Clinical impact of the Predict Prostate risk communication tool in men newly diagnosed with non-metastatic prostate cancer: a multi-centre randomised controlled trial.
BAUS ePoster online library. Thurtle D. 06/21/21; 318997; p1-9
Disclosure(s): The Urology Foundation - Research Scholarship
Mr. David Thurtle
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Abstract
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Introduction
Predict Prostate is a NICE-endorsed online personalised risk-communication tool for men diagnosed with non-metastatic prostate cancer (prostate.predict.nhs.uk). Its accuracy has been widely demonstrated but impact on patient decision-making had not previously been evaluated.
Patients and Methods
A multi-centre RCT was performed across 8 UK centres (ISRCTN 28468474). Newly diagnosed men considering either surveillance or radical treatment, were randomised to standard of care(SOC) or SOC and presentation of Predict Prostate. Validated questionnaires were completed assessing impact of the tool on decisional conflict, uncertainty, anxiety and perception of prognosis.
Results
156 patients were recruited; mean age 67 years (range 44-80) and PSA 6.9ng/ml. 81 were randomised to Predict Prostate, and 75 to SOC. Mean overall decisional conflict scores were 26% lower in the Predict Prostate group compared to SOC, and lower for most pre-defined subscales including 'uncertainty' (Table 1).
Patient perceptions of 15-year prostate cancer specific mortality (PCSM) and survival benefit from radical treatment were considerably lower in the Predict Prostate group (p<0.0001). For example, mean patient-perceived 15-year PCSM was 41.9% (95%CI:35.6-48.3) in the SOC group, compared to 21.7% (95%CI:16.9-26.4) in men who saw Predict Prostate (p<0.001).
58% reported the Predict Prostate estimates for PCSM were lower than expected, and 35% reported being less likely to select radical treatment having seen the tool. 92% and 94% found Predict useful and would recommend it to others respectively.
Conclusion
Predict Prostate reduces decisional conflict and uncertainty, and shifts patient perceptions around prognosis. Its use can inform the complex decision-making process in prostate cancer.
Predict Prostate is a NICE-endorsed online personalised risk-communication tool for men diagnosed with non-metastatic prostate cancer (prostate.predict.nhs.uk). Its accuracy has been widely demonstrated but impact on patient decision-making had not previously been evaluated.
Patients and Methods
A multi-centre RCT was performed across 8 UK centres (ISRCTN 28468474). Newly diagnosed men considering either surveillance or radical treatment, were randomised to standard of care(SOC) or SOC and presentation of Predict Prostate. Validated questionnaires were completed assessing impact of the tool on decisional conflict, uncertainty, anxiety and perception of prognosis.
Results
156 patients were recruited; mean age 67 years (range 44-80) and PSA 6.9ng/ml. 81 were randomised to Predict Prostate, and 75 to SOC. Mean overall decisional conflict scores were 26% lower in the Predict Prostate group compared to SOC, and lower for most pre-defined subscales including 'uncertainty' (Table 1).
Patient perceptions of 15-year prostate cancer specific mortality (PCSM) and survival benefit from radical treatment were considerably lower in the Predict Prostate group (p<0.0001). For example, mean patient-perceived 15-year PCSM was 41.9% (95%CI:35.6-48.3) in the SOC group, compared to 21.7% (95%CI:16.9-26.4) in men who saw Predict Prostate (p<0.001).
58% reported the Predict Prostate estimates for PCSM were lower than expected, and 35% reported being less likely to select radical treatment having seen the tool. 92% and 94% found Predict useful and would recommend it to others respectively.
Conclusion
Predict Prostate reduces decisional conflict and uncertainty, and shifts patient perceptions around prognosis. Its use can inform the complex decision-making process in prostate cancer.
Introduction
Predict Prostate is a NICE-endorsed online personalised risk-communication tool for men diagnosed with non-metastatic prostate cancer (prostate.predict.nhs.uk). Its accuracy has been widely demonstrated but impact on patient decision-making had not previously been evaluated.
Patients and Methods
A multi-centre RCT was performed across 8 UK centres (ISRCTN 28468474). Newly diagnosed men considering either surveillance or radical treatment, were randomised to standard of care(SOC) or SOC and presentation of Predict Prostate. Validated questionnaires were completed assessing impact of the tool on decisional conflict, uncertainty, anxiety and perception of prognosis.
Results
156 patients were recruited; mean age 67 years (range 44-80) and PSA 6.9ng/ml. 81 were randomised to Predict Prostate, and 75 to SOC. Mean overall decisional conflict scores were 26% lower in the Predict Prostate group compared to SOC, and lower for most pre-defined subscales including 'uncertainty' (Table 1).
Patient perceptions of 15-year prostate cancer specific mortality (PCSM) and survival benefit from radical treatment were considerably lower in the Predict Prostate group (p<0.0001). For example, mean patient-perceived 15-year PCSM was 41.9% (95%CI:35.6-48.3) in the SOC group, compared to 21.7% (95%CI:16.9-26.4) in men who saw Predict Prostate (p<0.001).
58% reported the Predict Prostate estimates for PCSM were lower than expected, and 35% reported being less likely to select radical treatment having seen the tool. 92% and 94% found Predict useful and would recommend it to others respectively.
Conclusion
Predict Prostate reduces decisional conflict and uncertainty, and shifts patient perceptions around prognosis. Its use can inform the complex decision-making process in prostate cancer.
Predict Prostate is a NICE-endorsed online personalised risk-communication tool for men diagnosed with non-metastatic prostate cancer (prostate.predict.nhs.uk). Its accuracy has been widely demonstrated but impact on patient decision-making had not previously been evaluated.
Patients and Methods
A multi-centre RCT was performed across 8 UK centres (ISRCTN 28468474). Newly diagnosed men considering either surveillance or radical treatment, were randomised to standard of care(SOC) or SOC and presentation of Predict Prostate. Validated questionnaires were completed assessing impact of the tool on decisional conflict, uncertainty, anxiety and perception of prognosis.
Results
156 patients were recruited; mean age 67 years (range 44-80) and PSA 6.9ng/ml. 81 were randomised to Predict Prostate, and 75 to SOC. Mean overall decisional conflict scores were 26% lower in the Predict Prostate group compared to SOC, and lower for most pre-defined subscales including 'uncertainty' (Table 1).
Patient perceptions of 15-year prostate cancer specific mortality (PCSM) and survival benefit from radical treatment were considerably lower in the Predict Prostate group (p<0.0001). For example, mean patient-perceived 15-year PCSM was 41.9% (95%CI:35.6-48.3) in the SOC group, compared to 21.7% (95%CI:16.9-26.4) in men who saw Predict Prostate (p<0.001).
58% reported the Predict Prostate estimates for PCSM were lower than expected, and 35% reported being less likely to select radical treatment having seen the tool. 92% and 94% found Predict useful and would recommend it to others respectively.
Conclusion
Predict Prostate reduces decisional conflict and uncertainty, and shifts patient perceptions around prognosis. Its use can inform the complex decision-making process in prostate cancer.
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