PD45-04 IMPROVING QUALITY OF PROSTATE CANCER SURGERY BY PROVIDING FEEDBACK TO SURGEONS: THE SURGICAL REPORT CARD (SUREP) STUDY
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Résumé
You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (PD45)1 Apr 2019PD45-04 IMPROVING QUALITY OF PROSTATE CANCER SURGERY BY PROVIDING FEEDBACK TO SURGEONS: THE SURGICAL REPORT CARD (SUREP) STUDY Ravi M. Kumar*, Luke T. Lavallée, Christopher Morash, Ilias Cagiannos, Dean Fergusson, David Sands, Sonya Cnossen, Ranjeeta Mallick, Michael Horrigan, Dawn Stacey, and Rodney H. Breau Ravi M. Kumar*Ravi M. Kumar* More articles by this author , Luke T. LavalléeLuke T. Lavallée More articles by this author , Christopher MorashChristopher Morash More articles by this author , Ilias CagiannosIlias Cagiannos More articles by this author , Dean FergussonDean Fergusson More articles by this author , David SandsDavid Sands More articles by this author , Sonya CnossenSonya Cnossen More articles by this author , Ranjeeta MallickRanjeeta Mallick More articles by this author , Michael HorriganMichael Horrigan More articles by this author , Dawn StaceyDawn Stacey More articles by this author , and Rodney H. BreauRodney H. Breau More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556600.95443.98AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Goals of radical prostatectomy include complete tumor resection, optimization of urinary function, and maintenance of erectile function. In this Surgical Report card (SuRep) study, we aimed to closely monitor cancer, urinary, and sexual outcomes and provide surgeons with report cards assessing their performance. METHODS: Prospective radical prostatectomy patients at The Ottawa Hospital were consented for participation in SuRep. All 8 prostate cancer surgeons at The Ottawa Hospital also consented to participation. Feasibility goals for the study were 95% patient enrollment, with 80% participation at 6-months follow-up, and 70% participation at 12-months. At enrollment and follow-up, patient reported outcomes were assessed using validated questionnaires (EPIC and EQ-5D). Patients were defined as potent if they had no erectile dysfunction and continent if they had no incontinence. The patient data was analyzed and report cards were provided to surgeons every 3 months starting approximately 1 year after the first patient was enrolled. RESULTS: During the study period, 422 of 436 (97%) radical prostatectomy patients participated in the study. Follow-up data was available for 358 (85%) patients at 6-months and 356 (84%) patients at 12-months following surgery. Two-hundred and ten (50%) patients were included in the first year (pre-report card) and 212 (50%) patients were included in the second year (post-report card). Baseline characteristics were similar in the pre- and post-report card cohorts. Almost all patients were continent (98%) and the majority were potent (61%) prior to surgery. Nerve sparing surgery increased from 148 (70%) pre-report card to 173 (82%) post-report card. There was a non-statistically significant increase in the proportion of patients with a positive surgical margin post-report cards (32% pre-report card vs 39% post-report card; p=0.09). There was no difference in post-operative erectile function (24% vs 26%; p=0.69) and a decrease in continence (76% vs 63.2%; p=0.01). CONCLUSIONS: A surgical report card program including patient reported outcomes is feasible. The data was used to accurately counsel patients about their expected outcomes following radical prostatectomy. With one year of surgical report cards, overall patient outcomes did not improve. We believe that specific initiatives and longer duration of feedback are needed for positive change to occur. Source of Funding: Funded in part by Prostate Cancer Canada (Discovery 2014 D2014-2), The Ottawa Hospital Academic Medical Organization, and the Prostate Cancer Fight Foundation & TELUS Ride For Dad. All statements in this report are solely those of the authors. Ottawa, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e827-e827 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ravi M. Kumar* More articles by this author Luke T. Lavallée More articles by this author Christopher Morash More articles by this author Ilias Cagiannos More articles by this author Dean Fergusson More articles by this author David Sands More articles by this author Sonya Cnossen More articles by this author Ranjeeta Mallick More articles by this author Michael Horrigan More articles by this author Dawn Stacey More articles by this author Rodney H. Breau More articles by this author Expand All 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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,042 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,107 | 0,012 |
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 source (Gemma direct ou Codex distillé), 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 ».