Evidence map›Paper›PMID 29477313›Full record

ArticleUrology2018

Which Patients Report That Their Urologists Advised Them to Forgo Initial Treatment for Prostate Cancer?

Archana Radhakrishnan, David Grande, Nandita Mitra, Craig Evan Pollack

Open access · greenAbstract read
In one paragraph

Article in Urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 36% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. 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.

Archana RadhakrishnanDivision of General Medicine, University of Michigan, Ann Arbor, MI. Electronic address: arra@med.umich.edu.
David GrandeDivision of General Internal Medicine, University of Pennsylvania, Philadelphia, PA.
Nandita MitraDepartment of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA.
Craig Evan PollackDivision of General Internal Medicine, Johns Hopkins University, Baltimore, MD; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
University of Pennsylvania · USJohns Hopkins University · USUniversity of Michigan · US

Funding

BEHAVIORAL RESEARCH IN HEART &VASCULAR DISEASET32HL007180 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI MARUTHUR, NISA M · 1985 to 2020
$11.4M
Research Traiing/Education CoreP60MD006900 · NIMHD · UNIVERSITY OF PENNSYLVANIA · PI ARMSTRONG, KATRINA · 2012 to 2016
$6.6M
A Network Analytic Approach to Modeling Variation in Prostate Cancer CareK07CA151910 · NCI · JOHNS HOPKINS UNIVERSITY · PI POLLACK, CRAIG EVAN · 2011 to 2015
$780k
NCI NIH HHS K07 CA151910NHLBI NIH HHS T32 HL007180NIMHD NIH HHS P60 MD006900
6 · The paper itself

Abstract

objectiveTo examine how frequently patients report that their urologist recommended forgoing definitive treatment and assess the impact of these recommendations on treatment choice and perceived quality of cancer care.

methodsWe mailed surveys to men newly diagnosed with localized prostate cancer between 2014 and 2015 (adjusted response rate of 51.3%). Men reported whether their urologist recommended forgoing definitive treatment. Using logistic regression models, we assessed patient-level predictors of receiving a recommendation to forgo definitive treatment and estimated associations of receiving this recommendation with receipt of definitive treatment and perceived quality of cancer care among men with low-risk tumors and limited life expectancies.

resultsNearly two-thirds (62.2%) of men with low-risk tumors and 46.4% with limited life expectancies received recommendations from their urologists to forgo definitive treatment. Among men with limited life expectancies, those with low-risk tumors were more likely to receive this recommendation compared with men with high-risk tumors (odds ratio [OR] 3.41; 95% confidence interval [CI] 2.17-5.37). Men with low-risk tumors who were recommended to forgo definitive treatment were less likely to receive definitive treatment (OR 0.48; 95% CI 0.32-0.73) but did not report lower perceived quality of care (OR 0.97; 95% CI 0.63-1.48).

conclusionIn this population-based study, a majority of men with low-risk prostate cancer report receiving recommendations from their urologists to forgo definitive treatment. Our results suggest that urologists have a strong influence on patient treatment choice and could increase active surveillance uptake in men eligible for expectant management without patients perceiving lower quality of cancer care.

Indexed as

Directive CounselingLife ExpectancyQuality of Health CareWatchful WaitingAgedHealth Care SurveysHumansMaleMiddle AgedNeoplasm GradingProstatic NeoplasmsRisk FactorsUrology

Identifiers

PMID29477313
PMCPMC5960608
OpenAlexW2794780315

What OpenQuestion holds

Textmetadata
LicenceTDM
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.