Understanding the Adoption and Impact of New Risk Assessment Technologies in Prostate Cancer Care
Understanding the Adoption and Impact of New Risk Assessment Technologies in Prostate Cancer Care
批准号:
10526667
负责人:
Michael Stuart Leapman
金额:
$12.72万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2019
资助国家:
美国
项目状态:
已结题
起止时间:
2019-03-01 至 2024-02-29
关键词:
AddressAdoptionAffectClinicalClinical ManagementClinical TrialsControlled StudyDataData SetDecision MakingDevelopmentDiagnosisDiseaseDisease ManagementGenomicsGoalsHealth SciencesHigh PrevalenceImageIndolentInterviewKnowledgeLearningMagnetic Resonance ImagingMalignant NeoplasmsMalignant neoplasm of prostateMentored Research Scientist Development AwardMethodsMonitorNatureOutcomePatient CarePatientsPhasePhysiciansPositioning AttributeProstateQualitative ResearchResearchResearch PersonnelRiskRisk AssessmentShapesSurgeonTechnologyTechnology AssessmentTestingTraining ProgramsUncertaintyUniversitiesWorkcancer carecancer riskcomparativecostimplementation scienceimprovedmennew technologyovertreatmentpatient orientedpractice settingprostate cancer riskside effectskillstoolunnecessary treatment
中文摘要
项目摘要/摘要
新的、昂贵的风险评估技术正在迅速整合到对患有
前列腺癌。先进的成像(前列腺核磁共振)和基因组测试已经开发出来,现在正在进行
部署是为了克服疾病管理中的一个核心挑战:非常高的流行率,
但杀伤力相对较低。几十年来,关于患者前列腺真实性质的不确定性
癌症导致数百万男性对惰性(低风险)疾病进行不必要的治疗,从而导致
对许多人来说都有持久的副作用。通过提高区分低风险癌症和侵袭性癌症的能力,它是
相信更准确的工具将让许多患者安全地仔细观察低风险癌症
监控(主动监控)。尽管这两种占优势的技术已经在受控领域进行了评估
研究表明,没有现实世界的证据来理解它们的影响。具体地说,还不知道是哪种
患者正在接受检测,这些技术的使用是否减少了不必要的治疗,或者如何
患者和医生都意识到了他们的好处。为了解决这些知识差距,我们的目标是全面
了解前列腺核磁共振和基因组检测如何影响前列腺癌的治疗。我们会
通过两个相辅相成的阶段实现这一目标,旨在:(1)确定如何采用前列腺核磁共振
和/或基因组检测已影响临床管理,以及(2)了解患者和医生如何
在决策过程中要注意这些工具。我们假设无论是前列腺核磁共振和/或
基因组测试的执行取决于他们看的医生,但这种测试与
较低的治疗率。我们将使用前列腺癌男性的大型国家数据集,并检查
采用前列腺核磁共振和/或基因组检测,以及这些技术的使用是否与
更多地使用观察而不是治疗。要了解这些工具如何用于低成本的决策-
前列腺癌的风险,我们将对前列腺癌患者和
诊断和治疗疾病。这项研究的结果将决定改进这些工具的方式的努力
用于前列腺癌患者的治疗。候选人:这项提案支持专业人士
将候选人培养为独立的、以患者为导向的外科医生-调查员,专注于改进
前列腺癌护理。此应用程序以严格的培训计划为中心,包括
利用候选人作为前列腺癌外科医生和临床结果研究人员的背景,
之前的工作主要集中在风险评估技术和低风险前列腺癌的主动监测上。
申请者将在其专业知识的基础上获得耶鲁大学的健康科学硕士学位,以及
培养定性研究和实施科学方面的技能。本次辅导培训的完成
奖项将使候选人能够开发和测试一个框架,以完善新技术的使用
前列腺癌患者,潜在地减少过度治疗和成本。
英文摘要
PROJECT SUMMARY/ABSTRACT
New, expensive risk assessment technologies are rapidly being integrated into the care of patients with
prostate cancer. Advanced imaging (prostate MRI) and genomic tests have been developed and are now
deployed to overcome a central challenge in the management of the disease: a remarkably high prevalence,
yet comparatively low lethality. For decades, uncertainty regarding the true nature of a patient's prostate
cancer has led to the unnecessary treatment of indolent (`low-risk') disease in millions of men resulting in
lasting side-effects for many. By improving the ability to distinguish low-risk from aggressive cancers, it is
believed that more accurate tools will allow many patients to safely observe low-risk cancers with careful
monitoring (active surveillance). Although these two ascendant technologies have been evaluated in controlled
studies, no real-world evidence is available to understand their impact. Specifically, it is not known which
patients are receiving testing, whether use of these technologies reduces unnecessary treatment, or how
patients and doctors perceive of their benefit. To address these knowledge gaps, we aim to comprehensively
understand how prostate MRI and genomic testing impact the management of prostate cancer. We will
accomplish this goal through two complementary phases aimed at: (1) defining how adoption of prostate MRI
and/or genomic testing has affected clinical management, and (2) understanding how patients and physicians
perceive of these tools during decision-making. We hypothesize that whether or not prostate MRI and/or
genomic testing are performed is dependent on the doctor that they see, but that testing is associated with
lower rates of treatment. We will use large national datasets of men with prostate cancer and examine the
adoption of prostate MRI and/or genomic testing, and whether the use of these technologies is associated with
increased use of observation versus treatment. To learn how these tools are used in decision-making for low-
risk prostate cancer, we will conduct in-depth interviews of both patients with prostate cancer and doctors who
diagnose and treat the disease. The results from this research will shape efforts to improve how these tools are
used in the management of men with prostate cancer. Candidate: this proposal supports the professional
development of the candidate as an independent, patient-oriented surgeon-investigator focusing on improving
prostate cancer care. This application is centered around a rigorous training program including coursework that
leverages the candidate's background as a prostate cancer surgeon and clinical outcomes researcher whose
prior work has focused on risk assessment technologies and active surveillance of low-risk prostate cancer.
The applicant will build upon his expertise by earning a Masters in Health Science from Yale University, and
develop a skill set in qualitative research and implementation science. The completion of this mentored training
award will position the candidate to develop and test a framework for refining the use of new technologies for
patients with prostate cancer, potentially reducing over-treatment and cost.
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DOI:
10.1001/jamanetworkopen.2021.28646
发表时间:
2021-10-01
期刊:
JAMA network open
影响因子:
13.8
作者:
[Leapman MS, Wang R, Park HS, Yu JB, Sprenkle PC, Dinan MA, Ma X, Gross CP]
通讯作者:
Gross CP
DOI:
10.1007/s00261-020-02496-5
发表时间:
2020-12
期刊:
Abdominal radiology (New York)
影响因子:
--
作者:
[Rajwa P, Syed J, Leapman MS]
通讯作者:
Leapman MS
National trends in the management of patients with positive surgical margins at radical prostatectomy.
根治性前列腺切除术中手术切缘阳性患者管理的全国趋势。
DOI:
10.1007/s00345-020-03298-6
发表时间:
2021
期刊:
World journal of urology
影响因子:
3.4
作者:
[Ghabili,Kamyar, Park,HenryS, Yu,JamesB, Sprenkle,PrestonC, Kim,SimonP, Nguyen,KevinA, Ma,Xiaomei, Gross,CaryP, Leapman,MichaelS]
通讯作者:
Leapman,MichaelS
DOI:
10.1002/cam4.3482
发表时间:
2020-12
期刊:
Cancer medicine
影响因子:
4
作者:
[Kaps B, Leapman M, An Y]
通讯作者:
An Y
DOI:
10.1097/upj.0000000000000109
发表时间:
2020-07
期刊:
Urology practice
影响因子:
0.8
作者:
[Hsiang W, Han X, Jemal A, Nguyen KA, Shuch B, Park H, Yu JB, Gross CP, Davidoff AJ, Leapman MS]
通讯作者:
Leapman MS
Optimizing prostate cancer care: integrating risks, benefits, and patient experiences in the new era of molecular imaging
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批准号:10712074
-
项目类别:
-
资助金额:$66.04万
-
财政年份:2023
-
负责人:Michael Stuart Leapman
-
依托单位:
Understanding the Adoption and Impact of New Risk Assessment Technologies in Prostate Cancer Care
-
批准号:10352214
-
项目类别:
-
资助金额:$25.44万
-
财政年份:2019
-
负责人:Michael Stuart Leapman
-
依托单位:
海外基金