PD28-03 COMPLIANCE WITH EVIDENCE BASED BONE HEALTH MANAGEMENT IN MEN ON CHRONIC ADT: OPPORTUNITIES FOR IMPROVEMENT
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Résumé
You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) I1 Apr 2016PD28-03 COMPLIANCE WITH EVIDENCE BASED BONE HEALTH MANAGEMENT IN MEN ON CHRONIC ADT: OPPORTUNITIES FOR IMPROVEMENT Franklin Gaylis, Jaclyn Gaylis, Kevin McGill, Sothary Julie Van, Hilary Prime, Jenna Essakow, Renee Calabrese, Susan S. Levy, and Paul Dato Franklin GaylisFranklin Gaylis More articles by this author , Jaclyn GaylisJaclyn Gaylis More articles by this author , Kevin McGillKevin McGill More articles by this author , Sothary Julie VanSothary Julie Van More articles by this author , Hilary PrimeHilary Prime More articles by this author , Jenna EssakowJenna Essakow More articles by this author , Renee CalabreseRenee Calabrese More articles by this author , Susan S. LevySusan S. Levy More articles by this author , and Paul DatoPaul Dato More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.390AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men on chronic Androgen Depravation Therapy (ADT) are at risk for bone demineralization and complications including fracture. The National Osteoporosis Foundation recommendations include a baseline assessment of bone density with a DEXA scan and daily calcium and Vitamin D supplementation. In this study we report compliance with these evidence based guidelines. METHODS Cohort included 500 men treated with chronic ADT (defined as > 1 year). EMR (Allcripts TM) was queried for baseline Calcium, Vitamin D and DEXA scanning at the onset of ADT. The EMR was automatically queried by the WIzMDTM software program electronically abstracting both structured and unstructured data. Trained data analysts manually abstracted the same data for comparison and validation. Bone health management compliance was compared between a dedicated Advanced Prostate Cancer Center (APCC) and the Primary Urology Office (PUO). RESULTS Calcium and/or Vitamin D was prescribed to 33% of the 500 patient cohort. Of these patients, 25% were prescribed both Vitamin D and Calcium. 5%, and 3% were prescribed either Vitamin D or Calcium, respectively. 12.8% of all patients received a baseline DEXA scan. A dedicated centralized Advanced Prostate Cancer Center (APCC) was compared to the Primary Urology Office (PUO) for compliance with baseline DEXA scanning and Calcium/Vitamin D prescription. Chi-square tests of independence revealed a significant relationship (p < .001) between health management delivery site and receipt of a baseline DEXA scan for those who qualified, with 78% at the APCC receiving a scan compared to 22% at the PUO. Similarly, significant relationships (p < .001) were found between delivery care site and compliance to recommended vitamin D and Calcium supplementation. Of those receiving care at the APCC, 76.6 % complied to recommendations and 23.4% did not, compared to PUO care-delivered patients, of whom 24.9% complied to recommendations and 75.1% did not. Inter-abstractor reliability was preformed by randomly reviewing 10% of the data, yielding a 90% agreement between data abstractors. CONCLUSIONS Men at risk for adverse bone consequences from chronic ADT do not always receive care according to evidence based guidelines. These findings call for improved processes that standardize evidence based practice including baseline and follow up bone density assessment and daily calcium and vitamin D supplementation. Our findings of significantly improved compliance at a dedicated Advanced Prostate Cancer Center, highlights the value of dedicated physicians and nurses in a centralized facility, managing patients with advanced prostate cancer. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e655 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Franklin Gaylis More articles by this author Jaclyn Gaylis More articles by this author Kevin McGill More articles by this author Sothary Julie Van More articles by this author Hilary Prime More articles by this author Jenna Essakow More articles by this author Renee Calabrese More articles by this author Susan S. Levy More articles by this author Paul Dato More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».