Clinical Evaluation of an Individualized Risk Prediction Tool for Men on Active Surveillance for Prostate Cancer - 05/12/18

Doi : 10.1016/j.urology.2018.08.021

Joseph H. Huntley ^a, Rebecca Y. Coley ^b, H. Ballentine Carter ^c, Archana Radhakrishnan ^d, Melinda Krakow ^e, Craig E. Pollack ^a,^⁎
^a Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
^b Kaiser Permanente Washington Health Research Institute, Seattle, WA
^c Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, MD
^d Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI
^e National Cancer Institute, National Institutes of Health, Bethesda, MD

^⁎Address correspondence to: Craig E. Pollack, MD, MHS, Division of General Internal Medicine, Johns Hopkins School of Medicine, 2024 E. Monument Street, Suite 2-519, Baltimore, MD 21287.Division of General Internal Medicine, Johns Hopkins School of Medicine2024 E. Monument Street, Suite 2-519BaltimoreMD21287

Abstract

Objective

To determine whether providing individualized predictions of health outcomes to men on active surveillance (AS) alleviates cancer-related anxiety and improves risk understanding.

Materials and Methods

We consecutively recruited men from our large, institutional AS program before (n = 36) and after (n = 31) implementation of a risk prediction tool. Men in both groups were surveyed before and after their regular visits to assess their perceived cancer control, biopsy-specific anxiety, and burden from cancer-related information. We compared pre-/post-visit differences between men who were and were not shown the tool using two-sample t-tests. Satisfaction with and understanding of the predictions were elicited from men in the intervention period.

Results

Men reported a relatively high level of cancer control at baseline. Men who were not shown the tool saw a 6.3 point increase (scaled from 0 to 100) in their perceived cancer control from before to after their visit whereas men who were shown the tool saw a 12.8 point increase, indicating a statistically significant difference between groups (p = .04). Biopsy-specific anxiety and burden from cancer information were not significantly different between groups. Men were satisfied with the tool and demonstrated moderate understanding.

Conclusion

Providing individualized predictions to men on AS helps them better understand their cancer risk and should be considered at other clinical sites.

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Plan

PATIENTS AND METHODS

Individualized Risk Prediction Tool

Sociodemographic and Clinical Characteristics

Primary and Secondary Outcomes

DISCUSSION

CONCLUSION

	Financial Disclosure: Dr. Pollack reports stock ownership in Gilead Pharmaceuticals.
	Funding Support: This study was supported by funding from the Maryland Cigarette Restitution Fund.

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Vol 121

P. 118-124 - novembre 2018 Retour au numéro

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Clinical Evaluation of an Individualized Risk Prediction Tool for Men on Active Surveillance for Prostate Cancer - 05/12/18

Abstract

Objective

Materials and Methods

Results

Conclusion

Plan

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