Observational studyPloS one2023
Prediction models of incontinence and sexual function one year after radical prostatectomy based on data from 20 164 prostate cancer patients.
Observational study in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Multimodal artificial intelligence in urologic precision oncology: from algorithm to translational medicine (a systemized narrative review).Frontiers in oncology · 2026Review
- Review
- Short-Term Urinary Incontinence After Radical Prostatectomy Is Still Based on Patients' Age, Nerve-Sparing Approach, and Surgical-Experience, Despite the Higher-Use of Robotic Surgery in 2022 Compared to 2016 Real-World Results of a Large Rehabilitation Center in Germany.Cancer reports (Hoboken, N.J.) · 2024Article
- Value-Based Health Care for Prostate Cancer Centers by Implementing Specific Key Performance Indicators Using a Balanced Score Card.Healthcare (Basel, Switzerland) · 2024Article
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Authors and funding
37 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool.
methodsObservational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80-20 splitting of the data set and 10-fold cross validation. To assess performance, R2, RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models.
resultsFor model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R2 = 0.12, RMSE = 25.40, sexual function: R2 = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/.
conclusionThe final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients.
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