A national survey of radiation oncologists and urologists on prediction tools and nomograms for localized prostate cancer

Boris Gershman, Paul Maroni, Jon C. Tilburt, Robert J. Volk, Badrinath R Konety, Charles L. Bennett, Alexander Kutikov, Marc C. Smaldone, Victor Chen, Simon P. Kim

Research output: Contribution to journalArticle

Abstract

Purpose: Although prediction tools for prostate cancer (PCa) are essential for high-quality treatment decision-making, little is known about the degree of confidence in existing tools and whether they are used in clinical practice from radiation oncologists (RO) and urologists (URO). Herein, we performed a national survey of specialists about perceived attitudes and use of prediction tools. Methods: In 2017, we invited 940 URO and 911 RO in a national survey to query their confidence in and use of the D’Amico criteria, Kattan Nomogram, and CAPRA score. The statistical analysis involved bivariate association and multivariable logistic regression analyses to identify physician characteristics (age, gender, race, practice affiliation, specialty, access to robotic surgery, ownership of linear accelerator and number of prostate cancer per week) associated with survey responses and use of active surveillance (AS) for low-risk PCa. Results: Overall, 691 (37.3%) specialists completed the surveys. Two-thirds (range 65.6–68.4%) of respondents reported being “somewhat confident”, but only a fifth selected “very confident” for each prediction tool (18.0–20.1%). 19.1% of specialists in the survey reported not using any prediction tools in clinical practice, which was higher amongst URO than RO (23.9 vs. 13.4%; p < 0.001). Respondents who reported not using prediction tools were also associated with low utilization of AS in their low-risk PCa patients (adjusted OR 2.47; p = 0.01). Conclusions: While a majority of RO and URO view existing prediction tools for localized PCa with some degree of confidence, a fifth of specialists reported not using any such tools in clinical practice. Lack of using such tools was associated with low utilization of AS for low-risk PCa.

LanguageEnglish (US)
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Jan 1 2019

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Nomograms
Prostatic Neoplasms
Particle Accelerators
Ownership
Robotics
Surveys and Questionnaires
Radiation Oncologists
Urologists
Decision Making
Logistic Models
Regression Analysis
Physicians

Keywords

  • Active surveillance
  • Decision aids
  • National survey
  • Prostate cancer
  • Shared decision-making

Cite this

A national survey of radiation oncologists and urologists on prediction tools and nomograms for localized prostate cancer. / Gershman, Boris; Maroni, Paul; Tilburt, Jon C.; Volk, Robert J.; Konety, Badrinath R; Bennett, Charles L.; Kutikov, Alexander; Smaldone, Marc C.; Chen, Victor; Kim, Simon P.

In: World Journal of Urology, 01.01.2019.

Research output: Contribution to journalArticle

Gershman, Boris ; Maroni, Paul ; Tilburt, Jon C. ; Volk, Robert J. ; Konety, Badrinath R ; Bennett, Charles L. ; Kutikov, Alexander ; Smaldone, Marc C. ; Chen, Victor ; Kim, Simon P. / A national survey of radiation oncologists and urologists on prediction tools and nomograms for localized prostate cancer. In: World Journal of Urology. 2019.
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abstract = "Purpose: Although prediction tools for prostate cancer (PCa) are essential for high-quality treatment decision-making, little is known about the degree of confidence in existing tools and whether they are used in clinical practice from radiation oncologists (RO) and urologists (URO). Herein, we performed a national survey of specialists about perceived attitudes and use of prediction tools. Methods: In 2017, we invited 940 URO and 911 RO in a national survey to query their confidence in and use of the D’Amico criteria, Kattan Nomogram, and CAPRA score. The statistical analysis involved bivariate association and multivariable logistic regression analyses to identify physician characteristics (age, gender, race, practice affiliation, specialty, access to robotic surgery, ownership of linear accelerator and number of prostate cancer per week) associated with survey responses and use of active surveillance (AS) for low-risk PCa. Results: Overall, 691 (37.3{\%}) specialists completed the surveys. Two-thirds (range 65.6–68.4{\%}) of respondents reported being “somewhat confident”, but only a fifth selected “very confident” for each prediction tool (18.0–20.1{\%}). 19.1{\%} of specialists in the survey reported not using any prediction tools in clinical practice, which was higher amongst URO than RO (23.9 vs. 13.4{\%}; p < 0.001). Respondents who reported not using prediction tools were also associated with low utilization of AS in their low-risk PCa patients (adjusted OR 2.47; p = 0.01). Conclusions: While a majority of RO and URO view existing prediction tools for localized PCa with some degree of confidence, a fifth of specialists reported not using any such tools in clinical practice. Lack of using such tools was associated with low utilization of AS for low-risk PCa.",
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AU - Maroni, Paul

AU - Tilburt, Jon C.

AU - Volk, Robert J.

AU - Konety, Badrinath R

AU - Bennett, Charles L.

AU - Kutikov, Alexander

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AU - Chen, Victor

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