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Objective To identify and characterize patient-centered outcomes (PCOs) relating to multiparametric MRI (mpMRI) and MRI-guided biopsy as diagnostic tests for possible prostate cancer. Methods Medline via OVID, EMBASE, PsycInfo, and the Cochrane Central register of Controlled Trials (CENTRAL) were searched for relevant articles. Hand searching of reference lists and snowballing techniques were performed. Studies of mpMRI and MRI-guided biopsy that measured any PCO were included. There were no restrictions placed on year of publication, language, or country for study inclusion. All database search hits were screened independently by two reviewers, and data were extracted using a standardized form. Results Overall, 2,762 database search hits were screened based on title and abstract. Of these, 222 full-text articles were assessed, and 10 studies met the inclusion criteria. There were 2,192 participants featured in the included studies, all of which were conducted in high-income countries. Nineteen different PCOs were measured, with a median of four PCOs per study (range 1-11). Urethral bleeding, pain, and urinary tract infection were the most common outcomes measured. In the four studies that compared mpMRI or MRI-guided biopsy to transrectal ultrasound biopsy, most adverse outcomes occurred less frequently in MRI-related tests. These four studies were assessed as having a low risk of bias. Discussion PCOs measured in studies of mpMRI or MRI-guided biopsy thus far have mostly been physical outcomes, with some evidence that MRI tests are associated with less frequent adverse outcomes compared with transrectal ultrasound biopsy. There was very little evidence for the effect of mpMRI and MRI-guided biopsy on emotional, cognitive, social, or behavioral outcomes.

Background One in five British children are overweight or obese when entering primary school but most parents fail to recognise child overweight. Health-care professionals are expected to manage childhood overweight, but initiating conversations with parents is difficult. The aim of this study was to inform the development of a visual and language toolbox to support health-care professionals in initiating sensitive conversations about weight with parents of overweight preschool children. Methods Three focus group discussions were conducted with health-care professionals (total n=29) recruited from general practices in London and Bristol, UK, and 15 semi-structured interviews were undertaken with parents of preschool children ( Findings Health-care professionals perceived parents as being unconcerned about child overweight; parents were apprehensive about health-care professionals criticising their parenting skills. Some health-care professionals did not consider child overweight to be their responsibility. General practitioners were reluctant to discuss weight with parents because of shortage of time, fear of damaging patient–practitioner relationships, and insufficient training; nurses were more willing. Both health-care professionals and parents were positive about the potential for body image scales to facilitate conversations, generally preferring scales based on three-dimensional body scans over artists' drawings. Parents thought that language used by health-care professionals needed to be clear and impactful, but not stigmatising—eg, overweight, very overweight (but not fat, heavy, or obese). Interpretation The findings suggest that a visual and language toolbox would be well received by parents and health-care professionals. Anatomically accurate preschool body image scales are needed for use in consultations. Practice nurses may be better placed than general practitioners to initiate conversations with parents. Health-care professionals should consider parents' conceptions of health and blame when conducting consultations, to encourage parental recognition of preschool overweight, with the ultimate aim of facilitating appropriate behaviour change. Funding This study is funded by a Cancer Research UK/Bupa Foundation Innovation award. The funders had no role in the writing of the abstract or the decision to submit it for publication.

Background Prostate cancer is the second most common cancer in the UK, with 39 741 cases diagnosed in 2014. The National Cancer Registration and Analysis Service (NCRAS) collects data about cancer (including prostate cancer) in England. The CAP study is a cluster-randomised controlled trial investigating the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing. The value of cancer registries is high if they receive and process quality data, which can be evaluated in various domains, including completeness and validity. This study aimed to compare the completeness and accuracy of the NCRAS registry with data from the CAP study. Methods We compared the percentage completeness and agreement of prostate cancer diagnosis by Union Internationale Contre le Cancer (UICC) TNM stage and Gleason grade in the NCRAS cancer registry with information collected via independent medical record review on participants in CAP. CAP study participants were matched to NCRAS registry entries by their National Health Service number. Agreement was assessed with Cohen's κ. Findings 1356 men were included in this study (mean age 75·1 years, SD 5·1). Both the NCRAS registry (97·9%) and CAP study (98·5%) had high levels of completeness for date of diagnosis. Agreement was high for combined Gleason score (κ=0·90, 95% CI 0·89–092) and low for American Joint Committee on Cancer (AJCC) group (0·48, 0·43–0·53) overall. TNM staging agreement was 0·35 (0·31–0·37) for T, 0·51 (0·45–0·57) for N, and 0·58 (0·51–0·66) for M stage. Agreement was moderate when considering local (T1–3N0M0) versus metastatic disease (T4NxMx/TxN1Mx/TxNxM1) (0·54, 0·44–0·64). Interpretation The NCRAS prostate cancer registry has a high level of completeness for case registration, and strong accuracy for Gleason grade. Agreement of exact TNM staging and AJCC group seems low, which could be explained if staging data were collected from different sources (ie, pathological vs imaging staging methods), and needs to be explored further. Prostate cancer stage and accuracy of grade data for the NCRAS registry need repeated assessment to drive improvements in data quality. Funding None.

1 (“Cardiovascular disease” or CVD or “myocardial infarction” or “acute myocardial infarction” or MI or AMI or “coronary heart disease” or CHD or “coronary artery disease” or CAD or “ischaemic heart disease” or IHD or “acute coronary syndrome” or ACS or “heart attack” or “heart disease” or atherosclerosis or stroke or CVA or “cerebrovascular accident” or “occlusive stoke” or “haemorrhagic stroke” or “hemorrhagic stroke” or “hypertensive stroke”). mp. [mp = title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept, rare disease supplementary concept, unique identifier] 618,168