MP23-18 FACTORS ASSOCIATED WITH LONG-TERM ADHERENCE TO ACTIVE SURVEILLANCE AMONG MEN WITH LOW RISK PROSTATE CANCER: A POPULATION BASED STUDY FROM ONTARIO
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Résumé
You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I (MP23)1 Apr 2020MP23-18 FACTORS ASSOCIATED WITH LONG-TERM ADHERENCE TO ACTIVE SURVEILLANCE AMONG MEN WITH LOW RISK PROSTATE CANCER: A POPULATION BASED STUDY FROM ONTARIO Narhari Timilshina*, Patrick Richard, Maria Komisarenko, Doug Cheung, Lisa Martin, Shabbir Alibhai, and Antonio Finelli Narhari Timilshina*Narhari Timilshina* More articles by this author , Patrick RichardPatrick Richard More articles by this author , Maria KomisarenkoMaria Komisarenko More articles by this author , Doug CheungDoug Cheung More articles by this author , Lisa MartinLisa Martin More articles by this author , Shabbir AlibhaiShabbir Alibhai More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000856.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) has become widely accepted as the standard of care for low-risk prostate cancer (PC) worldwide.. However limited work has examined the population-level uptake and real world adherence. We describe the uptake and long-term adherence to AS, and the factors associated with them using provincial level data on men with low risk PC. METHODS: This was an observational, population-based study using linked administrative databases in Ontario. All men diagnosed with PC between 2008 and 2014 in Ontario, Canada were identified from the Ontario Cancer Registry. The treatment-free survival rate was estimated using cumulative incidence function methods. Factors associated with long-term adherence to AS were evaluated using Cox Proportional Hazard (PH) models. Sensitivity analyses used Fine and Gray models to account for competing risks of progression to metastases or death. RESULTS: Overall 51% of low risk PC patients were initially managed by AS. AS uptake increased substantially from 39.5 % to 63.5% between 2008 and 2014. The median time to discontinuation of AS was 58 months (IQR:23-101). Cumulative AS adherence rates at year 1 and year 5 were 87.1%% and 63.3%, respectively. On multivariable analysis, factors associated with lower AS discontinuation within the median 5-year were increasing age at diagnosis (75+year HR 0.31 95%CI 0.26-0.38 vs. <55), lower physician volume tertile and lower Institution tertile. Higher AS discontinuation was associates with higher PSA at diagnosed and higher prostate volume. CONCLUSIONS: The uptake of AS significantly increased in recent years in Ontario. We found large number of patients continue on As after 5-year at population level for men diagnosed with low risk PC in Canada. Factors affecting continue AS were higher PSA at diagnosis and higher prostate volume. Source of Funding: The Prostate Cancer Canada © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e345-e345 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Narhari Timilshina* More articles by this author Patrick Richard More articles by this author Maria Komisarenko More articles by this author Doug Cheung More articles by this author Lisa Martin More articles by this author Shabbir Alibhai More articles by this author Antonio Finelli 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 | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 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 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 ».