publicdata/ahrq-gov
1
0
Fork 0
Code Issues Pull requests Projects Releases Packages Wiki Activity Actions
ahrq-gov/archive.ahrq.gov/research/nov95/feature.htm
Scott Williams 58222b51ed Initial commit
2025-02-28 14:14:25 -05:00

237 lines
No EOL
14 KiB
HTML
Raw Blame History

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Research Activities, November/December 1995: Feature Story: Research on BPH and Prostate Cancer Takes Center Stage</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<!-- "metadata" -->
<meta name="Title" content="Research Activities, November/December 1995" />
<meta name="keywords" content="Agency for Health Care Policy and Research, Agency for Healthcare Research and Quality, AHRQ, AHCPR, AIDS/HIV, ambulatory care, benchmark, child, cost, elderly, health cost, healthcare cost, hospital, long-term care, managed care, markets, mental health, methodology, minority health, nursing, nursing homes, outcome research, out-of-pocket spending, patient care, primary, primary care, research, rural, spending, study, Translating Research Into Practice, TRIP" />
<meta name="description" content="Online newsletter summarizing published findings from AHRQ-funded studies, new AHRQ publications and products, and funding opportunities." />
<meta name="creator" content="Agency for Healthcare Research and Quality (AHRQ)" />
<meta name="language" content="English" />
<!-- end metadata -->
<link href="/includes/archive.css" rel="stylesheet" type="text/css" />
<link href="/includes/ahrqstyleprint_arch.css" rel="stylesheet" type="text/css" media="print" />
<script>
(function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
})(window,document,'script','//www.google-analytics.com/analytics.js','ga');
ga('create', 'UA-75759936-1', 'auto');
ga(' set', 'anonymizeIp', true);
ga('send', 'pageview');
</script></head><body><!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-W4DST4"
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
'//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
})(window,document,'script','dataLayer','GTM-W4DST4');</script>
<!-- End Google Tag Manager -->
<noscript>
Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser.
</noscript>
<!-- Page Header v2.0 -->
<a name="top" id="top"></a>
<!--Begin Banner CodeS-->
<div id="ahrqbanner">
<div class="hhsportion">
<a href="#h1" class="skipnav">Skip Navigation</a>
<a href="http://www.hhs.gov" title="U.S. Department of Health and Human Services">
<img src="/images/hhs_banner.gif" alt="U.S. Department of Health and Human Services" />
</a>
<a href="http://www.hhs.gov" title="www.hhs.gov" class="hhsright">
<img src="/images/hhs_link.gif" alt="www.hhs.gov" />
</a>
</div>
<div class="ahrqportion">
<a href="/" title="Archive: Agency for Healthcare Research Quality">
<img src="/images/ahrq_banner.gif" alt="Agency for Healthcare Research Quality" />
</a><form name="searchForm" method="get" action="https://search.ahrq.gov/search" id="banner_searchform">
<label for="search" style="z-index:-1;position:relative;margin-right:-65px; font-size:0px;">Search</label>
<input name="q" type="text" value=" Search Archive" size="11" onfocus="this.value='';" class="gotext" label="Search archive" id="search" />
<input type="hidden" name="entqr" value="0" />
<input type="hidden" name="output" value="xml_no_dtd" />
<input type="hidden" name="proxystylesheet" value="ARCHIVE_Front_End" />
<input type="hidden" name="client" value="ARCHIVE_Front_End" />
<input type="hidden" name="site" value="ARCHIVE_AHRQ_GOV" />
<input src="/images/topbn_GoButton.gif" class="gobtn" name="Submit" onclick="javascript:document.searchForm.submit();" type="image" alt="Search" />
</form>
<a href="https://www.ahrq.gov/" class="ahrqright">www.ahrq.gov</a>
</div><div class="ahrqlinks"><a href="https://www.ahrq.gov/">AHRQ Home&#8212;Live Site</a> | <a href="/">Archive Home</a> | <a href="/sitemap.htm">Site Map</a> <!-- | &nbsp;<img src="/images/envelope1.jpg" alt="" width="21" height="14" /><a href="https://subscriptions.ahrq.gov/service/multi_subscribe.html?code=USAHRQ">E-mail Updates</a> --></div>
</div>
<div id="PrintBanner">
<img src="/images/printbanner_arch.jpg" alt="Archive print banner" />
</div>
<a name="h1"></a>
<!-- End banner code -->
<!-- End of Page header -->
<!-- Content Body -->
<div id="mainContent">
<table width="100%" border="0" cellspacing="0" cellpadding="0" >
<tr valign="top">
<td width="70%">
<!-- Center Content section -->
<table width="100%" border="0" cellpadding="0" cellspacing="0" style="margin-left:10px; margin-right:10px;margin-top:5px" summary="This table gives the layout format of the bread crumb area and the center content area.">
<!--DWLayoutTable-->
<tr>
<td class="crumb_link"><div id="crumbContent">
<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/research/resarch.htm" class="crumb_link"><em>Research Activities</em> Archive</a> &gt; <a href="." class="crumb_link">November/December 1995</a> </span></p>
</div>
</td>
</tr>
<tr>
<td><h1><a name="h1" id="h1"></a> Feature Story </h1>
</td>
</tr>
<tr>
<td><div id="centerContent"><div class="headnote">
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<h2>Research on BPH and Prostate Cancer Takes Center
Stage</h2>
<h3>Researchers confirm the importance of involving patients in
BPH treatment decisions and discuss coverage of PSA
testing</h3>
<p>The Prostate Patient Outcomes Research Team (PORT) was funded by
the Agency for Health Care Policy and Research (HS06336) to
assess therapies for localized prostate cancer and benign
prostatic hyperplasia (BPH). Prostate PORT researchers, led by
John E. Wennberg, M.D., of Dartmouth College, recently published
four studies, discussed below. Three of the studies demonstrate
men's resilience in coping with the aftereffects of radical
prostatectomy and the importance of involving patients in
decisions to treat BPH; the fourth is an issue paper which
discusses whether or not Medicare should reimburse physicians for
PSA testing for early detection of prostate cancer, which is
recommended annually by the American Cancer Society for men 50
years of age and older.</p><p>
<strong>Fowler, F.J., Barry, M.J., Lu-Yao, G., and others (1995, June).
"Effect of radical prostatectomy for prostate cancer on patient
quality of life: Results from a Medicare survey." <em>Urology</em> 45(6),
pp. 1007-1015.</strong></p>
<p>Nearly one third (32 percent) of the Medicare patients who have
undergone radical prostatectomy wear pads to deal with wetness,
and 60 percent or more have become impotent. Yet many elderly
patients are able to adapt to these problems, according to
Prostate PORT researchers (also supported by AHCPR grant
HS08397). On average, incontinence to the point of needing to
wear pads bothered patients more than the loss of sexual
function. Overall, postsurgical patients scored comparatively
high on quality of life measures, reported feeling positive about
the results of the surgery (81 percent), and would choose
surgical treatment again (89 percent). Nonetheless, some patients
were less positive about the surgery and its impact on their
quality of life. These findings suggest that properly selected
and prepared patients are willing to sacrifice some quality of
life for the chance to be surgically cured of their cancer. They
also reinforce the importance of individualized decisions about
radical prostatectomy for prostate cancer, conclude the
researchers. These findings are based on mail, telephone, and
personal interviews with a national sample of 1,072 Medicare
patients who underwent the surgery from 1988 through 1990.</p><p>
<strong>Wagner, E.H., Barrett, P., Barry, M.J., and others (1995). "The
effect of a shared decisionmaking program on rates of surgery for
benign prostatic hyperplasia," and Barry, M.J., Fowler, F.J.,
Mulley, A.G., and others. "Patient reactions to a program
designed to facilitate patient participation in treatment
decisions for benign prostatic hyperplasia." <em>Medical Care</em> 33(8),
pp. 765-770 and 771-782.</strong></p>
<p>BPH is a nonmalignant but progressive condition that can cause
obstruction of the urethra and chronic urinary symptoms or
infections. Transurethral resection of the prostate (TURP) is
sometimes necessary. Patients with BPH who are informed about the
pros and cons of TURP versus watchful waiting for their condition
may change their minds about surgery, according to a Prostate
PORT pilot study (also supported by AHCPR grants HS08397 and
HS06540). Patients with BPH in two HMOs were shown an interactive
videodisc-based patient education program, The Shared
Decisionmaking Program (SDP) for BPH, which was designed to help
patients make an informed choice about whether to elect TURP or
watchful waiting. Before viewing the SDP, about two-thirds of the
men preferred watchful waiting. After viewing the program, this
figure increased to 79 percent. Also, 27 percent of the men
initially favoring surgery changed their minds compared with only
1 percent of those initially inclined to wait. The researchers
conclude that educating patients and involving them in decisions
about their care can have measurable impacts on therapeutic
choices. A related Prostate PORT study showed that 421 patients
in three urology practices (including the two HMOs noted above)
reacted very positively to the videodisc program in 1989 and
1990. Patients rated the program as generally clear, informative,
and balanced; 77 percent of patients were very positive and 16
percent were generally positive about the program's usefulness in
making a treatment decision.</p>
<p><strong>Barry, M.J., Fleming, C., Coley, C.M., and others (1995).
"Should Medicare provide reimbursement for prostate-specific
antigen testing for early detection of prostate cancer? Part I:
Framing the debate." <em>Urology</em> 46(1), pp. 2-13.</strong></p><p>
This article by Prostate PORT researchers (also supported by
AHCPR grant HS08397) is the first of a four-part policy analysis
of whether or not Medicare should provide reimbursement for PSA
testing for early detection of prostate cancer. This first
article frames the debate and discusses the magnitude of the
problem of prostate cancer among older men, describes the
rationale for early detection and treatment, and outlines special
issues in screening Medicare-age men. The researchers also
discuss current conflicting recommendations on early detection of
prostate cancer and review the basic biology and epidemiology of
the condition. Finally, they discuss ongoing and planned
randomized trials for the early detection and treatment of
clinically localized prostate cancer. Future articles will review
early detection strategies for prostate cancer; examine
management strategies; and estimate the risks, benefits, and
costs of an early detection program among older men.</p>
<p class="size2"><a href=".">Return to Contents</a><br />
<a href="dept1.htm">Proceed to Next Section</a></p>
<div class="footnote">
<p> The information on this page is archived and provided for reference purposes only.</p></div>
<p>&nbsp;</p>
</div>
</td>
</tr>
</table>
<!-- End of Center Content section -->
</td>
</tr>
</table>
</div>
<!-- End of Content Body -->
<!-- Footer graphic 1.2-->
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tr>
<td width="125" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_1.jpg" width="125" alt="AHRQ" /></td>
<td width="100%" background="/images/bottom_ahrq_bkg.jpg" ><img src="/images/bottom_ahrq_bkg.jpg" width="10" height="34" alt="" /></td>
<td width="310" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_2.gif" alt="Advancing Excellence in Health Care" width="310" height="34" /></td>
</tr>
</table>
<!-- Footer links section -->
<div id="banner_Footer2"><p> <a href="https://www.ahrq.gov/">AHRQ Home</a> | <a href="https://info.ahrq.gov" class="footer_navlink">Questions?</a> | <a href="https://www.ahrq.gov/contact/index.html" class="footer_navlink">Contact AHRQ</a> | <a href="https://www.ahrq.gov/sitemap.html" class="footer_navlink">Site Map</a> | <a href="https://www.ahrq.gov/policy/electronic/accessibility/index.html" class="footer_navlink">Accessibility</a> | <a href="https://www.ahrq.gov/policy/electronic/privacy/index.html" class="footer_navlink">Privacy
Policy</a> | <a href="https://www.ahrq.gov/policy/foia/index.html" class="footer_navlink">Freedom of Information Act</a> | <a href="https://www.ahrq.gov/policy/electronic/disclaimers/index.html" class="footer_navlink">Disclaimers</a> | <a href="http://www.hhs.gov/open/recordsandreports/plainwritingact/index.html" class="footer_navlink">Plain Writing Act</a> <br />
<a href="http://www.hhs.gov" class="footer_navlink">U.S. Department of Health &amp; Human Services</a> | <a href="http://www.whitehouse.gov" class="footer_navlink">The White House</a> | <a href="http://www.usa.gov" class="footer_navlink">USA.gov: The U.S. Government's Official Web Portal</a></p>
</div>
<div id="banner_Footeraddress"><p>Agency for Healthcare Research and Quality <img src="/images/bottom_dot.gif" alt="" /> 5600 Fishers Lane Rockville, MD 20857 <img src="/images/bottom_dot.gif" alt="" /> Telephone: (301) 427-1364</p></div>
<!-- End of Footer links section -->
</body>
</html>
Reference in a new issue View git blame Copy permalink