Evidence map›Paper›PMID 33541309›Full record

ArticleBMC urology2021

A modified Delphi study to develop a practical guide for selecting patients with prostate cancer for active surveillance.

Samuel W D Merriel, Daniel Moon, Phil Dundee, Niall Corcoran, Peter Carroll, Alan Partin, Joseph A Smith, Freddie Hamdy, Caroline Moore, Piet Ost and 1 more

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

Article in BMC urology, 2021. 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
0.6field-weighted citation impact, top 33% 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, 5 citations in OpenAlex.

  1. Article
  2. 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

11 authors at 9 institutions in 4 countries.

Samuel W D MerrielCollege of Medicine and Health, University of Exeter, 1.18 College House, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK. s.w.d.merriel@exeter.ac.uk.
Daniel MoonDepartment of Surgery, University of Melbourne, Melbourne, Australia.
Phil DundeeDepartment of Urology, Royal Melbourne Hospital, Melbourne, Australia.
Niall CorcoranDepartment of Urology, Royal Melbourne Hospital, Melbourne, Australia.
Peter CarrollDepartment of Urology, University of California San Francisco, San Francisco, USA.
Alan PartinJames Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, USA.
Joseph A SmithDepartment of Urologic Surgery, Vanderbilt University, Nashville, USA.
Freddie HamdyNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Caroline MooreDivision of Surgery and Interventional Medicine, University College London, London, UK.
Piet OstRadiation Oncology, Ghent University Hospital, Ghent, Belgium.
Tony CostelloDepartment of Surgery, University of Melbourne, Melbourne, Australia.
The Royal Melbourne Hospital · AUGhent University Hospital · BEJohns Hopkins University · USUniversity College London · GBUniversity of California, San Francisco · USUniversity of Exeter · GBUniversity of Melbourne · AUUniversity of Oxford · GBVanderbilt University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundActive surveillance (AS) is a management option for men diagnosed with lower risk prostate cancer. There is wide variation in all aspects of AS internationally, from patient selection to investigations and follow-up intervals, and a lack of clear evidence on the optimal approach to AS. This study aimed to provide guidance for clinicians from an international panel of prostate cancer experts.

methodsA modified Delphi approach was undertaken, utilising two rounds of online questionnaires followed by a face-to-face workshop. Participants indicated their level of agreement with statements relating to patient selection for AS via online questionnaires on a 7-point Likert scale. Factors not achieving agreement were iteratively developed between the two rounds of questionnaires. Draft statements were presented at the face-to-face workshop for discussion and consensus building.

results12 prostate cancer experts (9 urologists, 2 academics, 1 radiation oncologist) participated in this study from a range of geographical regions (4 USA, 4 Europe, 4 Australia). Complete agreement on statements presented to the participants was 29.4% after Round One and 69.0% after Round Two. Following robust discussions at the face-to-face workshop, agreement was reached on the remaining statements. PSA, PSA density, Multiparametric MRI, and systematic biopsy (with or without targeted biopsy) were identified as minimum diagnostic tests required upon which to select patients to recommend AS as a treatment option for prostate cancer. Patient factors and clinical parameters that identified patients appropriate to potentially receive AS were agreed. Genetic and genomic testing was not recommended for use in clinical decision-making regarding AS.

conclusionsThe lack of consistency in the practice of AS for men with lower risk prostate cancer between and within countries was reflected in this modified Delphi study. There are, however, areas of common practice and agreement from which clinicians practicing in the current environment can use to inform their clinical practice to achieve the best outcomes for patients.

Indexed as

Delphi TechniquePatient SelectionWatchful WaitingHumansMaleMiddle AgedProstatic NeoplasmsActive surveillanceCancer treatment protocolsPatient selectionProstate cancer

Identifiers

PMID33541309
PMCPMC7863517
OpenAlexW3124118501

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.