Evidence map›Paper›PMID 39870995›Full record

ArticleJournal of general internal medicine2025

Multi-level Factors to Build Confidence and Support in Active Surveillance for Low-Risk Prostate Cancer: A Qualitative Study.

Jason C Chen, Lalita Subramanian, Ted A Skolarus, Sarah T Hawley, Aaron Rankin, Michael D Fetters, Karla Witzke, Tudor Borza, Archana Radhakrishnan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2025. 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
–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

1 citing paper in PubMed.

  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

9 authors.

Jason C Chen *Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. jasonchn@med.umich.edu.ORCID 0000-0002-0988-766X
Lalita Subramanian *Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Ted A SkolarusDepartment of Surgery, Urology Section, University of Chicago, Chicago, IL, USA.
Sarah T HawleyDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Aaron RankinDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Michael D FettersDepartment of Family Medicine, University of Michigan, Ann Arbor, MI, USA.
Karla WitzkeDepartment of Urology, MyMichigan Health, Midland, MI, USA.
Tudor BorzaDepartment of Urology, University of Michigan, Ann Arbor, MI, USA.
Archana RadhakrishnanDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Funding

Engaging PCPs to optimize active surveillance of low-risk prostate cancerK08CA245237 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI RADHAKRISHNAN, ARCHANA · 2019 to 2023
$1.2M
NCI NIH HHS K08 CA245237NIH HHS K08 CA245237
6 · The paper itself

Abstract

backgroundActive surveillance (AS) is the guideline-recommended treatment for low-risk prostate cancer and involves routine provider visits, lab tests, imaging, and prostate biopsies. Despite good uptake, adherence to AS, in terms of receiving recommended follow-up testing and remaining on AS in the absence of evidence of cancer progression, remains challenging.

objectiveWe sought to better understand urologist, primary care providers (PCPs), and patient experiences with AS care delivery to identify opportunities to improve adherence.

designA qualitative study involving patients, PCPs, and urologists with experience of AS.

participantsPCPs (19), urologists (15), and patients (15) in Michigan. APPROACH: Participants were recruited through a statewide quality improvement collaborative. Semi-structured interviews were conducted virtually from June 2020 to April 2021. The Theoretical Domains Framework and the Behavior Change Wheel's Capability, Opportunity, and Motivation model guided interviews and coding. Thematic analysis was used to identify shared perspectives on AS care delivery.

resultsThree main themes emerged from the PCP, urologist, and patient data collected related to AS care delivery that were needed to improve AS adherence: (1) building patient confidence in AS by leveraging provider roles and expertise and creating connection through communication across the care team and with patients; (2) building confidence in AS through psychosocial support by involving families and peers, and addressing anxiety and uncertainty; (3) building AS support within healthcare processes and electronic health record systems.

conclusionThese themes reflect opportunities for interventions at the care team, community (family and peers), and health system levels that could better support individualized care and overcome challenges to AS adherence through team-based approaches.

Indexed as

Prostatic NeoplasmsWatchful WaitingAgedHumansMaleMichiganMiddle AgedQualitative Researchactive surveillanceprostate cancerqualitative research

Identifiers

PMID39870995
PMCPMC11968603

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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.