PURPOSE: Although clinical guidelines recommend assessing quality of life (QOL), cancer aggressiveness, and life expectancy for localized prostate cancer (PC) treatment decisions, it is unknown whether instruments that objectively measure such outcomes have disseminated into clinical practice.
In this context, we sought to determine whether QOL and prediction instruments for PC have been adopted by radiation oncologists and urologists in the U.S.
METHODS: From a nationally representative mail survey of 1,422 PC specialists in the U.S., we queried about self-reported clinical implementation of QOL instruments, PC nomograms, and life expectancy prediction tools in late 2011. Pearson's chi-square test and multivariate logistic regression tested for differences in the use of each instrument by physician characteristics.
RESULTS: Overall, 313 radiation oncologists and 328 urologists completed the survey for a response rate of 45%. Although 55% of respondents reported using PC nomograms, only 27% and 23% reported using QOL and life expectancy prediction instruments, respectively. On multivariable analysis, urologists were less likely to use QOL instruments compared with radiation oncologists (OR: 0.40; p< 0.001). Physicians spending ≥ 30 minutes counseling patients were consistently more likely to use QOL instruments (OR: 2.57; p< 0.001), PC nomograms (OR: 1.83; p=0.009) and life expectancy prediction tools (OR: 1.85; p=0.02) compared with those spending < 15 minutes.
CONCLUSIONS: Although PC nomograms have been implemented into clinical practice to some degree, utilization of QOL and life expectancy tools has been more limited. Increased attention to implementing validated instruments into clinical practice may facilitate shared decision-making for PC patients.
Written by:
Kim SP, Karnes RJ, Nguyen PL, Ziegenfuss JY, Han LC, Thompson RH, Trinh QD, Sun M, Boorjian SA, Beebe TJ, Tilburt JC. Are you the author?
Mayo Clinic, Department of Urology, Rochester, Minnesota.
Reference: J Urol. 2012 Dec 3. pii: S0022-5347(12)05806-5.
doi: 10.1016/j.juro.2012.11.174
PubMed Abstract
PMID: 23219546
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