Defining a standard set of patient-centered outcomes for men with localized prostate cancer

Neil E. Martin, Laura Massey, Caleb Stowell, Chris Bangma, Alberto Briganti, Anna Bill-Axelson, Michael Blute, James Catto, Ronald C. Chen, Anthony V. D'Amico, Günter Feick, John M. Fitzpatrick, Steven J. Frank, Michael Froehner, Mark Frydenberg, Adam Glaser, Markus Graefen, Daniel Hamstra, Adam Kibel, Nancy MendenhallKim Moretti, Jacob Ramon, Ian Roos, Howard Sandler, Francis J. Sullivan, David Swanson, Ashutosh Tewari, Andrew Vickers, Thomas Wiegel, Hartwig Huland

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Background Value-based health care has been proposed as a unifying force to drive improved outcomes and cost containment. Objective To develop a standard set of multidimensional patient-centered health outcomes for tracking, comparing, and improving localized prostate cancer (PCa) treatment value. Design, setting, and participants We convened an international working group of patients, registry experts, urologists, and radiation oncologists to review existing data and practices. Outcome measurements and statistical analysis The group defined a recommended standard set representing who should be tracked, what should be measured and at what time points, and what data are necessary to make meaningful comparisons. Using a modified Delphi method over a series of teleconferences, the group reached consensus for the Standard Set. Results and limitations We recommend that the Standard Set apply to men with newly diagnosed localized PCa treated with active surveillance, surgery, radiation, or other methods. The Standard Set includes acute toxicities occurring within 6 mo of treatment as well as patient-reported outcomes tracked regularly out to 10 yr. Patient-reported domains of urinary incontinence and irritation, bowel symptoms, sexual symptoms, and hormonal symptoms are included, and the recommended measurement tool is the Expanded Prostate Cancer Index Composite Short Form. Disease control outcomes include overall, cause-specific, metastasis-free, and biochemical relapse-free survival. Baseline clinical, pathologic, and comorbidity information is included to improve the interpretability of comparisons. Conclusions We have defined a simple, easily implemented set of outcomes that we believe should be measured in all men with localized PCa as a crucial first step in improving the value of care. Patient summary Measuring, reporting, and comparing identical outcomes across treatments and treatment centers will provide patients and providers with information to make informed treatment decisions. We defined a set of outcomes that we recommend being tracked for every man being treated for localized prostate cancer.

Original languageEnglish
Pages (from-to)460-467
Number of pages8
JournalEuropean Urology
Volume67
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015
Externally publishedYes

Keywords

  • Outcome measurement
  • Patient-reported
  • Prostate cancer
  • Value

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    Martin, N. E., Massey, L., Stowell, C., Bangma, C., Briganti, A., Bill-Axelson, A., Blute, M., Catto, J., Chen, R. C., D'Amico, A. V., Feick, G., Fitzpatrick, J. M., Frank, S. J., Froehner, M., Frydenberg, M., Glaser, A., Graefen, M., Hamstra, D., Kibel, A., ... Huland, H. (2015). Defining a standard set of patient-centered outcomes for men with localized prostate cancer. European Urology, 67(3), 460-467. https://doi.org/10.1016/j.eururo.2014.08.075