Evidence map›Paper›PMID 28471976›Full record

SynthesisMedicine2017

Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: A systematic review and meta-analysis (PRISMA Compliant).

Ravishankar Jayadevappa, Sumedha Chhatre, Yu-Ning Wong, Marsha N Wittink, Ratna Cook, Knashawn H Morales, Neha Vapiwala, Diane K Newman, Thomas Guzzo, Alan J Wein and 4 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
19.8field-weighted citation impact, top 1% 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

11 citing papers in PubMed, 20 citations in OpenAlex.

  1. Trial
  2. The British journal of radiology · 2019
    Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Bloom Syndrome Protein Activates AKT and PRAS40 in Prostate Cancer Cells.Oxidative medicine and cellular longevity · 2019
    Article
  9. Review
  10. Article
  11. Article
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

14 authors at 4 institutions in 1 country.

Ravishankar JayadevappaDepartment of Medicine Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania Corporal Michael J. Crescenz VAMC Leonard Davis Institute of Health Economics Abramson Cancer Center Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania Fox Chase Cancer Center, Temple University, Philadelphia, PA Department of Psychiatry, University of Rochester Medical Center, NY Department of Biostatistics and Epidemiology, Perelman School of Medicine Department of Radiation Oncology Health Care Management Department, Wharton School of Business, University of Pennsylvania, Philadelphia, PA General Internal Medicine, Johns Hopkins University School of Medicine, and Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Sumedha Chhatre
Yu-Ning Wong
Marsha N Wittink
Ratna Cook
Knashawn H Morales
Neha Vapiwala
Diane K Newman
Thomas Guzzo
Alan J Wein
Stanley B Malkowicz
David I Lee
Jerome S Schwartz
Joseph J Gallo
University of Pennsylvania · USAbramson Cancer CenterFox Chase Cancer Center · USUniversity of Rochester Medical Center · US

Funding

Provider Characteristics and Quality of Prostate Cancer CareR01HS024106 · AHRQ · UNIVERSITY OF PENNSYLVANIA · PI JAYADEVAPPA, RAVISHANKAR · 2015 to 2018
$923k
AHRQ HHS R01 HS024106
6 · The paper itself

Abstract

backgroundIn the context of prostate cancer (PCa) characterized by the multiple alternative treatment strategies, comparative effectiveness analysis is essential for informed decision-making. We analyzed the comparative effectiveness of PCa treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients.

methodsWe performed a systematic review of literature published in English from 1995 to October 2016. A search strategy was employed using terms "prostate cancer," "localized," "outcomes," "mortality," "health related quality of life," and "complications" to identify relevant randomized controlled trials (RCTs), prospective, and retrospective studies. For observational studies, only those adjusting for selection bias using propensity-score or instrumental-variables approaches were included. Multivariable adjusted hazard ratio was used to assess all-cause and disease-specific mortality. Funnel plots were used to assess the level of bias.

resultsOur search strategy yielded 58 articles, of which 29 were RCTs, 6 were prospective studies, and 23 were retrospective studies. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting (all-cause HR = 0.63 CI = 0.45, 0.87; disease-specific HR = 0.48 CI = 0.40, 0.58), and radiation therapy (all-cause HR = 0.65 CI = 0.57, 0.74; disease-specific HR = 0.51 CI = 0.40, 0.65). However, we had minimal comparative information about tradeoffs between and within treatment for other patient-centered outcomes in the short and long-term.

conclusionLack of patient-centered outcomes in comparative effectiveness research in localized PCa is a major hurdle to informed and shared decision-making. More rigorous studies that can integrate patient-centered and intermediate outcomes in addition to mortality are needed.

Indexed as

Comparative Effectiveness ResearchHumansMalePatient Outcome AssessmentProstatic Neoplasms

Identifiers

PMID28471976
PMCPMC5419922
OpenAlexW2610909234

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.