Aaron A Laviana1, Agustin Hernandez1, Li-Ching Huang2, Zhiguo Zhao2, Tatsuki Koyama2, Ralph Conwill3, Karen Hoffman4, Irene D Feurer2,5, Michael Goodman6, Ann S Hamilton7, Xiao-Cheng Wu8, Lisa E Paddock9, Antoinette Stroup9, Matthew R Cooperberg10, Mia Hashibe11, Brock B O'Neil12, Sherrie H Kaplan13, Sheldon Greenfield13, David F Penson1, Daniel A Barocas1. 1. Department of Urology, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee. 2. Department of Biostatistics, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee. 3. Office of Patient and Community Education, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee. 4. Department of Radiation Oncology, University of Texas MD Anderson Center, Houston, Texas. 5. Department of Surgery, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee. 6. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia. 7. Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, California. 8. Department of Epidemiology, Louisiana State University New Orleans School of Public Health, New Orleans, Louisiana. 9. Department of Epidemiology, Cancer Institute of New Jersey, Rutgers Health, New Brunswick, New Jersey. 10. Department of Urology, University of California-San Francisco, San Francisco, California. 11. Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah. 12. Department of Urology, University of Utah Health, Salt Lake City, Utah. 13. Department of Medicine, University of California-Irvine, Irvine, California.
Abstract
PURPOSE: The EPIC-26 (Expanded Prostate Cancer Index Composite-Short Form) is a validated questionnaire for measuring health related quality of life. However, the relationship between domain scores and functional outcomes remains unclear, leading to potential confusion about expectations after treatment. For instance, does a sexual function domain score of 80 mean that a patient can achieve erection sufficient for intercourse? Consequently we sought to determine the relationship between the domain score and the response to obtaining the best possible outcome for each question. MATERIALS AND METHODS: Using data from the CEASAR (Comparative Effectiveness Analysis of Surgery and Radiation) study, a multicenter, prospective study of men diagnosed with localized prostate cancer, we analyzed 11,464 EPIC-26 questionnaires from a total of 2,563 men at baseline through 60 months of followup who were treated with robotic prostatectomy, radiotherapy or active surveillance. We dichotomized every item into its best possible outcome and assessed the percent of men at each domain score who achieved the best result. RESULTS: For every EPIC-26 item the frequency of the best possible outcome was reported by domain score category. For example, a score of 80 to 100 on sexual function corresponded to 97% of men reporting erections sufficient for intercourse while at a score of 40 to 60 only 28% reported adequate erections. Also, at a score of 80 to 100 on the urinary incontinence domain 93% of men reported rarely or never leaking vs 6% at a score of 61 to 80. CONCLUSIONS: Our findings indicate a novel way to interpret EPIC-26 domain scores, demonstrating large variations in the percent of respondents reporting the best possible outcomes over narrow domain score differences. This information may be valuable when counseling men on treatment options.
PURPOSE: The EPIC-26 (Expanded Prostate Cancer Index Composite-Short Form) is a validated questionnaire for measuring health related quality of life. However, the relationship between domain scores and functional outcomes remains unclear, leading to potential confusion about expectations after treatment. For instance, does a sexual function domain score of 80 mean that a patient can achieve erection sufficient for intercourse? Consequently we sought to determine the relationship between the domain score and the response to obtaining the best possible outcome for each question. MATERIALS AND METHODS: Using data from the CEASAR (Comparative Effectiveness Analysis of Surgery and Radiation) study, a multicenter, prospective study of men diagnosed with localized prostate cancer, we analyzed 11,464 EPIC-26 questionnaires from a total of 2,563 men at baseline through 60 months of followup who were treated with robotic prostatectomy, radiotherapy or active surveillance. We dichotomized every item into its best possible outcome and assessed the percent of men at each domain score who achieved the best result. RESULTS: For every EPIC-26 item the frequency of the best possible outcome was reported by domain score category. For example, a score of 80 to 100 on sexual function corresponded to 97% of men reporting erections sufficient for intercourse while at a score of 40 to 60 only 28% reported adequate erections. Also, at a score of 80 to 100 on the urinary incontinence domain 93% of men reported rarely or never leaking vs 6% at a score of 61 to 80. CONCLUSIONS: Our findings indicate a novel way to interpret EPIC-26 domain scores, demonstrating large variations in the percent of respondents reporting the best possible outcomes over narrow domain score differences. This information may be valuable when counseling men on treatment options.
Authors: Aaron A Laviana; Zhiguo Zhao; Li-Ching Huang; Tatsuki Koyama; Ralph Conwill; Karen Hoffman; Michael Goodman; Ann S Hamilton; Xiao-Cheng Wu; Lisa E Paddock; Antoinette Stroup; Matthew R Cooperberg; Mia Hashibe; Brock B O'Neil; Sherrie H Kaplan; Sheldon Greenfield; David F Penson; Daniel A Barocas Journal: Eur Urol Date: 2020-02-22 Impact factor: 20.096
Authors: Blanca Noriega Esquives; Tae K Lee; Patricia I Moreno; Rina S Fox; Betina Yanez; Gregory E Miller; Ryne Estabrook; Mark J Begale; Sarah C Flury; Kent Perry; Shilajit D Kundu; Frank J Penedo Journal: J Behav Med Date: 2022-02-02
Authors: Alex J Bates; B R Simon Rosser; Elizabeth J Polter; Christopher W Wheldon; Kristine M C Talley; Ryan Haggart; Morgan Wright; Darryl Mitteldorf; William West; Michael W Ross; Badrinath R Konety; Nidhi Kohli Journal: Front Oncol Date: 2022-04-13 Impact factor: 5.738
Authors: Oskar Bergengren; Anna Pia Enblad; Hans Garmo; Ola Bratt; Lars Holmberg; Eva Johansson; Anna Bill-Axelson Journal: Psychooncology Date: 2020-09-01 Impact factor: 3.894