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Measuring and predicting prostate cancer related quality of life changes using EPIC for clinical practice.
- Source :
-
The Journal of urology [J Urol] 2014 Mar; Vol. 191 (3), pp. 638-45. Date of Electronic Publication: 2013 Sep 25. - Publication Year :
- 2014
-
Abstract
- Purpose: We expanded the clinical usefulness of EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) by evaluating its responsiveness to health related quality of life changes, defining the minimally important differences for an individual patient change in each domain and applying it to a sexual outcome prediction model.<br />Materials and Methods: In 1,201 subjects from a previously described multicenter longitudinal cohort we modeled the EPIC-CP domain scores of each treatment group before treatment, and at short-term and long-term followup. We considered a posttreatment domain score change from pretreatment of 0.5 SD or greater clinically significant and p ≤ 0.01 statistically significant. We determined the domain minimally important differences using the pooled 0.5 SD of the 2, 6, 12 and 24-month posttreatment changes from pretreatment values. We then recalibrated an EPIC-CP based nomogram model predicting 2-year post-prostatectomy functional erection from that developed using EPIC-26.<br />Results: For each health related quality of life domain EPIC-CP was sensitive to similar posttreatment health related quality of life changes with time, as was observed using EPIC-26. The EPIC-CP minimally important differences in changes in the urinary incontinence, urinary irritation/obstruction, bowel, sexual and vitality/hormonal domains were 1.0, 1.3, 1.2, 1.6 and 1.0, respectively. The EPIC-CP based sexual prediction model performed well (AUC 0.76). It showed robust agreement with its EPIC-26 based counterpart with 10% or less predicted probability differences between models in 95% of individuals and a mean ± SD difference of 0.0 ± 0.05 across all individuals.<br />Conclusions: EPIC-CP is responsive to health related quality of life changes during convalescence and it can be used to predict 2-year post-prostatectomy sexual outcomes. It can facilitate shared medical decision making and patient centered care.<br /> (Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Longitudinal Studies
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Prostatic Neoplasms radiotherapy
Surveys and Questionnaires
Intestinal Diseases physiopathology
Intestinal Diseases psychology
Postoperative Complications physiopathology
Postoperative Complications psychology
Prostatectomy
Prostatic Neoplasms surgery
Quality of Life
Sexual Dysfunction, Physiological physiopathology
Sexual Dysfunction, Physiological psychology
Urologic Diseases physiopathology
Urologic Diseases psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3792
- Volume :
- 191
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 24076307
- Full Text :
- https://doi.org/10.1016/j.juro.2013.09.040