Evidence map›Paper›PMID 34673273›Full record

ArticleContemporary clinical trials2021

Prostate cancer clinical trial completion: The role of geography.

Kristian D Stensland, Samuel D Kaffenberger, Arvin K George, Todd M Morgan, David C Miller, Simpa S Salami, Rodney L Dunn, Ganesh S Palapattu, Jeffrey S Montgomery, Brent K Hollenbeck and 1 more

Open access · greenAbstract read
In one paragraph

Article in Contemporary clinical trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 22% 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

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Applying implementation frameworks to the clinical trial context.Implementation science communications · 2022
    Article
  7. 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 3 institutions in 1 country.

Kristian D StenslandDepartment of Urology, Dow Division of Health Services Research, University of Michigan, USA; Department of Urology, Division of Urologic Oncology, University of Michigan, USA.
Samuel D KaffenbergerDepartment of Urology, Division of Urologic Oncology, University of Michigan, USA.
Arvin K GeorgeDepartment of Urology, Division of Urologic Oncology, University of Michigan, USA; VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, USA.
Todd M MorganDepartment of Urology, Division of Urologic Oncology, University of Michigan, USA.
David C MillerDepartment of Urology, Dow Division of Health Services Research, University of Michigan, USA; Department of Urology, Division of Urologic Oncology, University of Michigan, USA.
Simpa S SalamiDepartment of Urology, Division of Urologic Oncology, University of Michigan, USA.
Rodney L DunnDepartment of Urology, Dow Division of Health Services Research, University of Michigan, USA.
Ganesh S PalapattuDepartment of Urology, Division of Urologic Oncology, University of Michigan, USA.
Jeffrey S MontgomeryDepartment of Urology, Division of Urologic Oncology, University of Michigan, USA.
Brent K HollenbeckDepartment of Urology, Dow Division of Health Services Research, University of Michigan, USA; Department of Urology, Division of Urologic Oncology, University of Michigan, USA.
Ted A SkolarusDepartment of Urology, Dow Division of Health Services Research, University of Michigan, USA; Department of Urology, Division of Urologic Oncology, University of Michigan, USA; VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, USA. Electronic address: tskolar@med.umich.edu.
University of Michigan–Ann Arbor · USVA Center for Clinical Management Research · USMichigan Medicine · US

Funding

De-implementation of low value castration for men with prostate cancerR37CA222885 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SAINI, SAMEER DEV, SKOLARUS, TED ALBERT · 2018 to 2023
$3.6M
Advanced Training in Urologic OncologyT32CA180984 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu, VAHAKN B SHAHINIAN · 2014 to 2026
$3.4M
Refining castration use for recurrent prostate cancerR01CA242559 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SKOLARUS, TED ALBERT, TSODIKOV, ALEXANDER · 2020 to 2023
$1.4M
Building capacity for clinical trial improvement through implementation scienceF32CA264874 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI STENSLAND, KRISTIAN DONALD · 2021 to 2021
$84k
NCI NIH HHS F32 CA264874NCI NIH HHS R01 CA242559NCI NIH HHS R37 CA222885NCI NIH HHS T32 CA180984
6 · The paper itself

Abstract

BACKGROUND/

aimsOne in five cancer clinical trials fails with another third failing to meet enrollment goals. Prior efforts to improve enrollment focus on patient facing interventions, but geographic factors such as regional cancer incidence may doom trials before they even begin. For these reasons, we examined associations of regional prostate cancer incidence with trial termination, and identified scientifically-underserved areas where future trials might thrive.

methodsWe merged US phase 2-3 prostate cancer clinical trial data from ClinicalTrials.gov with prostate cancer incidence data from statecancerprofiles.cancer.gov. We matched trial information from 293 closed and 560 active trials with incidence data for 2947 counties. Using multivariable logistic regression, we identified associations with trial termination. We identified 'scientifically-underserved' counties with the highest cancer incidence quintile (>61 annual cases) but lowest active trials quintile (0 or 1 trial).

resultsOf 293 closed trials, one in three was terminated (n = 96, 32.8%). On multivariable analysis, only lower regional prostate cancer incidence was associated with higher likelihood of premature trial termination (OR 0.98, 95% CI [0.96-0.99] for every 100 cases, p = 0.03). We identified 188 counties with >61 annual prostate cancer cases but 0 or 1 active trials, indicating potential scientifically-underserved areas.

conclusionsIn this novel study, we found prostate cancer trials in areas with low prostate cancer incidence were more likely to fail. We also identified scientifically-underserved areas where trials might thrive. Our findings provide a more nuanced understanding of clinical trial feasibility and upstream opportunities for improvement.

Indexed as

Prostatic NeoplasmsGeographyHumansIncidenceLogistic ModelsMaleAccess to careClinical trialsProstate cancerQuality improvement

Identifiers

PMID34673273
PMCPMC8908357
OpenAlexW3206828908

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.