The long-term objective of this application is to develop health policy and practice guidelines on prostate cancer screening and management with an ultimate instant to enhance the quality and quantity of life of male primary care patients.
The Specific Aims are to: 1) determine the appropriateness of screening for prostate cancer from the perspective of male patients and their spouses; 2) estimate the concordance of husband's and wife's utilities for complications of prostate cancer treatment; and 3) compare findings from Aims 1 and 2 for White, African-American, and hispanic-American male patients and their spouses. The application proposes to do utility assessment and clinical decision analysis to estimate preferred screening strategies for a multi=-racial/ethnic sample of primary care patients and their wives. A probability sample of 150 (50 White, 50 African American, 50 Hispanic-American) male patients, ages 45 to 70, and their partners will be enrolled. The study will include utility assessment using category scaling, time trade-off, and standard gamble methods. Optimal screening strategies will be determined using utilities from the entire sample and then separately for each couple. Sensitivity analysis will be used to identify thresholds for utility values. This is a common disease. Screening for prostate cancer is controversial because clinical trials to demonstrate the value of screening are ongoing but have not made final recommendations. While the screening indications are not clear, it is a utility sensitive decision and must depend on the screening preferences of patients and their spouses. Related to the cultural issues, the application states that literature on health beliefs of African- Americans and Hispanics indicate a more fatalistic orientation towards health. Some have suggested that this fatalistic orientation explains the lower use of primary and secondary preventive medical care. This application presents plans to conduct an analysis to better understand how these groups of patients associate the dis-utilities of outcomes of cancer prostate treatment with their screening preferences.
| Cantor, Scott B; Deshmukh, Ashish A; Krahn, Murray D et al. (2015) Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model. Health Expect 18:1610-20 |
