Variation in prostate cancer detection rates in a statewide quality improvement collaborative.
Identifieur interne : 000F20 ( Main/Exploration ); précédent : 000F19; suivant : 000F21Variation in prostate cancer detection rates in a statewide quality improvement collaborative.
Auteurs : Christopher B. Riedinger [États-Unis] ; Paul R. Womble [États-Unis] ; Susan M. Linsell [États-Unis] ; Zaojun Ye [États-Unis] ; James E. Montie [États-Unis] ; David C. Miller [États-Unis] ; Brian R. Lane [États-Unis]Source :
- The Journal of urology [ 1527-3792 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Tumeurs de la prostate.
- statistiques et données numériques : Biopsie.
- épidémiologie : Tumeurs de la prostate.
- Adulte d'âge moyen, Amélioration de la qualité, Humains, Mâle, Sujet âgé, Types de pratiques des médecins, Urologie.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Prostatic Neoplasms.
- pathology : Prostatic Neoplasms.
- statistics & numerical data : Biopsy.
- Aged, Humans, Male, Middle Aged, Practice Patterns, Physicians', Quality Improvement, Urology.
Abstract
PURPOSE
There remains significant controversy surrounding the optimal criteria for recommending prostate biopsy. To examine this issue further urologists in MUSIC assessed statewide prostate biopsy practice patterns and variation in prostate cancer detection.
MATERIALS AND METHODS
MUSIC is a statewide, physician led collaborative designed to improve prostate cancer care. From March 2012 through June 2013 at 17 MUSIC practices standardized clinical and pathological data were collected on a total of 3,015 men undergoing first-time prostate biopsy. We examined pathological biopsy outcomes according to patient characteristics and across MUSIC practices.
RESULTS
The average cancer detection rate was 52% with significant variability across MUSIC practices (range 43% to 70%, p<0.0001). Of all patients biopsied 27% were older than 69 years, ranging from 19% to 36% at individual practices. Men with prostate specific antigen less than 4 ng/ml comprised an average of 26% of the study population (range 10% to 37%). The detection rate in patients older than 69 years ranged from 42% to 86% at individual practices (p=0.0008). In the 793 patients with prostate specific antigen less than 4 ng/ml the cancer detection rate ranged from 22% to 58% across individual practices (p=0.0065). The predicted probability of cancer detection varied significantly across MUSIC practices even after adjusting for patient age, prostate specific antigen, prostate size, family history and digital rectal examination findings (p<0.0001).
CONCLUSIONS
While overall detection rates are higher than previously reported, the cancer yield of prostate biopsy varies widely across urology practices in Michigan. These data serve as a foundation for our efforts to understand and improve patient selection for prostate biopsy.
DOI: 10.1016/j.juro.2014.02.088
PubMed: 24582538
Affiliations:
Links toward previous steps (curation, corpus...)
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Womble</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Department of Urology, University of Michigan Medical School, Ann Arbor</wicri:cityArea></affiliation></author><author><name sortKey="Linsell, Susan M" sort="Linsell, Susan M" uniqKey="Linsell S" first="Susan M" last="Linsell">Susan M. 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Montie</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Department of Urology, University of Michigan Medical School, Ann Arbor</wicri:cityArea></affiliation></author><author><name sortKey="Miller, David C" sort="Miller, David C" uniqKey="Miller D" first="David C" last="Miller">David C. Miller</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Department of Urology, University of Michigan Medical School, Ann Arbor</wicri:cityArea></affiliation></author><author><name sortKey="Lane, Brian R" sort="Lane, Brian R" uniqKey="Lane B" first="Brian R" last="Lane">Brian R. Lane</name><affiliation wicri:level="2"><nlm:affiliation>Spectrum Health Hospital System, Grand Rapids, Michigan. Electronic address: brian.lane@spectrumhealth.org.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Spectrum Health Hospital System, Grand Rapids</wicri:cityArea></affiliation></author></analytic><series><title level="j">The Journal of urology</title><idno type="eISSN">1527-3792</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Biopsy (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Practice Patterns, Physicians' (MeSH)</term><term>Prostatic Neoplasms (epidemiology)</term><term>Prostatic Neoplasms (pathology)</term><term>Quality Improvement (MeSH)</term><term>Urology (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Amélioration de la qualité (MeSH)</term><term>Biopsie (statistiques et données numériques)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Tumeurs de la prostate (anatomopathologie)</term><term>Tumeurs de la prostate (épidémiologie)</term><term>Types de pratiques des médecins (MeSH)</term><term>Urologie (MeSH)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs de la prostate</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Prostatic Neoplasms</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Prostatic Neoplasms</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Biopsy</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Biopsie</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Tumeurs de la prostate</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Practice Patterns, Physicians'</term><term>Quality Improvement</term><term>Urology</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Amélioration de la qualité</term><term>Humains</term><term>Mâle</term><term>Sujet âgé</term><term>Types de pratiques des médecins</term><term>Urologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE</b></p><p>There remains significant controversy surrounding the optimal criteria for recommending prostate biopsy. To examine this issue further urologists in MUSIC assessed statewide prostate biopsy practice patterns and variation in prostate cancer detection.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>MUSIC is a statewide, physician led collaborative designed to improve prostate cancer care. From March 2012 through June 2013 at 17 MUSIC practices standardized clinical and pathological data were collected on a total of 3,015 men undergoing first-time prostate biopsy. We examined pathological biopsy outcomes according to patient characteristics and across MUSIC practices.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The average cancer detection rate was 52% with significant variability across MUSIC practices (range 43% to 70%, p<0.0001). Of all patients biopsied 27% were older than 69 years, ranging from 19% to 36% at individual practices. Men with prostate specific antigen less than 4 ng/ml comprised an average of 26% of the study population (range 10% to 37%). The detection rate in patients older than 69 years ranged from 42% to 86% at individual practices (p=0.0008). In the 793 patients with prostate specific antigen less than 4 ng/ml the cancer detection rate ranged from 22% to 58% across individual practices (p=0.0065). The predicted probability of cancer detection varied significantly across MUSIC practices even after adjusting for patient age, prostate specific antigen, prostate size, family history and digital rectal examination findings (p<0.0001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>While overall detection rates are higher than previously reported, the cancer yield of prostate biopsy varies widely across urology practices in Michigan. These data serve as a foundation for our efforts to understand and improve patient selection for prostate biopsy.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24582538</PMID><DateCompleted><Year>2014</Year><Month>09</Month><Day>18</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1527-3792</ISSN><JournalIssue CitedMedium="Internet"><Volume>192</Volume><Issue>2</Issue><PubDate><Year>2014</Year><Month>Aug</Month></PubDate></JournalIssue><Title>The Journal of urology</Title><ISOAbbreviation>J Urol</ISOAbbreviation></Journal><ArticleTitle>Variation in prostate cancer detection rates in a statewide quality improvement collaborative.</ArticleTitle><Pagination><MedlinePgn>373-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.juro.2014.02.088</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0022-5347(14)00346-2</ELocationID><Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">There remains significant controversy surrounding the optimal criteria for recommending prostate biopsy. To examine this issue further urologists in MUSIC assessed statewide prostate biopsy practice patterns and variation in prostate cancer detection.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">MUSIC is a statewide, physician led collaborative designed to improve prostate cancer care. From March 2012 through June 2013 at 17 MUSIC practices standardized clinical and pathological data were collected on a total of 3,015 men undergoing first-time prostate biopsy. We examined pathological biopsy outcomes according to patient characteristics and across MUSIC practices.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The average cancer detection rate was 52% with significant variability across MUSIC practices (range 43% to 70%, p<0.0001). Of all patients biopsied 27% were older than 69 years, ranging from 19% to 36% at individual practices. Men with prostate specific antigen less than 4 ng/ml comprised an average of 26% of the study population (range 10% to 37%). The detection rate in patients older than 69 years ranged from 42% to 86% at individual practices (p=0.0008). In the 793 patients with prostate specific antigen less than 4 ng/ml the cancer detection rate ranged from 22% to 58% across individual practices (p=0.0065). The predicted probability of cancer detection varied significantly across MUSIC practices even after adjusting for patient age, prostate specific antigen, prostate size, family history and digital rectal examination findings (p<0.0001).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">While overall detection rates are higher than previously reported, the cancer yield of prostate biopsy varies widely across urology practices in Michigan. These data serve as a foundation for our efforts to understand and improve patient selection for prostate biopsy.</AbstractText><CopyrightInformation>Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Riedinger</LastName><ForeName>Christopher B</ForeName><Initials>CB</Initials><AffiliationInfo><Affiliation>Michigan State University College of Human Medicine, Grand Rapids, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Womble</LastName><ForeName>Paul R</ForeName><Initials>PR</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Linsell</LastName><ForeName>Susan M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ye</LastName><ForeName>Zaojun</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Montie</LastName><ForeName>James E</ForeName><Initials>JE</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>David C</ForeName><Initials>DC</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lane</LastName><ForeName>Brian R</ForeName><Initials>BR</Initials><AffiliationInfo><Affiliation>Spectrum Health Hospital System, Grand Rapids, Michigan. Electronic address: brian.lane@spectrumhealth.org.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Michigan Urological Surgery Improvement Collaborative</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>02</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Urol</MedlineTA><NlmUniqueID>0376374</NlmUniqueID><ISSNLinking>0022-5347</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001706" MajorTopicYN="N">Biopsy</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010818" MajorTopicYN="Y">Practice Patterns, Physicians'</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011471" MajorTopicYN="N">Prostatic Neoplasms</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058996" MajorTopicYN="Y">Quality Improvement</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014572" MajorTopicYN="Y">Urology</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Michigan</Keyword><Keyword MajorTopicYN="N">biopsy</Keyword><Keyword MajorTopicYN="N">physician's practice patterns</Keyword><Keyword MajorTopicYN="N">prostate</Keyword><Keyword MajorTopicYN="N">prostatic neoplasms</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2014</Year><Month>02</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>9</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24582538</ArticleId><ArticleId IdType="pii">S0022-5347(14)00346-2</ArticleId><ArticleId IdType="doi">10.1016/j.juro.2014.02.088</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li></region></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Riedinger, Christopher B" sort="Riedinger, Christopher B" uniqKey="Riedinger C" first="Christopher B" last="Riedinger">Christopher B. Riedinger</name></region><name sortKey="Lane, Brian R" sort="Lane, Brian R" uniqKey="Lane B" first="Brian R" last="Lane">Brian R. Lane</name><name sortKey="Linsell, Susan M" sort="Linsell, Susan M" uniqKey="Linsell S" first="Susan M" last="Linsell">Susan M. Linsell</name><name sortKey="Miller, David C" sort="Miller, David C" uniqKey="Miller D" first="David C" last="Miller">David C. Miller</name><name sortKey="Montie, James E" sort="Montie, James E" uniqKey="Montie J" first="James E" last="Montie">James E. Montie</name><name sortKey="Womble, Paul R" sort="Womble, Paul R" uniqKey="Womble P" first="Paul R" last="Womble">Paul R. Womble</name><name sortKey="Ye, Zaojun" sort="Ye, Zaojun" uniqKey="Ye Z" first="Zaojun" last="Ye">Zaojun Ye</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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