightfoot AF .
Factor analysis of the CES-D 12 among a community sample of black men.
Am J Mens Health 2019 Mar-Apr;13(2):1557988319834105. doi: 10.1177/1557988319834105..
Keywords: Depression, Diagnostic Safety and Quality, Men's Health, Behavioral Health, Racial and Ethnic Minorities
Sun CJ, Nall JL, Rhodes SD
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice.
AHRQ-funded; HS022981.
Citation: Sun CJ, Nall JL, Rhodes SD .
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Am J Mens Health 2019 Jan-Feb;13(1):1557988318804901. doi: 10.1177/1557988318804901..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Men's Health, Community-Based Practice, Patient Adherence/Compliance
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.
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
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
Wright NC, Hooker ER, Nielson CM
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
The goal of this study was to calculate the frequency of and to identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. The researchers identified incident wrist fractures in men aged 65 or older. Potential risk factors included demographics, lifestyle, bone mineral density, selected medications, biomarkers, and physical function and performance measures. The researcher confirmed that fracture history and certain medications are predictors, and also identified novel predictors such as markers of kidney function and an inability to perform the grip strength test. They did not find associations with factors commonly associated with wrist and other osteoporosis fractures such as falls, diabetes, calcium and vitamin D intake, or alcohol intake.
AHRQ-funded; HS023009.
Citation: Wright NC, Hooker ER, Nielson CM .
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
Osteoporos Int 2018 Apr;29(4):859-70. doi: 10.1007/s00198-017-4349-9..
Keywords: Arthritis, Elderly, Injuries and Wounds, Men's Health, Risk
Behler RL, Cornwell BT, Schneider JA
Patterns of social affiliations and healthcare engagement among young, black, men who have sex with men.
This study investigates how individuals’ social affiliations affect their knowledge of and engagement with public health services. A sample of 618 young black men who have sex with men (YBMSM) in Chicago were used to identify connections within their social networks. Men who had stronger affiliations with the Chicago gay community had more knowledge of pre-exposure prophylaxis (PrEP), while men who had stronger affiliations with the black community had improved HIV treatment outcomes.
AHRQ-funded; HS024167.
Citation: Behler RL, Cornwell BT, Schneider JA .
Patterns of social affiliations and healthcare engagement among young, black, men who have sex with men.
AIDS Behav 2018 Mar;22(3):806-18. doi: 10.1007/s10461-016-1668-3..
Keywords: Disparities, Healthcare Delivery, Human Immunodeficiency Virus (HIV), Men's Health, Racial and Ethnic Minorities
Blackburn J, Albright KC, Haley WE
Men lacking a caregiver have greater risk of long-term nursing home placement after stroke.
The purpose of this study was to understand how the availability of a caregiver can affect nursing home placement after ischemic stroke and how this affects different subgroups differently. The investigators found that in men aged 65 and older who have survived an ischemic stroke, the lack of an available caregiver is associated with triple the risk of NHP within 5 years.
AHRQ-funded; HS023009.
Citation: Blackburn J, Albright KC, Haley WE .
Men lacking a caregiver have greater risk of long-term nursing home placement after stroke.
J Am Geriatr Soc 2018 Jan;66(1):133-39. doi: 10.1111/jgs.15166..
Keywords: Cardiovascular Conditions, Caregiving, Elderly, Long-Term Care, Men's Health, Nursing Homes, Stroke
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
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health
Palar K, Laraia B, Tsai AC
Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
The researchers examined the population-level association between food insecurity, HIV risk factors, and HIV serostatus among men. They found that food insecurity is associated with prevalent HIV, STIs, and illicit drug use among men in the United States.
AHRQ-funded; HS000046.
Citation: Palar K, Laraia B, Tsai AC .
Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
AIDS 2016 Jun 1;30(9):1457-65. doi: 10.1097/qad.0000000000001095.
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Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Men's Health, Nutrition, Substance Abuse
Baillargeon J, Deer RR, Kuo YF
Androgen therapy and rehospitalization in older men with testosterone deficiency.
This study assessed whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. It concluded that androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency.
AHRQ-funded; HS022134.
Citation: Baillargeon J, Deer RR, Kuo YF .
Androgen therapy and rehospitalization in older men with testosterone deficiency.
Mayo Clin Proc 2016 May;91(5):587-95. doi: 10.1016/j.mayocp.2016.03.016.
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Keywords: Elderly, Hospital Readmissions, Medication, Men's Health, Patient-Centered Outcomes Research
Najari BB, Katz MJ, Schulster ML
Increased body mass index in men with varicocele is associated with larger spermatic vein diameters when supine.
The researchers evaluated the association of body mass index (BMI) and spermatic vein diameters (SVDs) in men treated for varicocele. They concluded that increased BMI is associated with larger left SVD while supine, suggesting that increased abdominal pressure while recumbent may contribute to varicocele pathology in this population.
AHRQ-funded; HS00066.
Citation: Najari BB, Katz MJ, Schulster ML .
Increased body mass index in men with varicocele is associated with larger spermatic vein diameters when supine.
Urology 2016 Mar;89:40-4. doi: 10.1016/j.urology.2015.11.033.
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Keywords: Obesity, Men's Health, Sexual Health
Dinan MA, Li Y, Zhang Y
Resource use in the last year of life among patients who died with versus of prostate cancer.
The researchers conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Patients who died of prostate cancer rather than from other causes had more hospice and outpatient use, less inpatient and ICU use, and lower overall costs. Efforts to shift care toward outpatient settings might provide more efficient and judicious care for patients during the end of life.
AHRQ-funded; HS022189.
Citation: Dinan MA, Li Y, Zhang Y .
Resource use in the last year of life among patients who died with versus of prostate cancer.
Clin Genitourin Cancer 2016 Feb;14(1):28-37.e2. doi: 10.1016/j.clgc.2015.07.006.
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Keywords: Cancer, Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Men's Health, Mortality, Palliative Care, Patient-Centered Outcomes Research
Strope SA, Vetter J, Elliott S
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
To assess the impact of surgery for benign prostatic hyperplasia (BPH) on use of medication (5-alpha reductase inhibitors, alpha blockers, antispasmodics), the researchers assessed preoperative and postoperative medication utilization among surgically treated men. They found that most patients experience durable improvement after surgical intervention for BPH. However, their results show a need for effective patient counseling about continued or new use of medical therapy after laser and TURP procedures.
AHRQ-funded; HS019455.
Citation: Strope SA, Vetter J, Elliott S .
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
Urology 2015 Dec;86(6):1115-22. doi: 10.1016/j.urology.2015.07.019..
Keywords: Surgery, Medication, Patient-Centered Outcomes Research, Men's Health