Objective
To measure past active surveillance (AS) adoption rates, institute the best practice,
and measure the AS adoption rates following implementation. We report our findings
over a 3-year period.
Methods
Patient prostate needle biopsy and treatment data from the period August 2011 to August
2014 were retrieved from an integrated electronic medical records (Allscripts) and
stored in a Microsoft Access database for analysis. Structured data were queried using
the automated software program WizMD and unstructured data were abstracted by manual
review. AS adoption was calculated according to four different selection criteria.
Between 2013 and 2014, physicians at Genesis Healthcare Partners (GHP) underwent an
educational training program on the University of California, San Diego/GHP AS best
practice for managing low-risk prostate cancer patients and were provided report cards
on their AS adoption and comparative reporting.
Results
AS adoption increased for the 3 years of the study. AS adoption for all newly diagnosed
patients managed at GHP increased from 12.9% to 14.74%. AS adoption for patients with
low-risk prostate cancer (as defined by the National Comprehensive Cancer Network)
increased from 31.90% to 58.46% from year 1 to year 3 of the study (P < .001), and AS adoption for the most strict (restrictive) criteria increased from
43.75% to 82.61% (P < .001) after the educational and comparative reporting intervention.
Conclusion
These data highlight the potential benefit of physician education and comparative
reporting to enhance AS adoption. AS adoption rates vary according to selection criteria
used for analysis. Carefully selected outcomes from evidence-based guidelines have
the potential to enhance medical quality.
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Article info
Publication history
Published online: February 11, 2016
Accepted:
November 26,
2015
Received:
August 24,
2015
Footnotes
Financial Disclosure: Dr. Franklin Gaylis is an owner of GenIT (which owns WizMDTM) and a consultant for Janssen Pharmaceuticals and Sanofi; he is also the recipient of study grants from Bayer and Janssen. Renee Calabrese and Dr. Edward Cohen are also owners of GenIT. Dr. Paul Dato is an owner of GenIT and a consultant for Astellas Pharma. Dr. Christopher J. Kane is a consultant for Astellas and Janssen Pharmaceuticals. The remaining author declares that she has no relevant financial interests.
Funding Support: This research was funded by Genesis Healthcare Partners in collaboration with the Department of Urology, UC San Diego Health.
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© 2016 Elsevier Inc. All rights reserved.
