scholarly journals Comparison of Physician-Documented Versus Patient-Reported Collection of Comorbidities Among Patients With Prostate Cancer Upon First Visit to the Urology Clinic

2018 ◽  
pp. 1-10 ◽  
Author(s):  
Katherine Fleshner ◽  
Amy Tin ◽  
Nicole Benfante ◽  
Sigrid Carlsson ◽  
Andrew J. Vickers
Keyword(s):  
Prostate Cancer ◽  
Medical History ◽  
Online Survey ◽  
Statistical Significance ◽  
Complete Information ◽  
Frequency Distributions ◽  
Physician Review ◽  
Starting Point ◽  
Patient Reported ◽  
Urology Clinic

Purpose To determine whether patient-reported collection of comorbidities online is sufficiently accurate to warrant use as part of a physician-reviewed, baseline medical history. Methods Comorbidities were collected for a sample of 213 new prostate cancer visits to our urology clinic through an online survey (called Baseline Medical History) before the clinical encounter. The frequency distributions of comorbidities as reported by patients before physician review were compared with those documented by physicians for a sample of 298 consecutive patients presenting to the same urology clinic before the survey went live. Results The overall frequency distribution of comorbidities and life expectancy estimates were similar between the two groups. A few comorbidity categories were reported with higher frequency in the patient-reported group compared with the physician-documented group, including neurologic comorbidities (7.5% v 1.7%; difference 6%; 95% CI, 2.0% to 10%; P = .001) and back pain (24% v 13%; difference 12%; 95% CI, 4.8% to 19%; P = .001). A similar trend was seen for vascular conditions, although the difference did not meet conventional levels of statistical significance. Genitourinary comorbidities, including problems with urination and erectile dysfunction, were better captured by the physician-reported group compared with the patient-reported group (68% v 53%; difference 15%; 95% CI, 7% to 24%; P = .001), as were other musculoskeletal comorbidities (8.7% v 1.9%; difference 7%; 95% CI, 3.2% to 11%; P = .001). Conclusion Patients completing a medical history, at their own pace and in the comfort of their own home, provide relatively accurate and complete information, even before physician review. Patient reporting of comorbidities thus seems to be a reliable starting point for the documentation of the medical history in the clinic.

Lower risk of prostate cancer in patients with sedentary occupations presenting for a prostate biopsy: Analysis of a Veterans Affairs cohort.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 257-257
Author(s):  
Rimaz M. Khadir ◽  
Rashid K. Sayyid ◽  
Martha K. Terris
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
High Volume ◽  
Veterans Affairs ◽  
High Grade ◽  
Increased Risk ◽  
Patient Reported

257 Background: Sedentary behavior has been associated with increased serum prostate-specific antigen (PSA) levels. It is currently unknown whether this correlates with an increased risk of underlying prostate cancer (PCa). Our objective was to determine whether patients with sedentary occupations presenting for a prostate biopsy were at increased risk of PCa diagnosis. Methods: A prospectively collected registry of patients undergoing a prostate biopsy between July 1995 and June 2016 at the Veterans Affairs Medical Center in Augusta, GA was utilized. The occupation was classified as sedentary if it was associated with prolonged periods of sitting (i.e. >50% work hours). This was determined via patient reported history at time of biopsy. The associations between a sedentary lifestyle and risk of a positive prostate biopsy, high grade cancer (i.e. Gleason score 8 or higher), and high volume cancer (i.e. at least 50% of total cores were positive) were evaluated using multivariable logistic regression analyses, controlling for age, race, body mass index, PSA level, free PSA ratio, clinical stage, prostate volume, and family history of prostate cancer. Statistical significance was set at p<0.05. All statistical analyses were performed using R version 3.6.1. Results: Our cohort included 1,914 patients. 271 (14.2%) patients had sedentary jobs. Median patient age was 61.0 years (Interquartile range [IQR] 57.0 – 66.0). Median PSA at time of biopsy was 5.7 ng/ml (IQR 4.4 – 8.2). Of the 1,914 initial biopsies performed, 974 (50.9%) were positive for malignancy. Of patients diagnosed with PCa, 229 (23.5%) had high-grade disease and 316 (32.4%) had high volume disease. On multivariable analysis, patients with a sedentary job had a significantly decreased risk of PCa diagnosis (Odds ratio [OR] 0.43, 95% confidence interval [CI] 0.18-1.03, p= 0.058), but no difference in odds of high grade (OR 0.63, 95% CI 0.089-2.99, p= 0.60) or high volume disease (OR 1.07, 95% CI 0.93-1.21, p= 0.89). Conclusions: Patients with sedentary occupations presenting for a prostate biopsy are at a lower apparent risk for a positive prostate biopsy. These results suggest that the serum PSA levels in such patients may be artificially elevated secondary to increased recumbence with no corresponding increase in risk of malignancy. [Table: see text]

National Radiation Oncology Registry: The pilot prostate cancer registry.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 267-267
Author(s):  
Jason Alexander Efstathiou ◽  
Deborah Nassif ◽  
Ronald C. Chen ◽  
Karen Elizabeth Hoffman ◽  
Deborah A. Kuban ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Oncology ◽  
Online Survey ◽  
Care Delivery ◽  
The United States ◽  
Data Dictionary ◽  
Infrastructure Development ◽  
Willingness To Participate ◽  
Patient Reported ◽  
Data Elements

267 Background: The National Radiation Oncology Registry (NROR), sponsored by the Radiation Oncology Institute and the American Society for Radiation Oncology, is building a nationwide electronic infrastructure to collect standardized information on cancer care delivery among patients treated with radiotherapy in the United States. The NROR pilot registry will focus on patients with prostate cancer (PCa). Methods: Since October 2010 the NROR has undertaken four main efforts (1) stakeholder engagement, including hosting a forum with ongoing opportunities for feedback from patients, clinicians, payers, vendors, and federal agencies; (2) electronic infrastructure development to facilitate transfer of information from disparate clinical systems to a database model designed for efficient aggregate analysis; (3) data dictionary development with guidance from PCa and technical experts, and health services researchers; and (4) pilot site engagement, in which over 80 clinical centers indicated willingness to participate in the pilot registry by filling out an online survey. Results: The stakeholder forum revealed enthusiasm for the NROR and emphasized the need for patient-centered outcomes, minimal data burden, and maximal connectivity to existing registries and databases. In partnership with Healthcare IT, Inc, the NROR is building an electronic infrastructure to provide connectivity across radiation oncology and hospital information systems. The data dictionary provides standardized data elements in seven domains: facility characteristics, physician demographics, patient demographics and comorbidity status, radiotherapy technical data for external beam and brachytherapy, hormone therapy details, clinician- and patient-reported outcomes. Up to 30 clinical centers will be selected to serve as pilot sites through an objective, blinded, and transparent process. Pilot registry endpoints include percentage of eligible patients enrolled, percentage of data elements captured for each participant, determination of barriers to participation, and patterns of care delivery. Conclusions: The NROR pilot study will provide the framework for expansion to a nationwide electronic registry for radiation oncology.

Implementation of an electronic patient reported outcome system in a prostate cancer urology clinic.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 143-143
Author(s):  
Maria Spillane ◽  
Phil Pollock ◽  
Lindsay Hedden ◽  
Eugenia Wu ◽  
Larry Goldenberg ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Patient Reported Outcome ◽  
Vancouver General Hospital ◽  
Single Individual ◽  
Clinic Staff ◽  
Training Clinic ◽  
Clinic Appointment ◽  
Patient Reported ◽  
The University ◽  
Urology Clinic

143 Background: The Prostate Clinic at Vancouver General Hospital recently implemented electronic Patient Reported Outcomes (ePRO) collection from prostate cancer patients (pts). The ePRO system was adopted from the University Health Network, Toronto. Our objective was to review the successes and challenges related to the implementation of the system during its first 6 months of use. Methods: All newly diagnosed pts, those going for a prostate biopsy, and pts booking surgery are asked to complete ePRO on iPads at their clinic appointment. The ePRO includes the EPIC-26, EQ-5D-5L, WHODAS 2.0 questionnaires and the Distress Thermometer. It takes about 4-5 minutes to complete the questions, and consent to be contacted about future prostate cancer research is also requested. Afterwards, pts complete ePROs at each clinic appointment. They receive a report summarizing that day’s responses in the context of previous responses. Results: Between 4-1-17 and 10-16-17, 360 pts were eligible to complete the ePRO. 311/360 pts (86.4%) filled out the ePRO at least once. Of the 49 who didn’t, 24 were missed by the coordinator and 21 were not referred by clinic staff. Only 4 pts (8.2%) refused to answer the ePRO. 18 of the 311 pts only partially answered the ePRO, most often due to the length of the questionnaires. 396 instances of ePRO were completed by 311 pts. WiFi connectivity issues were encountered 30/396 times, which prolonged ePRO completion time, and on 3 occasions resulted in patients refusing to complete ePRO. Conclusions: Implementation of the ePRO system into our urology clinic is a success based on a high completion and low refusal rate, and was organized mainly by a single individual. Challenges include training clinic staff to refer pts to complete ePROs at appropriate times, technical difficulties with WiFi connectivity, and the need to interact with each pt individually, which can be time consuming and result in lost data. Eventually, all pts will be trained to pick up an iPad and complete ePROs prior to each appointment. We found the system straightforward to use, and have updated our iPads with additional questionnaires. It is clear that systems collecting ePROs will become standard practice as technology improves and costs go down.

AR Copy Number and AR Signaling-directed Therapies in Castrationresistant Prostate Cancer

2018 ◽  
Vol 18 (9) ◽  
pp. 869-876
Author(s):  
Samanta Salvi ◽  
Vincenza Conteduca ◽  
Cristian Lolli ◽  
Sara Testoni ◽  
Valentina Casadio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Copy Number ◽  
Clinical Trial Design ◽  
Complete Information ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Anti Cancer ◽  
Hormone Sensitive ◽  
Predictive And Prognostic Biomarker

Background: Adaptive upregulation of Androgen Receptor (AR) is the most common event involved in the progression from hormone sensitive to Castration-Resistant Prostate Cancer (CRPC). AR signaling remains the main target of new AR signalling-directed therapies such as abiraterone and enzalutamide in CRPC patients. Objective: In this review, we discuss general mechanisms of resistance to AR-targeted therapies, with a focus on the role of AR Copy Number (CN). We reported methods and clinical applications of AR CN evaluation in tissue and liquid biopsy, thus to have a complete information regarding its role as predictive and prognostic biomarker. Conclusion: Outcomes of CRPC patients are reported to be highly variable as the consequence of tumor heterogeneity. AR CN could contribute to patient selection and tumor monitoring in CRPC treated with new anti-cancer treatment as abiraterone and enzalutamide. Further studies to investigate AR CN effect to these agents and its potential combination with other prognostic or predictive clinical factors are necessary in the context of harmonized clinical trial design.

scholarly journals Physicists and Astronomers Use Google as a Starting Point for Specific Queries, but Do Not Intentionally Use It to Search for Articles

2011 ◽  
Vol 6 (1) ◽  
pp. 81
Author(s):  
Laura Newton Miller
Keyword(s):  
Search Engine ◽  
Information Seeking ◽  
Critical Incident ◽  
Online Survey ◽  
Daily Basis ◽  
Specific Information ◽  
Information Seeking Behaviour ◽  
Starting Point ◽  
General Search ◽  
Information Event

A Review of: Jamali, H. R., & Asadi, S. (2010). Google and the scholar: The role of Google in scientists' information seeking behaviour. Online Information Review, 34(2), 282-294. Objective – To determine how Google’s general search engine impacts the information-seeking behaviour of physicists and astronomers. Design – Using purposive stratified non-random sampling, a mixed-methods study was conducted which included one-on-one interviews, information-event cards, and an online questionnaire survey. Setting – Department of Physics and Astronomy at University College London. Subjects – The researchers interviewed 26 PhD students and 30 faculty members (23% of the department’s 242 faculty and students), and 24 of those participants completed information-event cards. A total of 114 respondents (47.1% of the department members) participated in the online survey. Methods – The researchers conducted 56 interviews which lasted an average of 44 minutes each. These were digitally recorded, fully transcribed, and coded. The researchers asked questions related to information-seeking behaviour and scholarly communication. Four information-event cards were given to volunteer interviewees to gather critical incident information on their first four information-seeking actions after the interview. These were to be completed preferably within the first week of receiving the cards, with 82 cards completed by 24 participants. Once initial analysis of the interviews was completed, the researchers sent an online survey to the members of the same department. Main Results – This particular paper examined only the results related to the scholars’ information-seeking behaviour in terms of search engines and web searching. Details of further results are examined in Jamali (2008) and Jamali and Nicholas (2008). The authors reported that 18% of the respondents used Google on a daily basis to identify articles. They also found that 11% searched subject databases, and 9% searched e-journal websites on a daily basis. When responses on daily searching were combined with those from participants who searched two to three times per week, the most popular method for finding research was by tracking references at the end of an article (61%). This was followed by Google (58%) and ToC email alerts (35%). Responses showed that 46% never used Google Scholar to discover research articles. When asked if they intentionally searched Google to find articles, all except two participants answered that they do not, instead using specific databases to find research. The researchers noted that finding articles in Google was not the original intention of participants’ searches, but more of a by-product of Google searching. In the information-event card study, two categories emerged based on the kinds of information required. This included participants looking for general information on a specific topic (64%, with 22 cases finding this information successfully), and participants knowing exactly what piece of information they were seeking (36%, with 28 cases finding information successfully). There was no occurrence of using Google specifically to conduct a literature search or to search for a paper during this information-event card study, although the researchers say that Google is progressively showing more scholarly information within its search results. (This cannot be ascertained from these specific results except for one response from an interviewee.) The researchers found that 29.4% of respondents used Google to find specific pieces of information, although it was not necessarily scholarly. Conclusion – Physics and astronomy researchers do not intentionally use Google’s general search engine to search for articles, but, Google seems to be a good starting point for problem-specific information queries.

scholarly journals Phase II study of stereotactic body radiotherapy with hydrogel spacer for prostate cancer: acute toxicity and propensity score-matched comparison

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mami Ogita ◽  
Hideomi Yamashita ◽  
Yuki Nozawa ◽  
Sho Ozaki ◽  
Subaru Sawayanagi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Propensity Score ◽  
Acute Toxicity ◽  
Phase Ii ◽  
Stereotactic Body Radiotherapy ◽  
Phase Ii Study ◽  
Summary Score ◽  
Trial Registration ◽  
Gu Toxicity ◽  
Patient Reported

Abstract Background The efficacy of a hydrogel spacer in stereotactic body radiotherapy (SBRT) has not been clarified. We evaluated the safety and efficacy of SBRT in combination with a hydrogel spacer for prostate cancer. Methods This is a prospective single-center, single-arm phase II study. Prostate cancer patients without lymph node or distant metastasis were eligible. All patients received a hydrogel spacer insertion, followed by SBRT of 36.25 Gy in 5 fractions with volumetric modulated arc therapy. The primary endpoint was physician-assessed acute gastrointestinal (GI) toxicity within 3 months. The secondary endpoints were physician-assessed acute genitourinary (GU) toxicity, patient-reported outcomes evaluated by the EPIC and FACT-P questionnaires, and dosimetric comparison. We used propensity score-matched analyses to compare patients with the hydrogel spacer with those without the spacer. The historical data of the control without a hydrogel spacer was obtained from our hospital’s electronic records. Results Forty patients were enrolled between February 2017 and July 2018. A hydrogel spacer significantly reduced the dose to the rectum. Grade 2 acute GI and GU toxicity occurred in seven (18%) and 17 (44%) patients. The EPIC bowel and urinary summary score declined from the baseline to the first month (P < 0.01, < 0.01), yet it was still significantly lower in the third month (P < 0.01, P = 0.04). For propensity score-matched analyses, no significant differences in acute GI and GU toxicity were observed between the two groups. The EPIC bowel summary score was significantly better in the spacer group at 1 month (82.2 in the spacer group and 68.5 in the control group). Conclusions SBRT with a hydrogel spacer had the dosimetric benefits of reducing the rectal doses. The use of the hydrogel spacer did not reduce physician-assessed acute toxicity, but it improved patient-reported acute bowel toxicity. Trial registration: Trial registration: UMIN-CTR, UMIN000026213. Registered 19 February 2017, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029385.

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