Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer

S. P. Kim, C. P. Gross, P. Y. Nguyen, M. C. Smaldone, R. H. Thompson, Nilay D Shah, A. Kutikov, L. C. Han, Robert Jeffrey Karnes, J. Y. Ziegenfuss, Jon C Tilburt

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL. Methods: We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson's chi-square and multivariable regression models were used to test for differences in each outcome. Results: Response rates were similar for radiation oncologists (52.6%) and urologists (52.3%; P=0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8-10 (35.2 vs 0.2%; P<0.001) to PSA 4-10 and Gleason score 7 (87.5 vs 20.9%; P<0.001). Radiation oncologists were also more likely to recommend radiation therapy relative to urologists (all P<0.001). From low- to high-risk prostate cancer, radiation oncologists and urologists perceived their treatment as being better for improving survival (all P<0.001). Each specialty also viewed their treatment as having less urinary incontinence (all P<0.001). Conclusions: Radiation oncologists and urologists both prefer the treatment modalities they offer, perceive them to be more effective and to lead to a better QOL. Patients may be receiving biased information, and a truly informed consent process with shared decision-making may be possible only if they are evaluated by both specialties before deciding upon a treatment course.

Original languageEnglish (US)
Pages (from-to)163-169
Number of pages7
JournalProstate Cancer and Prostatic Diseases
Volume17
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Prostatic Neoplasms
Quality of Life
Neoplasm Grading
Therapeutics
Survival
Radiation Oncologists
Urologists
Urinary Incontinence
Informed Consent
Decision Making
Radiotherapy
Physicians
Surveys and Questionnaires

Keywords

  • outcomes
  • quality of life
  • survey
  • treatment recommendations

ASJC Scopus subject areas

  • Oncology
  • Urology
  • Cancer Research
  • Medicine(all)

Cite this

Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer. / Kim, S. P.; Gross, C. P.; Nguyen, P. Y.; Smaldone, M. C.; Thompson, R. H.; Shah, Nilay D; Kutikov, A.; Han, L. C.; Karnes, Robert Jeffrey; Ziegenfuss, J. Y.; Tilburt, Jon C.

In: Prostate Cancer and Prostatic Diseases, Vol. 17, No. 2, 2014, p. 163-169.

Research output: Contribution to journalArticle

Kim, S. P. ; Gross, C. P. ; Nguyen, P. Y. ; Smaldone, M. C. ; Thompson, R. H. ; Shah, Nilay D ; Kutikov, A. ; Han, L. C. ; Karnes, Robert Jeffrey ; Ziegenfuss, J. Y. ; Tilburt, Jon C. / Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer. In: Prostate Cancer and Prostatic Diseases. 2014 ; Vol. 17, No. 2. pp. 163-169.
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abstract = "Background: Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL. Methods: We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson's chi-square and multivariable regression models were used to test for differences in each outcome. Results: Response rates were similar for radiation oncologists (52.6{\%}) and urologists (52.3{\%}; P=0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8-10 (35.2 vs 0.2{\%}; P<0.001) to PSA 4-10 and Gleason score 7 (87.5 vs 20.9{\%}; P<0.001). Radiation oncologists were also more likely to recommend radiation therapy relative to urologists (all P<0.001). From low- to high-risk prostate cancer, radiation oncologists and urologists perceived their treatment as being better for improving survival (all P<0.001). Each specialty also viewed their treatment as having less urinary incontinence (all P<0.001). Conclusions: Radiation oncologists and urologists both prefer the treatment modalities they offer, perceive them to be more effective and to lead to a better QOL. Patients may be receiving biased information, and a truly informed consent process with shared decision-making may be possible only if they are evaluated by both specialties before deciding upon a treatment course.",
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T1 - Specialty bias in treatment recommendations and quality of life among radiation oncologists and urologists for localized prostate cancer

AU - Kim, S. P.

AU - Gross, C. P.

AU - Nguyen, P. Y.

AU - Smaldone, M. C.

AU - Thompson, R. H.

AU - Shah, Nilay D

AU - Kutikov, A.

AU - Han, L. C.

AU - Karnes, Robert Jeffrey

AU - Ziegenfuss, J. Y.

AU - Tilburt, Jon C

PY - 2014

Y1 - 2014

N2 - Background: Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL. Methods: We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson's chi-square and multivariable regression models were used to test for differences in each outcome. Results: Response rates were similar for radiation oncologists (52.6%) and urologists (52.3%; P=0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8-10 (35.2 vs 0.2%; P<0.001) to PSA 4-10 and Gleason score 7 (87.5 vs 20.9%; P<0.001). Radiation oncologists were also more likely to recommend radiation therapy relative to urologists (all P<0.001). From low- to high-risk prostate cancer, radiation oncologists and urologists perceived their treatment as being better for improving survival (all P<0.001). Each specialty also viewed their treatment as having less urinary incontinence (all P<0.001). Conclusions: Radiation oncologists and urologists both prefer the treatment modalities they offer, perceive them to be more effective and to lead to a better QOL. Patients may be receiving biased information, and a truly informed consent process with shared decision-making may be possible only if they are evaluated by both specialties before deciding upon a treatment course.

AB - Background: Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL. Methods: We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson's chi-square and multivariable regression models were used to test for differences in each outcome. Results: Response rates were similar for radiation oncologists (52.6%) and urologists (52.3%; P=0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8-10 (35.2 vs 0.2%; P<0.001) to PSA 4-10 and Gleason score 7 (87.5 vs 20.9%; P<0.001). Radiation oncologists were also more likely to recommend radiation therapy relative to urologists (all P<0.001). From low- to high-risk prostate cancer, radiation oncologists and urologists perceived their treatment as being better for improving survival (all P<0.001). Each specialty also viewed their treatment as having less urinary incontinence (all P<0.001). Conclusions: Radiation oncologists and urologists both prefer the treatment modalities they offer, perceive them to be more effective and to lead to a better QOL. Patients may be receiving biased information, and a truly informed consent process with shared decision-making may be possible only if they are evaluated by both specialties before deciding upon a treatment course.

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