50 results on '"Young, Grace J."'
Search Results
2. Prostate Surgery for Men with Lower Urinary Tract Symptoms: Do We Need Urodynamics to Find the Right Candidates? Exploratory Findings from the UPSTREAM Trial
- Author
-
Young, Grace J., Metcalfe, Chris, Lane, J. Athene, Lewis, Amanda L., Abrams, Paul, Blair, Peter S., Ito, Hiroki, Chapple, Christopher, and Drake, Marcus J.
- Published
- 2022
- Full Text
- View/download PDF
3. Use of the International Consultation on Incontinence Questionnaires Bladder Diary in Men Seeking therapy for Lower Urinary Tract Symptoms
- Author
-
Ito, Hiroki, Abrams, Paul, Lewis, Amanda L., Young, Grace J., Blair, Peter S., Cotterill, Nikki, Lane, J. Athene, and Drake, Marcus J.
- Published
- 2022
- Full Text
- View/download PDF
4. Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality: A Secondary Analysis of the CAP Randomized Clinical Trial.
- Author
-
Martin, Richard M., Turner, Emma L., Young, Grace J., Metcalfe, Chris, Walsh, Eleanor I., Lane, J. Athene, Sterne, Jonathan A. C., Noble, Sian, Holding, Peter, Ben-Shlomo, Yoav, Williams, Naomi J., Pashayan, Nora, Bui, Mai Ngoc, Albertsen, Peter C., Seibert, Tyler M., Zietman, Anthony L., Oxley, Jon, Adolfsson, Jan, Mason, Malcolm D., and Davey Smith, George
- Abstract
This secondary analysis of a randomized clinical trial assesses whether screening for prostate-specific antigen reduces prostate cancer mortality at 15-year follow-up. Key Points: Question: In men aged 50 to 69 years, does a single invitation for a prostate-specific antigen (PSA) screening test reduce prostate cancer mortality at 15-year follow-up compared with no invitation for testing? Findings: In this secondary analysis of a randomized clinical trial of 415 357 men aged 50 to 69 years randomized to a single invitation for PSA screening (n = 195 912) or a control group without PSA screening (n = 219 445) and followed up for a median of 15 years, risk of death from prostate cancer was lower in the group invited to screening (0.69% vs 0.78%; mean difference, 0.09%) compared with the control group. Meaning: Compared with no invitation for routine PSA testing, a single invitation for a PSA screening test reduced prostate cancer mortality at a median follow-up of 15 years, but the absolute mortality benefit was small. Importance: The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) reported no effect of prostate-specific antigen (PSA) screening on prostate cancer mortality at a median 10-year follow-up (primary outcome), but the long-term effects of PSA screening on prostate cancer mortality remain unclear. Objective: To evaluate the effect of a single invitation for PSA screening on prostate cancer–specific mortality at a median 15-year follow-up compared with no invitation for screening. Design, Setting, and Participants: This secondary analysis of the CAP randomized clinical trial included men aged 50 to 69 years identified at 573 primary care practices in England and Wales. Primary care practices were randomized between September 25, 2001, and August 24, 2007, and men were enrolled between January 8, 2002, and January 20, 2009. Follow-up was completed on March 31, 2021. Intervention: Men received a single invitation for a PSA screening test with subsequent diagnostic tests if the PSA level was 3.0 ng/mL or higher. The control group received standard practice (no invitation). Main Outcomes and Measures: The primary outcome was reported previously. Of 8 prespecified secondary outcomes, results of 4 were reported previously. The 4 remaining prespecified secondary outcomes at 15-year follow-up were prostate cancer–specific mortality, all-cause mortality, and prostate cancer stage and Gleason grade at diagnosis. Results: Of 415 357 eligible men (mean [SD] age, 59.0 [5.6] years), 98% were included in these analyses. Overall, 12 013 and 12 958 men with a prostate cancer diagnosis were in the intervention and control groups, respectively (15-year cumulative risk, 7.08% [95% CI, 6.95%-7.21%] and 6.94% [95% CI, 6.82%-7.06%], respectively). At a median 15-year follow-up, 1199 men in the intervention group (0.69% [95% CI, 0.65%-0.73%]) and 1451 men in the control group (0.78% [95% CI, 0.73%-0.82%]) died of prostate cancer (rate ratio [RR], 0.92 [95% CI, 0.85-0.99]; P =.03). Compared with the control, the PSA screening intervention increased detection of low-grade (Gleason score [GS] ≤6: 2.2% vs 1.6%; P <.001) and localized (T1/T2: 3.6% vs 3.1%; P <.001) disease but not intermediate (GS of 7), high-grade (GS ≥8), locally advanced (T3), or distally advanced (T4/N1/M1) tumors. There were 45 084 all-cause deaths in the intervention group (23.2% [95% CI, 23.0%-23.4%]) and 50 336 deaths in the control group (23.3% [95% CI, 23.1%-23.5%]) (RR, 0.97 [95% CI, 0.94-1.01]; P =.11). Eight of the prostate cancer deaths in the intervention group (0.7%) and 7 deaths in the control group (0.5%) were related to a diagnostic biopsy or prostate cancer treatment. Conclusions and Relevance: In this secondary analysis of a randomized clinical trial, a single invitation for PSA screening compared with standard practice without routine screening reduced prostate cancer deaths at a median follow-up of 15 years. However, the absolute reduction in deaths was small. Trial Registration: isrctn.org Identifier: ISRCTN92187251 [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. Factors associated with trial recruitment, preferences, and treatments received were elucidated in a comprehensive cohort study
- Author
-
Holding, Peter, Mason, Malcolm, Catto, James W.F., Rosario, Derek J., Staffurth, John, Kynaston, Howard, Hughes, Owen, Bollina, Prasad, Doherty, Alan, Gnanapragasam, Vincent, Kockelbergh, Roger, Paul, Alan, Paez, Edgar, Gillatt, David, Rowe, Edward, Oxley, Jon, Donovan, Jenny L., Opmeer, Brent, Young, Grace J., Mills, Nicola, Martin, Richard M., Lane, J. Athene, Metcalfe, Chris, Peters, Tim J., Davis, Michael, Turner, Emma L., Walsh, Eleanor, Neal, David E., and Hamdy, Freddie C.
- Published
- 2019
- Full Text
- View/download PDF
6. Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms: Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM)
- Author
-
Lewis, Amanda L., Young, Grace J., Abrams, Paul, Blair, Peter S., Chapple, Christopher, Glazener, Cathryn M.A., Horwood, Jeremy, McGrath, John S., Noble, Sian, Taylor, Gordon T., Ito, Hiroki, Belal, Mohammed, Davies, Melissa C., Dickinson, Andrew J., Foley, Charlotte L., Foley, Steve, Fulford, Simon, Gammal, Mohsen M., Garthwaite, Mary, Harris, Mark R.E., Ilie, Petre C., Jones, Robert, Sabbagh, Samer, Mason, Robert G., McLarty, Ester, Mishra, Vibhash, Mom, Jaswant, Morley, Roland, Natale, Salvatore, Nitkunan, Tharani, Page, Tobias, Payne, David, Rashid, Tina G., Saeb-Parsy, Kasra, Sandhu, Sarb S., Simoes, Adrian, Singh, Gurpreet, Sullivan, Mark, Tempest, Heidi V., Viswanath, Srinivasa, Walker, Roger M.H., Lane, J. Athene, and Drake, Marcus J.
- Published
- 2019
- Full Text
- View/download PDF
7. A prospective cohort and extended comprehensive-cohort design provided insights about the generalizability of a pragmatic trial: the ProtecT prostate cancer trial
- Author
-
Bollina, Prasad, Catto, James, Doble, Andrew, Doherty, Alan, Gillatt, David, Gnanapragasam, Vincent, Holding, Peter, Hughes, Owen, Kockelbergh, Roger, Kynaston, Howard, Mason, Malcolm, Oxley, Jon, Paul, Alan, Paez, Edgar, Rosario, Derek J., Rowe, Edward, Staffurth, John, Donovan, Jenny L., Young, Grace J., Walsh, Eleanor I., Metcalfe, Chris, Lane, J. Athene, Martin, Richard M., Tazewell, Marta K., Davis, Michael, Peters, Tim J., Turner, Emma L., Mills, Nicola, Khazragui, Hanan, Khera, Tarnjit K., Neal, David E., and Hamdy, Freddie C.
- Published
- 2018
- Full Text
- View/download PDF
8. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer
- Author
-
Hamdy, Freddie C., primary, Donovan, Jenny L., additional, Lane, J. Athene, additional, Metcalfe, Chris, additional, Davis, Michael, additional, Turner, Emma L., additional, Martin, Richard M., additional, Young, Grace J., additional, Walsh, Eleanor I., additional, Bryant, Richard J., additional, Bollina, Prasad, additional, Doble, Andrew, additional, Doherty, Alan, additional, Gillatt, David, additional, Gnanapragasam, Vincent, additional, Hughes, Owen, additional, Kockelbergh, Roger, additional, Kynaston, Howard, additional, Paul, Alan, additional, Paez, Edgar, additional, Powell, Philip, additional, Rosario, Derek J., additional, Rowe, Edward, additional, Mason, Malcolm, additional, Catto, James W.F., additional, Peters, Tim J., additional, Oxley, Jon, additional, Williams, Naomi J., additional, Staffurth, John, additional, and Neal, David E., additional
- Published
- 2023
- Full Text
- View/download PDF
9. Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment
- Author
-
Donovan, Jenny L., primary, Hamdy, Freddie C., additional, Lane, J. Athene, additional, Young, Grace J., additional, Metcalfe, Chris, additional, Walsh, Eleanor I., additional, Davis, Michael, additional, Steuart-Feilding, Thomas, additional, Blazeby, Jane M., additional, Avery, Kerry N. L., additional, Martin, Richard M., additional, Bollina, Prasad, additional, Doble, Andrew, additional, Doherty, Alan, additional, Gillatt, David, additional, Gnanapragasam, Vincent, additional, Hughes, Owen, additional, Kockelbergh, Roger, additional, Kynaston, Howard, additional, Paul, Alan, additional, Paez, Edgar, additional, Powell, Phillip, additional, Rosario, Derek J., additional, Rowe, Edward, additional, Mason, Malcolm, additional, Catto, James W. F., additional, Peters, Tim J., additional, Wade, Julia, additional, Turner, Emma L., additional, Williams, Naomi J., additional, Oxley, Jon, additional, Staffurth, John, additional, Bryant, Richard J., additional, and Neal, David E., additional
- Published
- 2023
- Full Text
- View/download PDF
10. Sources of online information utilized by caregivers of pediatric patients with atopic dermatitis
- Author
-
Rowe, Georgina, primary, Young, Grace J., additional, and Luu, Minnelly, additional
- Published
- 2023
- Full Text
- View/download PDF
11. Evita’s lobotomy
- Author
-
Young, Grace J., Bi, Wenya Linda, Smith, Timothy R., Brewster, Ryan, Gormley, William B., Dunn, Ian F., Laws, Edward R., and Nijensohn, Daniel E.
- Published
- 2015
- Full Text
- View/download PDF
12. Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial
- Author
-
Martin, Richard M., Donovan, Jenny L., Turner, Emma L., Metcalfe, Chris, Young, Grace J., Walsh, Eleanor I., Lane, J. Athene, Noble, Sian, Oliver, Steven E., Evans, Simon, Sterne, Jonathan A. C., Holding, Peter, Ben-Shlomo, Yoav, Brindle, Peter, Williams, Naomi J., Hill, Elizabeth M., Ng, Siaw Yein, Toole, Jessica, Tazewell, Marta K., Hughes, Laura J., Davies, Charlotte F., Thorn, Joanna C., Down, Elizabeth, Davey Smith, George, Neal, David E., and Hamdy, Freddie C.
- Published
- 2018
- Full Text
- View/download PDF
13. Functional and quality of life outcomes of localised prostate cancer treatments (Prostate Testing for Cancer and Treatment [ProtecT] study).
- Author
-
Lane, Janet Athene, Donovan, Jenny L., Young, Grace J., Davis, Michael, Walsh, Eleanor I., Avery, Kerry N.L., Blazeby, Jane M., Mason, Malcolm D., Martin, Richard M., Peters, Tim J., Turner, Emma L., Wade, Julia, Bollina, Prasad, Catto, James W.F., Doherty, Alan, Gillatt, David, Gnanapragasam, Vincent, Hughes, Owen, Kockelbergh, Roger, and Kynaston, Howard
- Subjects
PROSTATE cancer ,CANCER treatment ,PATIENT reported outcome measures ,RADICAL prostatectomy ,QUALITY of life ,FECAL incontinence - Abstract
Objective: To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision‐making. Patients and Methods: Men aged 50–69 years diagnosed with localised prostate cancer by prostate‐specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external‐beam radiotherapy (EBRT) with concurrent androgen‐deprivation therapy (ADT) and 77 low‐dose‐rate brachytherapy (BT, not a randomised treatment). Patient‐reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results: Treatment‐received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion: Treatment decision‐making for localised prostate cancer can be informed by these 6‐year functional and QoL outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
14. Mycosis Fungoides in 2 Pediatric Patients with Atopic Dermatitis
- Author
-
Young, Grace J., primary, Luu, Minnelly, additional, and Izadi, Neema, additional
- Published
- 2021
- Full Text
- View/download PDF
15. Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received
- Author
-
Neal, David E., Metcalfe, Chris, Donovan, Jenny L., Lane, J. Athene, Davis, Michael, Young, Grace J., Dutton, Susan J., Walsh, Eleanor I., Martin, Richard M., Peters, Tim. J., Turner, Emma L., Mason, Malcolm, Bryant, Richard, Bollina, Prasad, Catto, James, Doherty, Alan, Gillatt, David, Gnanapragasam, Vincent, Holding, Peter, Hughes, Owen, Kockelbergh, Roger, Kynaston, Howard, Oxley, Jon, Paul, Alan, Paez, Edgar, Rosario, Derek J., Rowe, Edward, Staffurth, John, Altman, Doug G., Hamdy, Freddie C., Peters, Tim J., Doble, Andrew, Powell, Philip, Prescott, Stephen, Rosario, Derek, Anderson, John B., Aning, Jonathan, Durkan, Garett, Koupparis, Anthony, Leung, Hing, Mariappan, Param, McNeill, Alan, Persad, Raj, Schwaibold, Hartwig, Tulloch, David, Wallace, Michael, Bonnington, Susan, Bradshaw, Lynne, Cooper, Deborah, Elliott, Emma, Herbert, Phillipa, Howson, Joanne, Jones, Amanda, Lennon, Teresa, Lyons, Norma, Moody, Hilary, Plumb, Claire, O'Sullivan, Tricia, Salter, Elizabeth, Thompson, Pauline, Tidball, Sarah, Blaikie, Jan, Gray, Catherine, Adam, Tonia, Askew, Sarah, Atkinson, Sharon, Baynes, Tim, Brain, Carole, Breen, Viv, Brunt, Sarah, Bryne, Sean, Bythem, Jo, Clarke, Jenny, Cloete, Jenny, Dark, Susan, Davis, Gill, Rue, Rachael De La, Denizot, Jane, Dewhurst, Elspeth, Dimes, Anna, Dixon, Nicola, Ebbs, Penny, Emmerson, Ingrid, Ferguson, Jill, Gadd, Ali, Geoghegan, Lisa, Grant, Alison, Grant, Collette, Godfrey, Rosemary, Goodwin, Louise, Hall, Susie, Hart, Liz, Harvey, Andrew, Hoult, Chloe, Hawkins, Sarah, Holling, Sharon, Innes, Alastair, Kilner, Sue, Marshall, Fiona, Mellen, Louise, Moore, Andrea, Napier, Sally, Needham, Julie, Pearse, Kevin, Pisa, Anna, Rees, Mark, Richards, Ellie, Robson, Lindsay, Roxburgh, Janet, Samuel, Nikki, Sharkey, Irene, Slater, Michael, Smith, Donna, Taggart, Pippa, Taylor, Helen, Taylor, Vicky, Thomas, Ayesha, Tomkies, Briony, Trewick, Nicola, Ward, Claire, Walker, Christy, Williams, Ayesha, Woodhouse, Colin, Wyber, Elizabeth, Bahl, Amit, Benson, Richard, Beresford, Mark, Ferguson, Catherine, Graham, John, Herbert, Chris, Howard, Grahame, James, Nick, Kirkbride, Peter, Law, Alastair, Loughrey, Carmel, McClaren, Duncan, Patterson, Helen, Pedley, Ian, Roberts, Trevor, Robinson, Angus, Russell, Simon, Symonds, Paul, Thanvi, Narottam, Vasanthan, Subramaniam, Wilson, Paula, Robinson, Mary, Bhattarai, Selina, Deshmukh, Neeta, Dormer, John, Fernando, Malee, Goepel, John, Griffiths, David, Grigor, Ken, Mayer, Nick, Varma, Murali, Warren, Anne, Appleby, Helen, Ash, Dominic, Aston, Dean, Bolton, Steven, Chalmers, Graham, Conway, John, Early, Nick, Geater, Tony, Goddall, Lynda, Heymann, Claire, Hicks, Deborah, Jones, Liza, Lamb, Susan, Lambert, Geoff, Lawrence, Gill, Lewis, Geraint, Lilley, John, MacLeod, Aileen, Massey, Pauline, McQueen, Alison, Moore, Rollo, Penketh, Lynda, Potterton, Janet, Roberts, Neil, Showler, Helen, Shuttleworth, Pam, Slade, Stephen, Steele, Alasdair, Swinscoe, James, Tiffany, Marie, Townley, John, Treeby, Jo, Weston, Michael, Wilkinson, Joyce, Williams, Lorraine, Wills, Lucy, Woodley, Owain, Yarrow, Sue, Brindle, Lucy, Davies, Linda, Dedman, Dan, Down, Elizabeth, Khazragui, Hanan, Noble, Sian, Taylor, Hilary, Tazewell, Marta, Wade, Julia, Walsh, Eleanor, Baker, Susan, Bellis-Sheldon, Elizabeth, Bougard, Chantal, Bowtell, Joanne, Brewer, Catherine, Burton, Chris, Charlton, Jennie, Christoforou, Nicholas, Clark, Rebecca, Coull, Susan, Croker, Christine, Currer, Rosemary, Daisey, Claire, Delaney, Gill, Donohue, Rose, Drew, Jane, Farmer, Rebecca, Fry, Susan, Haddow, Jean, Hale, Alex, Halpin, Susan, Harris, Belle, Hattrick, Barbara, Holmes, Sharon, Hunt, Helen, Jackson, Vicky, Johnson, Donna, Le Butt, Mandy, Leworthy, Jo, Liddiatt, Tanya, Martin, Alex, Mauree, Jainee, Moore, Susan, Moulam, Gill, Mutch, Jackie, Parker, Kathleen, Pawsey, Christopher, Purdie, Michelle, Robson, Teresa, Smith, Lynne, Stenton, Carole, Steuart-Feilding, Tom, Stott, Beth, Sully, Chris, Sutton, Caroline, Torrington, Carol, Wilkins, Zoe, Williams, Sharon, Wilson, Andrea, Weaver, Ashleigh, Albertsen, Peter, Adolfsson, Jan, Baum, Michael, McFarlane, Jon, Reid, Colette, Turner, Emma, Zietman, Anthony, Hill, Elizabeth, Ng, Siaw Yein, Williams, Naomi, Toole, Jessica, Davies, Charlotte, Hughes, Laura, Rowlands, Mari-Anne, Bell, Lindsey, Harrison, Sean, Mauree, Jainnee, Grant, Adrian, Roberts, Ian, Ashby, Deborah, Cowan, Richard, Fayers, Peter, Mellon, Killian, N’Dow, James, O’Brien, Tim, Sokhal, Michael, Dearnaley, David, Schröder, Fritz, Roberts, Tracy, and for the ProtecT Study Group, .
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Urinary incontinence ,Active monitoring ,BTC (Bristol Trials Centre) ,Metastasis ,law.invention ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,ProtecT trial ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,External beam radiotherapy ,Watchful Waiting ,Aged ,Prostatectomy ,Disease progression ,Radiotherapy ,business.industry ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,Radical prostatectomy ,Treatment Outcome ,030220 oncology & carcinogenesis ,Propensity score matching ,Cohort ,Disease Progression ,BRTC ,medicine.symptom ,Sexual function ,business ,Literatur Kommentiert - Abstract
Background: The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer (PCa) randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective: To determine report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, Setting, and Participants: This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention: Two cohorts included 1643 men who agreed to be randomised; 997 declined randomisation and chose treatment. Outcome Measurements and Statistical Analysis: Health-related quality of life impacts on urinary, bowel, and sexual function were assessed using patient-reported outcome measures. Analysis was carried out based on treatment received for each cohort and on pooled estimates using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and Limitations: According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and outdating of the interventions being evaluated during the lengthy follow-up required in trials of screen-detected PCa. Conclusions: Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient Summary: More than 90 out of every 100 men with localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are much better after active monitoring, but the risks of spreading of prostate cancer are more common.
- Published
- 2020
16. Oral prednisolone for acute lower respiratory tract infection in clinically unrecognised asthma: an exploratory analysis of the Oral Steroids for Acute Cough (OSAC) randomised controlled trial
- Author
-
Hawkey, Sean, primary, Young, Grace J, additional, Little, Paul, additional, Moore, Michael, additional, and Hay, Alastair D, additional
- Published
- 2020
- Full Text
- View/download PDF
17. Reply by Authors
- Author
-
Ito, Hiroki, primary, Young, Grace J., additional, Lewis, Amanda L., additional, Blair, Peter S., additional, Cotterill, Nikki, additional, Lane, J. Athene, additional, Sakamaki, Kentaro, additional, Drake, Marcus J., additional, and Abrams, Paul, additional
- Published
- 2020
- Full Text
- View/download PDF
18. Grading Severity and Bother Using the International Prostate Symptom Score and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Score in Men Seeking Lower Urinary Tract Symptoms Therapy
- Author
-
Ito, Hiroki, primary, Young, Grace J., additional, Lewis, Amanda L., additional, Blair, Peter S., additional, Cotterill, Nikki, additional, Lane, J. Athene, additional, Sakamaki, Kentaro, additional, Drake, Marcus J., additional, and Abrams, Paul, additional
- Published
- 2020
- Full Text
- View/download PDF
19. Diagnostic Assessment of Lower Urinary Tract Symptoms in Men Considering Prostate Surgery: A Noninferiority Randomised Controlled Trial of Urodynamics in 26 Hospitals
- Author
-
Drake, Marcus J., primary, Lewis, Amanda L., additional, Young, Grace J., additional, Abrams, Paul, additional, Blair, Peter S., additional, Chapple, Christopher, additional, Glazener, Cathryn M.A., additional, Horwood, Jeremy, additional, McGrath, John S., additional, Noble, Sian, additional, Taylor, Gordon T., additional, and Lane, J. Athene, additional
- Published
- 2020
- Full Text
- View/download PDF
20. Erratum to ‘Ten-year Mortality, Disease Progression, and Treatment-related Side Effects in Men with Localised Prostate Cancer from the ProtecT Randomised Controlled Trial According to Treatment Received’ [European Urology 77 (2020) 320–330]
- Author
-
Neal, David E., primary, Metcalfe, Chris, additional, Donovan, Jenny L., additional, Lane, J. Athene, additional, Davis, Michael, additional, Young, Grace J., additional, Dutton, Susan J., additional, Walsh, Eleanor I., additional, Martin, Richard M., additional, Peters, Tim. J., additional, Turner, Emma L., additional, Mason, Malcolm, additional, Bryant, Richard, additional, Bollina, Prasad, additional, Catto, James, additional, Doherty, Alan, additional, Gillatt, David, additional, Gnanapragasam, Vincent, additional, Holding, Peter, additional, Hughes, Owen, additional, Kockelbergh, Roger, additional, Kynaston, Howard, additional, Oxley, Jon, additional, Paul, Alan, additional, Paez, Edgar, additional, Rosario, Derek J., additional, Rowe, Edward, additional, Staffurth, John, additional, Altman, Doug G., additional, and Hamdy, Freddie C., additional
- Published
- 2020
- Full Text
- View/download PDF
21. Urodynamics tests for the diagnosis and management of bladder outlet obstruction in men: the UPSTREAM non-inferiority RCT
- Author
-
Lewis, Amanda L, primary, Young, Grace J, additional, Selman, Lucy E, additional, Rice, Caoimhe, additional, Clement, Clare, additional, Ochieng, Cynthia A, additional, Abrams, Paul, additional, Blair, Peter S, additional, Chapple, Christopher, additional, Glazener, Cathryn MA, additional, Horwood, Jeremy, additional, McGrath, John S, additional, Noble, Sian, additional, Taylor, Gordon T, additional, Lane, J Athene, additional, and Drake, Marcus J, additional
- Published
- 2020
- Full Text
- View/download PDF
22. The cost-effectiveness of transurethral resection of the prostate vs thulium laser transurethral vaporesection of the prostate in the UNBLOCS randomised controlled trial for benign prostatic obstruction
- Author
-
Noble, Sian M., primary, Ahern, Aideen M., additional, Worthington, Jo, additional, Hashim, Hashim, additional, Taylor, Hilary, additional, Young, Grace J., additional, Brookes, Sara, additional, Abrams, Paul, additional, Johnson, Lyndsey, additional, Khan, Rafiyah, additional, Page, Toby, additional, Swami, Kuchibhotla Satchi, additional, and Lane, Janet Athene, additional
- Published
- 2020
- Full Text
- View/download PDF
23. Drainage, irrigation and fibrinolytic therapy (DRIFT) for posthaemorrhagic ventricular dilatation: 10-year follow-up of a randomised controlled trial
- Author
-
Luyt, Karen, primary, Jary, Sally L, additional, Lea, Charlotte L, additional, Young, Grace J., additional, Odd, David E, additional, Miller, Helen E, additional, Kmita, Grazyna, additional, Williams, Cathy, additional, Blair, Peter S, additional, Hollingworth, William, additional, Morgan, Michelle, additional, Smith-Collins, Adam P, additional, Walker-Cox, Steven, additional, Aquilina, Kristian, additional, Pople, Ian, additional, and Whitelaw, Andrew G, additional
- Published
- 2020
- Full Text
- View/download PDF
24. Factors associated with trial recruitment, preferences, and treatments received were elucidated in a comprehensive cohort study
- Author
-
Donovan, Jenny L., primary, Opmeer, Brent, additional, Young, Grace J., additional, Mills, Nicola, additional, Martin, Richard M., additional, Lane, J. Athene, additional, Metcalfe, Chris, additional, Peters, Tim J., additional, Davis, Michael, additional, Turner, Emma L., additional, Walsh, Eleanor, additional, Neal, David E., additional, Hamdy, Freddie C., additional, Holding, Peter, additional, Mason, Malcolm, additional, Catto, James W.F., additional, Rosario, Derek J., additional, Staffurth, John, additional, Kynaston, Howard, additional, Hughes, Owen, additional, Bollina, Prasad, additional, Doherty, Alan, additional, Gnanapragasam, Vincent, additional, Kockelbergh, Roger, additional, Paul, Alan, additional, Paez, Edgar, additional, Gillatt, David, additional, Rowe, Edward, additional, and Oxley, Jon, additional
- Published
- 2019
- Full Text
- View/download PDF
25. Anaesthetic–analgesic ear drops to reduce antibiotic consumption in children with acute otitis media: the CEDAR RCT
- Author
-
Hay, Alastair D, primary, Downing, Harriet, additional, Francis, Nick A, additional, Young, Grace J, additional, Clement, Clare, additional, Harris, Sue D, additional, Ahern, Aideen, additional, Schofield, Behnaz, additional, Thomas, Tammy E, additional, Horwood, Jeremy, additional, Blair, Peter S, additional, Hollingworth, William, additional, Wilson, Victoria, additional, Metcalfe, Chris, additional, Stoddart, Peter, additional, Nunez, Desmond, additional, Lyttle, Mark D, additional, Little, Paul, additional, and Moore, Michael V, additional
- Published
- 2019
- Full Text
- View/download PDF
26. Ten-year follow-up of a randomised trial of drainage, irrigation and fibrinolytic therapy (DRIFT) in infants with post-haemorrhagic ventricular dilatation
- Author
-
Luyt, Karen, primary, Jary, Sally, additional, Lea, Charlotte, additional, Young, Grace J, additional, Odd, David, additional, Miller, Helen, additional, Kmita, Grazyna, additional, Williams, Cathy, additional, Blair, Peter S, additional, Fernández, Aída Moure, additional, Hollingworth, William, additional, Morgan, Michelle, additional, Smith-Collins, Adam, additional, Thai, N Jade, additional, Walker-Cox, Steven, additional, Aquilina, Kristian, additional, Pople, Ian, additional, and Whitelaw, Andrew, additional
- Published
- 2019
- Full Text
- View/download PDF
27. Cross-sectional study evaluating data quality of the National Cancer Registration and Analysis Service (NCRAS) prostate cancer registry data using the Cluster randomised trial of PSA testing for Prostate cancer (CAP)
- Author
-
Merriel, Samuel William David, Turner, Emma L, Walsh, Eleanor, Young, Grace J, Metcalfe, Chris, Hounsome, Luke, Tudge, Isobel, Donovan, Jenny, Hamdy, Freddie, Neal, David, and Martin, Richard M
- Subjects
Male ,urological tumours ,Epidemiology ,Research ,Prostate ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,BTC (Bristol Trials Centre) ,Data Accuracy ,Cross-Sectional Studies ,REGISTRY ,Lymphatic Metastasis ,Humans ,Registries ,Neoplasm Grading ,Cancer ,prostate disease ,Aged ,Neoplasm Staging ,Randomized Controlled Trials as Topic - Abstract
ObjectivesTo compare the completeness and agreement of prostate cancer data recorded by the National Cancer Registration and Analysis Service (NCRAS) with research-level data specifically abstracted from medical records from the Cluster randomised trial of PSA testing for Prostate cancer (CAP) trial.DesignCross-sectional comparison studyParticipantsWe included 1,356 men from the CAP trial cohort who were linked to the NCRASregistry.Primary and secondary outcome measuresCompleteness of prostate cancer data in NCRAS and CAP and agreement for TNMstage (T1/T2; T3; T4/N1/M1) and Gleason grade (4-6; 7; 8-10), measured bydifferences in proportions and Cohen’s Kappa statistic. Data were also stratified by year and pre- versus post-2010, when NCRAS reporting standards changed.ResultsCompared to CAP, completeness was lower in NCRAS for Gleason grade (41.2% vs 76.7%, difference 35.5 95% CI 32.1, 39.0) and TNM stage (29.9% vs 67.6%, difference 37.6 95% CI 34.1, 41.1). NCRAS completeness for Gleason grade (pre- versus post-2010 31.69% vs 64%; difference 32.31 95% CI 26.76, 37.87) and TNM stage (19.31% vs 55.50%; difference 36.19 95% CI 30.72, 41.67) improved over time. Agreement for Gleason grade was high (Cohen’s Kappa, κ=0.90 95% CI 0.88, 0.93), but lower for TNM stage (κ=0.41 95% CI 0.37, 0.51) overall. There was a trend towards improved agreement on Gleason grade, but not TNM stage, when comparing pre- and post-2010.ConclusionNCRAS case identification was very high, however data on prostate cancer grade was less complete than CAP, and agreement for TNM stage was modest. Although the completeness of NCRAS data has improved since 2010, the higher completeness rate in CAP demonstrate that gains could potentially be achieved in routine registry data. This study’s findings highlight a need for improved recording of stage and grade data in the source medical records.
- Published
- 2017
28. Prostate Specific Antigen (PSA) testing of men in UK general practice::a 10-year longitudinal cohort study
- Author
-
Young, Grace J, Harrison, Sean, Turner, Emma L, I Walsh, Eleanor, Oliver, Steven E, Ben-Shlomo, Yoav, Evans, Simon, Lane, J Athene, Neal, David E., Hamdy, Freddie C., Donovan, Jenny L., Martin, Richard M, and Metcalfe, Chris
- Subjects
Male ,Urologic Diseases ,Biopsy ,General Practice ,psa testing ,urologic and male genital diseases ,BTC (Bristol Trials Centre) ,Cohort Studies ,Diagnosis ,Humans ,Mass Screening ,CPRD ,Longitudinal Studies ,Early Detection of Cancer ,Aged ,PSA testing ,Primary Health Care ,Research ,screening ,Prostate Cancer ,Age Factors ,Prostate ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,prostate cancer ,primary health care ,Cross-Sectional Studies ,Centre for Surgical Research ,Screening ,BRTC ,Public Health ,ICEP ,Family Practice ,Men's Health - Abstract
OBJECTIVES: Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). SETTING, PARTICIPANTS AND OUTCOME MEASURES: Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. RESULTS: The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend
- Published
- 2017
29. Patient-reported outcomes in the ProtecT randomized trial of clinically localized prostate cancer treatments: study design, and baseline urinary, bowel and sexual function and quality of life
- Author
-
Lane, Athene, Metcalfe, Chris, Young, Grace J., Peters, Tim J., Blazeby, Jane, Avery, Kerry N. L., Dedman, Daniel, Down, Liz, Mason, Malcolm D., Neal, David E., Hamdy, Freddie C., Donovan, Jenny L., Bonnington, Sue, Bradshaw, Lynne, Cooper, Debbie, Elliott, Emma, Herbert, Pippa, Holding, Peter, Howson, Joanne, Jones, Mandy, Lennon, Teresa, Lyons, Norma, Moody, Hilary, Plumb, Claire, O'Sullivan, Tricia, Salter, Liz, Tidball, Sarah, Thompson, Pauline, Adam, Tonia, Askew, Sarah, Atkinson, Sharon, Baynes, Tim, Blaikie, Jan, Brain, Carole, Breen, Viv, Brunt, Sarah, Bryne, Sean, Bythem, Jo, Clarke, Jenny, Cloete, Jenny, Dark, Susan, Davis, Gill, De La Rue, Rachael, Denizot, Jane, Dewhurst, Elspeth, Dimes, Anna, Dixon, Nicola, Ebbs, Penny, Emmerson, Ingrid, Ferguson, Jill, Gadd, Ali, Geoghegan, Lisa, Grant, Alison, Grant, Collette, Gray, Catherine, Godfrey, Rosemary, Goodwin, Louise, Hall, Susie, Hart, Liz, Harvey, Andrew, Hoult, Chloe, Hawkins, Sarah, Holling, Sharon, Innes, Alastair, Kilner, Sue, Marshall, Fiona, Mellen, Louise, Moore, Andrea, Napier, Sally, Needham, Julie, Pearse, Kevin, Pisa, Anna, Rees, Mark, Richards, Elliw, Robson, Lindsay, Roxburgh, Janet, Samuel, Nikki, Sharkey, Irene, Slater, Michael, Smith, Donna, Taggart, Pippa, Taylor, Helen, Taylor, Vicky, Thomas, Ayesha, Tomkies, Briony, Trewick, Nicola, Ward, Claire, Walker, Christy, Williams, Ayesha, Woodhouse, Colin, Wyber, Elizabeth, Aning, Jonathan, Bollina, Prasad, Catto, Jim, Doble, Andrew, Doherty, Alan, Durkan, Garett, Gillatt, David, Hughes, Owen, Kocklebergh, Roger, Kouparis, Anthony, Kynaston, Howard, Leung, Hing, Mariappan, Param, McNeill, Alan, Paez, Edgar, Paul, Alan, Persad, Raj, Powell, Philip, Prescott, Stephen, Rosario, Derek, Rowe, Edward, Schwaibold, Hartwig, Tulloch, David, Wallace, Mike, Bahl, Amit, Benson, Richard, Beresford, Mark, Ferguson, Catherine, Graham, John, Herbert, Chris, Howard, Grahame, James, Nick, Law, Alastair, Loughrey, Carmel, McClaren, Duncan, Patterson, Helen, Pedley, Ian, Robinson, Angus, Russell, Simon, Staffurth, John, Symonds, Paul, Thanvi, Narottam, Vasanthan, Subramaniam, Wilson, Paula, Appleby, Helen, Ash, Dominic, Aston, Dean, Bolton, Steven, Chalmers, Graham, Conway, John, Early, Nick, Geater, Tony, Goddall, Lynda, Heymann, Claire, Hicks, Deborah, Jones, Liza, Lamb, Susan, Lambert, Geoff, Lawrence, Gill, Lewis, Geraint, Lilley, John, MacLeod, Aileen, Massey, Pauline, McQueen, Alison, Moore, Rollo, Penketh, Lynda, Potterton, Janet, Roberts, Neil, Showler, Helen, Slade, Stephen, Steele, Alasdair, Swinscoe, James, Tiffany, Marie, Townley, John, Treeby, Jo, Wilkinson, Joyce, Williams, Lorraine, Wills, Lucy, Woodley, Owain, Yarrow, Sue, Bhattarai, Selina, Deshmukh, Neeta, Dormer, John, Fernando, Malee, Goepel, John, Griffiths, David, Grigor, Ken, Mayer, Nick, Oxley, Jon, Robinson, Mary, Varma, Murali, Warren, Anne, Brindle, Lucy, Davis, Michael, Khazragui, Hanan, Noble, Sian, Taylor, Hilary, Tazewell, Marta, Turner, Emma, Wade, Julia, Walsh, Eleanor, Baker, Susan, Bellis‐Sheldon, Elizabeth, Bougard, Chantal, Bowtell, Joanne, Brewer, Catherine, Burton, Chris, Charlton, Jennie, Christoforou, Nicholas, Clark, Rebecca, Coull, Susan, Croker, Christine, Currer, Rosemary, Daisey, Claire, Delaney, Gill, Donohue, Rose, Drew, Jane, Farmer, Rebecca, Fry, Susan, Haddow, Jean, Hale, Alex, Halpin, Susan, Harris, Belle, Hattrick, Barbara, Holmes, Sharon, Hunt, Helen, Jackson, Vicky, Johnson, Donna, Le Butt, Mandy, Leworthy, Jo, Liddiatt, Tanya, Martin, Alex, Mauree, Jainee, Moore, Susan, Moulam, Gill, Mutch, Jackie, Nash, Alena, Parker, Kathleen, Pawsey, Christopher, Purdie, Michelle, Robson, Teresa, Smith, Lynne, Snoeck, Jo, Stenton, Carole, Steuart‐Feilding, Tom, Sully, Chris, Sutton, Caroline, Torrington, Carol, Wilkins, Zoe, Williams, Sharon, Wilson, Andrea, Grant, Adrian, Roberts, Ian, Ashby, Deborah, Cowan, Richard, Fayers, Peter, Mellon, Killian, N'Dow, James, O'Brien, Tim, Sokhal, Michael, Baum, Michael, Adolfson, Jan, Albertsen, Peter, Dearnaley, David, Schroeder, Fritz, Roberts, Tracy, and Zietman, Anthony
- Subjects
Male ,Urological Oncology ,functional status ,law.invention ,Prostate cancer ,0302 clinical medicine ,Randomized controlled trial ,Quality of life ,law ,030212 general & internal medicine ,media_common ,treatment ,Middle Aged ,Urology & Nephrology ,prostate cancer ,Treatment Outcome ,Centre for Surgical Research ,030220 oncology & carcinogenesis ,Functional status ,BRTC ,Sexuality ,medicine.medical_specialty ,Urology ,Urinary system ,media_common.quotation_subject ,Urination ,Social class ,BTC (Bristol Trials Centre) ,03 medical and health sciences ,ProtecT trial ,Digestive System Physiological Phenomena ,Internal medicine ,medicine ,Humans ,Patient Reported Outcome Measures ,Aged ,business.industry ,Prostatic Neoplasms ,1103 Clinical Sciences ,protect trial ,medicine.disease ,Treatment ,ISRCTN 20141297 ,Physical therapy ,Quality of Life ,Sexual function ,business - Abstract
Objectives To present the baseline patient-reported outcome measures (PROMs) in the Prostate Testing for Cancer and Treatment (ProtecT) randomized trial comparing active monitoring, radical prostatectomy and external-beam conformal radiotherapy for localized prostate cancer and to compare results with other populations. Materials and Methods A total of 1643 randomized men, aged 50–69 years and diagnosed with clinically localized disease identified by prostate-specific antigen (PSA) testing, in nine UK cities in the period 1999–2009 were included. Validated PROMs for disease-specific (urinary, bowel and sexual function) and condition-specific impact on quality of life (Expanded Prostate Index Composite [EPIC], 2005 onwards; International Consultation on Incontinence Questionnaire- Urinary Incontinence [ICIQ-UI], 2001 onwards; the International Continence Society short-form male survey [ICSmaleSF]; anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), generic mental and physical health (12-item short-form health survey [SF-12]; EuroQol quality-of-life survey, the EQ-5D-3L) were assessed at prostate biopsy clinics before randomization. Descriptive statistics are presented by treatment allocation and by men’s age at biopsy and PSA testing time points for selected measures. Results A total of 1438 participants completed biopsy questionnaires (88%) and 77–88% of these were analysed for individual PROMs. Fewer than 1% of participants were using pads daily (5/ 754). Storage lower urinary tract symptoms were frequent (e.g. nocturia 22%, 312/1423). Bowel symptoms were rare, except for loose stools (16%, 118/754). One third of participants reported erectile dysfunction (241/735) and for 16% (118/731) this was a moderate or large problem. Depression was infrequent (80/1399, 6%) but 20% of participants (278/1403) reported anxiety. Sexual function and bother were markedly worse in older men (65– 70 years), whilst urinary bother and physical health were somewhat worse than in younger men (49–54 years, all P < 0.001). Bowel health, urinary function and depression were unaltered by age, whilst mental health and anxiety were better in older men (P < 0.001). Only minor differences existed in mental or physical health, anxiety and depression between PSA testing and biopsy assessments. Conclusion The ProtecT trial baseline PROMs response rates were high. Symptom frequencies and generic quality of life were similar to those observed in populations screened for prostate cancer and control subjects without cancer.
- Published
- 2016
30. The ProtecT trial: analysis of the patient cohort, baseline risk stratification and disease progression.
- Author
-
Bryant, Richard J., Oxley, Jon, Young, Grace J., Lane, Janet A., Metcalfe, Chris, Davis, Michael, Turner, Emma L., Martin, Richard M., Goepel, John R., Varma, Murali, Griffiths, David F., Grigor, Ken, Mayer, Nick, Warren, Anne Y., Bhattarai, Selina, Dormer, John, Mason, Malcolm, Staffurth, John, Walsh, Eleanor, and Rosario, Derek J.
- Subjects
DISEASE progression ,PROPORTIONAL hazards models ,COHORT analysis - Abstract
Objective: To test the hypothesis that the baseline clinico‐pathological features of the men with localized prostate cancer (PCa) included in the ProtecT (Prostate Testing for Cancer and Treatment) trial who progressed (n = 198) at a 10‐year median follow‐up were different from those of men with stable disease (n = 1409). Patients and Methods: We stratified the study participants at baseline according to risk of progression using clinical disease stage, pathological grade and PSA level, using Cox proportional hazard models. Results: The findings showed that 34% of participants (n = 505) had intermediate‐ or high‐risk PCa, and 66% (n = 973) had low‐risk PCa. Of 198 participants who progressed, 101 (51%) had baseline International Society of Urological Pathology Grade Group 1, 59 (30%) Grade Group 2, and 38 (19%) Grade Group 3 PCa, compared with 79%, 17% and 5%, respectively, for 1409 participants without progression (P < 0.001). In participants with progression, 38% and 62% had baseline low‐ and intermediate‐/high‐risk disease, compared with 69% and 31% of participants with stable disease (P < 0.001). Treatment received, age (65–69 vs 50–64 years), PSA level, Grade Group, clinical stage, risk group, number of positive cores, tumour length and perineural invasion were associated with time to progression (P ≤ 0.005). Men progressing after surgery (n = 19) were more likely to have a higher Grade Group and pathological stage at surgery, larger tumours, lymph node involvement and positive margins. Conclusions: We demonstrate that one‐third of the ProtecT cohort consists of people with intermediate‐/high‐risk disease, and the outcomes data at an average of 10 years' follow‐up are generalizable beyond men with low‐risk PCa. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
31. Factors Influencing Patient Decisions Regarding Treatments for Skin Growths: A Cross-Sectional Study
- Author
-
Li, David G., primary, Xia, Fan Di, additional, Rana, Jasmine, additional, Young, Grace J., additional, Alizadeh, Forootan, additional, Joyce, Cara, additional, Das, Shinjita, additional, and Mostaghimi, Arash, additional
- Published
- 2018
- Full Text
- View/download PDF
32. Generational influence on patient learning preferences in dermatology
- Author
-
Xia, Fan Di, primary, Rana, Jasmine, additional, Young, Grace J., additional, Das, Shinjita, additional, Alizadeh, Foorotan, additional, Joyce, Cara, additional, and Mostaghimi, Arash, additional
- Published
- 2018
- Full Text
- View/download PDF
33. A prospective cohort and extended comprehensive-cohort design provided insights about the generalizability of a pragmatic trial: the ProtecT prostate cancer trial
- Author
-
Donovan, Jenny L., primary, Young, Grace J., additional, Walsh, Eleanor I., additional, Metcalfe, Chris, additional, Lane, J. Athene, additional, Martin, Richard M., additional, Tazewell, Marta K., additional, Davis, Michael, additional, Peters, Tim J., additional, Turner, Emma L., additional, Mills, Nicola, additional, Khazragui, Hanan, additional, Khera, Tarnjit K., additional, Neal, David E., additional, Hamdy, Freddie C., additional, Bollina, Prasad, additional, Catto, James, additional, Doble, Andrew, additional, Doherty, Alan, additional, Gillatt, David, additional, Gnanapragasam, Vincent, additional, Holding, Peter, additional, Hughes, Owen, additional, Kockelbergh, Roger, additional, Kynaston, Howard, additional, Mason, Malcolm, additional, Oxley, Jon, additional, Paul, Alan, additional, Paez, Edgar, additional, Rosario, Derek J., additional, Rowe, Edward, additional, and Staffurth, John, additional
- Published
- 2018
- Full Text
- View/download PDF
34. A review of longitudinal clinical programs in US medical schools
- Author
-
Gheihman, Galina, primary, Jun, Tomi, additional, Young, Grace J, additional, Liebman, Daniel, additional, Sharma, Krishan, additional, Brandes, Eileen, additional, Ogur, Barbara, additional, and Hirsh, David A., additional
- Published
- 2018
- Full Text
- View/download PDF
35. Statistical analysis plan for the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM)
- Author
-
Young, Grace J., primary, Lewis, Amanda L., additional, Lane, J. Athene, additional, Winton, Helen L., additional, Drake, Marcus J., additional, and Blair, Peter S., additional
- Published
- 2017
- Full Text
- View/download PDF
36. Effect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Respiratory Tract Infection
- Author
-
Hay, Alastair D., primary, Little, Paul, additional, Harnden, Anthony, additional, Thompson, Matthew, additional, Wang, Kay, additional, Kendrick, Denise, additional, Orton, Elizabeth, additional, Brookes, Sara T., additional, Young, Grace J., additional, May, Margaret, additional, Hollinghurst, Sandra, additional, Carroll, Fran E., additional, Downing, Harriet, additional, Timmins, David, additional, Lafond, Natasher, additional, El-Gohary, Magdy, additional, and Moore, Michael, additional
- Published
- 2017
- Full Text
- View/download PDF
37. A computational model of 1,5-AG dynamics during pregnancy
- Author
-
Zekavat, Seyedeh M., primary, Butkovich, Slava, additional, Young, Grace J., additional, Nathan, David M., additional, and Petrasek, Danny, additional
- Published
- 2017
- Full Text
- View/download PDF
38. Management of intracranial melanomas in the era of precision medicine
- Author
-
Young, Grace J., primary, Bi, Wenya Linda, additional, Wu, Winona W., additional, Johanns, Tanner M., additional, Dunn, Gavin P., additional, and Dunn, Ian F., additional
- Published
- 2017
- Full Text
- View/download PDF
39. Assessing Interprofessional education in a student–faculty collaborative practice network
- Author
-
Young, Grace J., primary, Cohen, Marya J., additional, Blanchfield, Bonnie B., additional, Jones, Meissa M., additional, Reidy, Patricia A., additional, and Weinstein, Amy R., additional
- Published
- 2017
- Full Text
- View/download PDF
40. An unusual migratory polycyclic eruption after administration of prostaglandin E in a neonate
- Author
-
Young, Grace J., primary, Harter, Nicole, additional, and Luu, Minnelly, additional
- Published
- 2016
- Full Text
- View/download PDF
41. Informed consent in randomised controlled trials: development and preliminary evaluation of a measure of Participatory and Informed Consent (PIC).
- Author
-
Wade, Julia, Elliott, Daisy, Avery, Kerry N. L., Gaunt, Daisy, Young, Grace J., Barnes, Rebecca, Paramasivan, Sangeetha, Campbell, W. Bruce, Blazeby, Jane M., Birtle, Alison J., Stein, Rob C., Beard, David J., Halliday, Alison W., Donovan, Jenny L., ProtecT study group, CLASS study group, Chemorad study group, POUT study group, OPTIMA prelim study group, and CSAW study group and ACST-2 study group
- Subjects
INFORMED consent (Medical law) ,TRIALS (Law) ,CLINICAL trials ,PSYCHOMETRICS ,RANDOMIZED controlled trials ,CLINICAL trial laws ,PATIENT participation ,ATTITUDE (Psychology) ,COMMUNICATION ,HEALTH attitudes ,MEDICAL personnel ,MEDICAL protocols ,READABILITY (Literary style) ,RESEARCH evaluation ,ACCESS to information ,RESEARCH bias ,PATIENT selection ,PSYCHOLOGY of Research personnel ,PSYCHOLOGY of human research subjects ,HUMAN research subjects -- Legal status, laws, etc. ,MEDICAL laws - Abstract
Background: Informed consent (IC) is an ethical and legal prerequisite for trial participation, yet current approaches evaluating participant understanding for IC during recruitment lack consistency. No validated measure has been identified that evaluates participant understanding for IC based on their contributions during consent interactions. This paper outlines the development and formative evaluation of the Participatory and Informed Consent (PIC) measure for application to recorded recruitment appointments. The PIC allows the evaluation of recruiter information provision and evidence of participant understanding.Methods: Published guidelines for IC were reviewed to identify potential items for inclusion. Seventeen purposively sampled trial recruitment appointments from three diverse trials were reviewed to identify the presence of items relevant to IC. A developmental version of the measure (DevPICv1) was drafted and applied to six further recruitment appointments from three further diverse trials to evaluate feasibility, validity, stability and inter-rater reliability. Findings guided revision of the measure (DevPICv2) which was applied to six further recruitment appointments as above.Results: DevPICv1 assessed recruiter information provision (detail and clarity assessed separately) and participant talk (detail and understanding assessed separately) over 20 parameters (or 23 parameters for three-arm trials). Initial application of the measure to six diverse recruitment appointments demonstrated promising stability and inter-rater reliability but a need to simplify the measure to shorten time for completion. The revised measure (DevPICv2) combined assessment of detail and clarity of recruiter information and detail and evidence of participant understanding into two single scales for application to 22 parameters or 25 parameters for three-arm trials. Application of DevPICv2 to six further diverse recruitment appointments showed considerable improvements in feasibility (e.g. time to complete) with good levels of stability (i.e. test-retest reliability) and inter-rater reliability maintained.Conclusions: The DevPICv2 provides a measure for application to trial recruitment appointments to evaluate quality of recruiter information provision and evidence of patient understanding and participation during IC discussions. Initial evaluation shows promising feasibility, validity, reliability and ability to discriminate across a range of recruiter practice and evidence of participant understanding. More validation work is needed in new clinical trials to evaluate and refine the measure further. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
42. 131 Pediatric Skull Lesions
- Author
-
Jeelani, Yasser, primary, Da Silva, Stephanie L., additional, Young, Grace J., additional, Krieger, Mark D., additional, and McComb, J. Gordon, additional
- Published
- 2013
- Full Text
- View/download PDF
43. A review of longitudinal clinical programs in US medical schools
- Author
-
Gheihman, Galina, Jun, Tomi, Young, Grace J, Liebman, Daniel, Sharma, Krishan, Brandes, Eileen, Ogur, Barbara, and Hirsh, David A.
- Subjects
Undergraduate medical education ,longitudinality ,curriculum design ,integration ,continuity - Abstract
Background:: Longitudinal clinical experiences are a common component of undergraduate medical curricula, yet these programs have not been systematically characterized in US medical schools. Objective:: Our study sought to identify and characterize longitudinal clinical programs (LCPs) in US medical schools and measure associations between programs’ structures and goals. Design:: Using a mixed-methods approach, we conducted a secondary analysis of data from publicly available websites. We conducted a systematic keyword search of the websites of 137 LCME-accredited US medical schools to identify LCPs. We included programs with student–patient interactions of at least six months. We categorized programs using qualitative thematic analysis and compared associations between program structures and goals. Results:: We identified 98 LCPs in 69 schools. Half (52.0%) of LCPs occurred during the core clinical year. Program structures included ‘clinic attachments’ (50.0%), ‘longitudinal integrated clerkships’ (26.5%), and ‘patient attachments’ (20.4%). We identified goals in 89 programs, including ‘exposing students to specific topics, patient demographics, or practice settings’ (78.7%); ‘clinical or professional skill development’ (65.2%); and ‘understanding the patient experience’ (19.1%). Patient attachments were associated with ‘exposure to specific patient demographics’ (P = .04) and ‘understanding the patient experience’ (P = .03). Pre-clinical programs were associated with clinical skills development (P = .01). Conclusions:: Our study identifies the scope and nature of LCPs in US medical schools. Understanding connections between educational structures and goals may guide program design and research investigations of educational processes and outcomes.
- Published
- 2018
- Full Text
- View/download PDF
44. Synaptic plasticity and NO-cGMP-PKG signaling coordinately regulate ERK-driven gene expression in the lateral amygdala and in the auditory thalamus following Pavlovian fear conditioning
- Author
-
Ota, Kristie T., primary, Monsey, Melissa S., additional, Wu, Melissa S., additional, Young, Grace J., additional, and Schafe, Glenn E., additional
- Published
- 2010
- Full Text
- View/download PDF
45. A computational model of 1,5‐AG dynamics during pregnancy
- Author
-
Zekavat, Seyedeh M., Butkovich, Slava, Young, Grace J., Nathan, David M., and Petrasek, Danny
- Subjects
Endocrine and Metabolic Conditons ,Disorders and Treatments ,Reproductive Conditions ,Maternal ,Fetal and Neonatal Physiology ,Computational Physiology and Modelling ,5‐anhydroglucitol ,computational model ,diabetes ,gestational diabetes ,pregnancy - Abstract
The importance of 1,5‐anhydroglucitol (1,5‐AG) as an intermediate biomarker for diabetic pregnancy is multi‐fold: (1) it serves as a reliable indicator of moderate‐level glycemic control, especially during early gestation; (2) it has been associated with increased risk of diabetes, independent of HbA1c and fasting glucose; and (3) it is an independent risk factor for the development of eclampsia during pregnancy. However, the clinical use of this biomarker during pregnancy has been underutilized due to physiological changes in glomerular filtration rate, plasma volume, and other hemodynamic parameters which have been hypothesized to bias gestational serum 1,5‐AG concentrations. Here, we develop an in‐silico model of gestational 1,5‐AG by combining pre‐existing physiological data in the literature with a two‐compartment mathematical model, building off of a previous kinetic model described by Stickle and Turk (1997) Am. J. Physiol., 273, E821. Our model quantitatively characterizes how renal and hemodynamic factors impact measured 1,5‐AG during normal pregnancy and during pregnancy with gestational diabetes and diabetes mellitus. During both normal and diabetic pregnancy, we find that a simple two‐compartment model of 1,5‐AG kinetics, with all parameters but reabsorption fraction adjusted for time in pregnancy, efficiently models 1,5‐AG kinetics throughout the first two trimesters. Allowing reabsorption fraction to decrease after 25 weeks permits parameters closer to expected physiological values during the last trimester. Our quantitative model of 1,5‐AG confirms the involvement of hypothesized renal and hemodynamic mechanisms during pregnancy, clarifying the expected trends in 1,5‐AG to aid clinical interpretation. Further research and data may elucidate biological changes during the third trimester that account for the drop in 1,5‐AG concentrations, and clarify physiological differences between diabetes subtypes during pregnancy.
- Published
- 2017
- Full Text
- View/download PDF
46. Leiomyosarcoma of the Esophagus
- Author
-
Weinstein, Eugene C., primary, Kim, Y. S., additional, Young, Grace J., additional, and Kasimian, Dennis, additional
- Published
- 1988
- Full Text
- View/download PDF
47. A multifaceted intervention to reduce antibiotic prescribing among CHIldren with acute COugh and respiratory tract infection: the CHICO cluster RCT.
- Author
-
Blair PS, Young GJ, Clement C, Dixon P, Seume P, Ingram J, Taylor J, Horwood J, Lucas PJ, Cabral C, Francis NA, Beech E, Gulliford M, Creavin S, Lane JA, Bevan S, and Hay AD
- Subjects
- Child, Humans, Infant, Newborn, Infant, Child, Preschool, Clinical Decision-Making, State Medicine, Uncertainty, Cough drug therapy, Anti-Bacterial Agents therapeutic use, Respiratory Tract Infections drug therapy
- Abstract
Background: Clinical uncertainty in primary care regarding the prognosis of children with respiratory tract infections contributes to the unnecessary use of antibiotics. Improved identification of children at low risk of future hospitalisation might reduce clinical uncertainty. A National Institute for Health and Care Research-funded 5-year programme (RP-PG-0608-10018) was used to develop and feasibility test an intervention., Objectives: The aim of the children with acute cough randomised controlled trial was to reduce antibiotic prescribing among children presenting with acute cough and respiratory tract infection without increasing hospital admission., Design: An efficient, pragmatic open-label, two-arm trial (with embedded qualitative and health economic analyses) using practice-level randomisation using routinely collected data as the primary outcome., Setting: General practitioner practices in England., Participants: General practitioner practices using the Egton Medical Information Systems
® patient-record system for children aged 0-9 years presenting with a cough or upper respiratory tract infection. Recruited by Clinical Research Networks and Clinical Commissioning Groups., Intervention: Comprised: (1) elicitation of parental concerns during consultation; (2) a clinician-focused prognostic algorithm to identify children with acute cough and respiratory tract infection at low, average or elevated risk of hospitalisation in the next 30 days accompanied by prescribing guidance, (3) provision of a printout for carers including safety-netting advice., Main Outcome Measures: Co-primaries using the practice list-size for children aged 0-9 years as the denominator: rate of dispensed amoxicillin and macrolide items at each practice (superiority comparison) from NHS Business Services Authority ePACT2 and rate of hospital admission for respiratory tract infection (non-inferiority comparison) from Clinical Commissioning Groups, both routinely collected over 12 months., Results: Of the 310 practices required, 294 (95%) were recruited (144 intervention and 150 controls) with 336,496 registered 0-9-year-olds (5% of all 0-9-year-old children in England) from 47 Clinical Commissioning Groups. Included practices were slightly larger than those not included, had slightly lower baseline dispensing rates and were located in more deprived areas (reflecting the distribution for practice postcodes nationally). Twelve practices (4%) subsequently withdrew (six related to the pandemic). The median number of times the intervention was used was 70 per practice (by a median of 9 clinicians) over 12 months. There was no evidence that the antibiotic dispensing rate in the intervention practices [0.155 (95% confidence interval 0.135 to 0.179)] differed to controls [0.154 (95% confidence interval 0.130 to 0.182), relative risk= 1.011 (95% confidence interval 0.992 to 1.029); p = 0.253]. There was, overall, a reduction in dispensing levels and intervention usage during the pandemic. The rate of hospitalisation for respiratory tract infection in the intervention practices [0.019 (95% confidence interval 0.014 to 0.026)] compared to the controls [0.021 (95% confidence interval 0.014 to 0.029)] was non-inferior [relative risk = 0.952 (95% confidence interval 0.905 to 1.003)]. The qualitative evaluation found the clinicians liked the intervention, used it as a supportive aid, especially with borderline cases but that it, did not always integrate well within the consultation flow and was used less over time. The economic evaluation found no evidence of a difference in mean National Health Service costs between arms; mean difference -£1999 (95% confidence interval -£6627 to 2630)., Conclusions: The intervention was feasible and subjectively useful to practitioners, with no evidence of harm in terms of hospitalisations, but did not impact on antibiotic prescribing rates., Future Work and Limitations: Although the intervention does not appear to change prescribing behaviour, elements of the approach may be used in the design of future interventions., Trial Registration: This trial is registered as ISRCTN11405239 (date assigned 20 April 2018) at www.controlled-trials.com (accessed 5 September 2022). Version 4.0 of the protocol is available at: https://www.journalslibrary.nihr.ac.uk/ (accessed 5 September 2022)., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment (NIHR award ref: 16/31/98) programme and is published in full in Health Technology Assessment ; Vol. 27, No. 32. See the NIHR Funding and Awards website for further award information.- Published
- 2023
- Full Text
- View/download PDF
48. Ten-year Mortality, Disease Progression, and Treatment-related Side Effects in Men with Localised Prostate Cancer from the ProtecT Randomised Controlled Trial According to Treatment Received.
- Author
-
Neal DE, Metcalfe C, Donovan JL, Lane JA, Davis M, Young GJ, Dutton SJ, Walsh EI, Martin RM, Peters TJ, Turner EL, Mason M, Bryant R, Bollina P, Catto J, Doherty A, Gillatt D, Gnanapragasam V, Holding P, Hughes O, Kockelbergh R, Kynaston H, Oxley J, Paul A, Paez E, Rosario DJ, Rowe E, Staffurth J, Altman DG, and Hamdy FC
- Subjects
- Aged, Disease Progression, Humans, Male, Middle Aged, Prostatectomy adverse effects, Prostatic Neoplasms pathology, Radiotherapy adverse effects, Radiotherapy methods, Time Factors, Treatment Outcome, Watchful Waiting, Prostatic Neoplasms mortality, Prostatic Neoplasms therapy
- Abstract
Background: The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer (PCa) randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy., Objective: To determine report outcomes according to treatment received in men in randomised and treatment choice cohorts., Design, Setting, and Participants: This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy., Intervention: Two cohorts included 1643 men who agreed to be randomised; 997 declined randomisation and chose treatment., Outcome Measurements and Statistical Analysis: Health-related quality of life impacts on urinary, bowel, and sexual function were assessed using patient-reported outcome measures. Analysis was carried out based on treatment received for each cohort and on pooled estimates using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores., Results and Limitations: According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p=0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p=0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6mo) and urinary incontinence (55% at 6mo) after surgery, and of sexual dysfunction (88% at 6mo) and bowel dysfunction (5% at 6mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and outdating of the interventions being evaluated during the lengthy follow-up required in trials of screen-detected PCa., Conclusions: Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group., Patient Summary: More than 90 out of every 100 men with localised prostate cancer do not die of prostate cancer within 10yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are much better after active monitoring, but the risks of spreading of prostate cancer are more common., (Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
49. Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.
- Author
-
Young GJ, Harrison S, Turner EL, Walsh EI, Oliver SE, Ben-Shlomo Y, Evans S, Lane JA, Neal DE, Hamdy FC, Donovan JL, Martin RM, and Metcalfe C
- Subjects
- Age Factors, Aged, Biopsy, Cohort Studies, Cross-Sectional Studies, Family Practice, Humans, Longitudinal Studies, Male, Men's Health, Middle Aged, Prostatic Neoplasms blood, Urologic Diseases blood, Urologic Diseases diagnosis, Early Detection of Cancer, General Practice, Mass Screening, Prostate pathology, Prostate-Specific Antigen blood, Prostatic Neoplasms diagnosis
- Abstract
Objectives: Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa)., Setting, Participants and Outcome Measures: Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study., Results: The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend <0.001). For those with a PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively)., Conclusion: A high proportion of men aged 45-69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa., Trial Registration Number: ISRCTN20141297,NCT02044172., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
- Full Text
- View/download PDF
50. Patient-reported outcomes in the ProtecT randomized trial of clinically localized prostate cancer treatments: study design, and baseline urinary, bowel and sexual function and quality of life.
- Author
-
Lane A, Metcalfe C, Young GJ, Peters TJ, Blazeby J, Avery KN, Dedman D, Down L, Mason MD, Neal DE, Hamdy FC, and Donovan JL
- Subjects
- Aged, Digestive System Physiological Phenomena, Humans, Male, Middle Aged, Prostatic Neoplasms pathology, Sexuality physiology, Treatment Outcome, Urination, Patient Reported Outcome Measures, Prostatic Neoplasms therapy, Quality of Life
- Abstract
Objectives: To present the baseline patient-reported outcome measures (PROMs) in the Prostate Testing for Cancer and Treatment (ProtecT) randomized trial comparing active monitoring, radical prostatectomy and external-beam conformal radiotherapy for localized prostate cancer and to compare results with other populations., Materials and Methods: A total of 1643 randomized men, aged 50-69 years and diagnosed with clinically localized disease identified by prostate-specific antigen (PSA) testing, in nine UK cities in the period 1999-2009 were included. Validated PROMs for disease-specific (urinary, bowel and sexual function) and condition-specific impact on quality of life (Expanded Prostate Index Composite [EPIC], 2005 onwards; International Consultation on Incontinence Questionnaire-Urinary Incontinence [ICIQ-UI], 2001 onwards; the International Continence Society short-form male survey [ICSmaleSF]; anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), generic mental and physical health (12-item short-form health survey [SF-12]; EuroQol quality-of-life survey, the EQ-5D-3L) were assessed at prostate biopsy clinics before randomization. Descriptive statistics are presented by treatment allocation and by men's age at biopsy and PSA testing time points for selected measures., Results: A total of 1438 participants completed biopsy questionnaires (88%) and 77-88% of these were analysed for individual PROMs. Fewer than 1% of participants were using pads daily (5/754). Storage lower urinary tract symptoms were frequent (e.g. nocturia 22%, 312/1423). Bowel symptoms were rare, except for loose stools (16%, 118/754). One third of participants reported erectile dysfunction (241/735) and for 16% (118/731) this was a moderate or large problem. Depression was infrequent (80/1399, 6%) but 20% of participants (278/1403) reported anxiety. Sexual function and bother were markedly worse in older men (65-70 years), whilst urinary bother and physical health were somewhat worse than in younger men (49-54 years, all P < 0.001). Bowel health, urinary function and depression were unaltered by age, whilst mental health and anxiety were better in older men (P < 0.001). Only minor differences existed in mental or physical health, anxiety and depression between PSA testing and biopsy assessments., Conclusion: The ProtecT trial baseline PROMs response rates were high. Symptom frequencies and generic quality of life were similar to those observed in populations screened for prostate cancer and control subjects without cancer., (© 2016 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)
- Published
- 2016
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.