Evidence map›Paper›PMID 38762384›Full record

ArticleUrologic oncology2024

Variation in content discussed by specialty in consultations for clinically localized prostate cancer.

Nadine A Friedrich, Michael Luu, Rebecca Gale, Antwon Chaplin, Leslie Ballas, Howard M Sandler, Edwin M Posadas, Stephen J Freedland, Brennan Spiegel, Paul Kokorowski and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urologic oncology, 2024. 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
–field-weighted citation impact
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.

  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.

Nadine A FriedrichDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Michael LuuBiostatistics and Bioinformatics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Rebecca GaleCedars-Sinai Center for Outcomes. Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Antwon ChaplinCedars-Sinai Center for Outcomes. Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Leslie BallasDepartment of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Howard M SandlerDepartment of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Edwin M PosadasDepartment of Medicine, Division of Hematology and Oncology, Cedars-Sinai Medical Center, Los Angeles , CA, USA.
Stephen J FreedlandDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Surgery, Urology Section, Veterans Affairs Health Care System, Durham, NC, USA; Center for Integrated Research in Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Brennan SpiegelCedars-Sinai Center for Outcomes. Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Pediatrics,Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Paul KokorowskiDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Pediatrics,Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Timothy J DaskivichDepartment of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Cedars-Sinai Center for Outcomes. Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: timothy.daskivich@cshs.org.

Funding

Training in Advanced Heart Disease ResearchT32HL116273 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI Joshua I Goldhaber, EDUARDO MARBAN · 2013 to 2026
$5.6M
A multidisciplinary training program in prostate cancerT32CA240172 · NCI · CEDARS-SINAI MEDICAL CENTER · PI BHOWMICK, NEIL A., FREEDLAND, STEPHEN JAY · 2019 to 2023
$988k
A Patient-Centered Approach to Integration of Life Expectancy into Treatment Decision Making for Patients with Genitourinary MalignancyK08CA230155 · NCI · CEDARS-SINAI MEDICAL CENTER · PI DASKIVICH, TIMOTHY · 2018 to 2022
$909k
NCI NIH HHS K08 CA230155NCI NIH HHS T32 CA240172NHLBI NIH HHS T32 HL116273
6 · The paper itself

Abstract

introductionMultidisciplinary consultations improve decisional conflict and guideline-concordant treatment for men with prostate cancer (PC), but differences in the content discussed by specialty during consultations are unknown.

methodsWe audiorecorded and transcribed 50 treatment consultations for localized PC across a multidisciplinary sample of urologists, radiation oncologists, and medical oncologists. Conversation was coded for narrative content using an open coding approach, grouping similar topics into major content areas. The number of words devoted to each content area per consult was used as a proxy for time spent. Multivariable Poisson regression calculated incidence rate ratios (IRR) for content-specific word count across specialties after adjustment for tumor risk and patient demographics.

resultsCoders identified 8 narrative content areas: overview of PC; medical history; baseline risk; cancer prognosis; competing risks; treatment options; physician recommendations; and shared decision making (SDM). In multivariable models, specialties significantly differed in proportion of time spent on treatment options, SDM, competing risks, and cancer prognosis. Urologists spent 1.8-fold more time discussing cancer prognosis than medical oncologists (IRR1.80, 95%CI:1.14-2.83) and radiation oncologists (IRR1.84, 95%CI:1.10-3.07). Urologists (IRR11.38, 95%CI:6.62-19.56) and medical oncologists (IRR10.60, 95%CI:6.01-18.72) spent over 10-fold more time discussing competing risks than radiation oncologists. Medical oncologists (IRR2.60, 95%CI:1.65-4.10) and radiation oncologists (IRR1.77, 95%CI:1.06-2.95) spent 2.6- and 1.8-fold more time on SDM than urologists, respectively.

conclusionsSpecialists focus on different content in PC consultations. Our results suggest that urologists should spend more time on SDM and radiation oncologists on competing risks. Our results also highlight the importance of medical oncologists in facilitating SDM.

Indexed as

Prostatic NeoplasmsReferral and ConsultationAgedHumansMaleMiddle AgedOncologistsPhysician-Patient RelationsUrologistsUrologyMedical oncologyProstate cancerRadiation oncologyTreatmentUrology

Identifiers

PMID38762384
PMCPMC11193607

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.