Evidence map›Paper›PMID 25712821›Full record

Observational studyBMJ open2015

Evaluating variation in use of definitive therapy and risk-adjusted prostate cancer mortality in England and the USA.

Ashwin Sachdeva, Jan H van der Meulen, Mark Emberton, Paul J Cathcart

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Ashwin SachdevaClinical Effectiveness Unit, Royal College of Surgeons of England, London, UK Division of Surgery and Interventional Science, University College London, London, UK Department of Urology, Freeman Hospital, Newcastle-upon-Tyne, UK.
Jan H van der MeulenClinical Effectiveness Unit, Royal College of Surgeons of England, London, UK London School of Hygiene & Tropical Medicine, London, UK.
Mark EmbertonClinical Effectiveness Unit, Royal College of Surgeons of England, London, UK Division of Surgery and Interventional Science, University College London, London, UK.
Paul J CathcartClinical Effectiveness Unit, Royal College of Surgeons of England, London, UK Division of Surgery and Interventional Science, University College London, London, UK Centre for Experimental Cancer Medicine, Bart's Cancer Institute, Queen Mary University of London, London, UK.
Royal College of Surgeons of England · GBFreeman Hospital · GBQueen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesProstate cancer mortality (PCM) in the USA is among the lowest in the world, whereas PCM in England is among the highest in Europe. This paper aims to assess the association of variation in use of definitive therapy on risk-adjusted PCM in England as compared with the USA.

designObservational study.

settingCancer registry data from England and the USA.

participantsMen diagnosed with non-metastatic prostate cancer (PCa) in England and the USA between 2004 and 2008. OUTCOME MEASURES: Competing-risks survival analyses to estimate subhazard ratios (SHR) of PCM adjusted for age, ethnicity, year of diagnosis, Gleason score (GS) and clinical tumour (cT) stage.

results222,163 men were eligible for inclusion. Compared with American patients, English patients were more likely to present at an older age (70-79 years: England 44.2%, USA 29.3%, p<0.001), with higher tumour stage (cT3-T4: England 25.1%, USA 8.6%, p<0.001) and higher GS (GS 8-10: England 20.7%, USA 11.2%, p<0.001). They were also less likely to receive definitive therapy (England 38%, USA 77%, p<0.001). English patients were more likely to die of PCa (SHR=1.9, 95% CI 1.7 to 2.0, p<0.001). However, this difference was no longer statistically significant when also adjusted for use of definitive therapy (SHR=1.0, 95% CI 1.0 to 1.1, p=0.3).

conclusionsRisk-adjusted PCM is significantly higher in England compared with the USA. This difference may be explained by less frequent use of definitive therapy in England.

Indexed as

AgedAge DistributionAnalysis of VarianceAntineoplastic Agents, HormonalHumansMaleMiddle AgedNeoplasm GradingProstateProstate-Specific AntigenProstatic NeoplasmsRegistriesRisk FactorsSurvival AnalysisUnited KingdomUnited StatesAntineoplastic Agents, HormonalProstate-Specific AntigenAdult oncology < ONCOLOGYHealth policy < HEALTH SERVICES ADMINISTRATION & MANAGEMENTProstate disease < UROLOGYUrological tumours < UROLOGY

Identifiers

PMID25712821
PMCPMC4342590
OpenAlexW2113211998

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.