Concordance between patient-reported and physician-reported sexual function after radical prostatectomy Journal Article
| Authors: | Thong, A. E.; Poon, B. Y.; Lee, J. K.; Vertosick, E.; Sjoberg, D. D.; Vickers, A. J.; Ehdaie, B. |
| Article Title: | Concordance between patient-reported and physician-reported sexual function after radical prostatectomy |
| Abstract: | Purpose: Accurately tracking health-related quality-of-life after radical prostatectomy is critical to counseling patients and improving technique. Physicians consistently overestimate functional recovery. We measured concordance between surgeon-assessed and patient-reported outcomes and evaluated a novel method to provide feedback to surgeons. Materials and methods: Men treated with radical prostatectomy self-completed the International Index of Erectile Function-6 questionnaire at each postoperative visit. Separately, physicians graded sexual function on a 5-point scale. International Index of Erectile Function -6 score<22 and grade ≥3 defined patient-reported and physician-assessed erectile dysfunction (ED), respectively. Feedback on concordance was given to physicians starting in May 2013 with the implementation of the Amplio feedback system. Chi-square tests were used to assess agreement proportions and linear regression to evaluate changes in agreement after implementation. Results: From 2009 to 2015, 3,053 men completed at least 1 postprostatectomy questionnaire and had a concurrent independent physician-reported outcome. Prior to implementation of feedback in 2013, patients and physicians were consistent as to ED 83% of the time; in 10% of cases, physicians overestimated function; in 7% of cases, physicians, but not patients reported ED. Agreement increased after implementation of feedback but this was not statistically significant, likely owing to a ceiling effect. Supporting this hypothesis, increase in agreement postfeedback was greater during late follow-up (≥12 mo), where baseline agreement was lower compared to earlier follow-up. Conclusions: Agreement was higher than expected at baseline; implementation of feedback regarding discrepancies between patient-reported and physician-assessed outcomes did not further improve agreement significantly. Our observed high rate of agreement may be partly attributed to our institutional practice of systematically capturing patient-reported outcomes as part of normal clinical care. © 2018 Elsevier Inc. |
| Keywords: | aged; middle aged; recovery of function; pathophysiology; linear models; quality of life; cohort studies; cohort analysis; questionnaires; postoperative complication; postoperative complications; prostatic neoplasms; questionnaire; prostatectomy; prostate tumor; chi-square distribution; erectile dysfunction; convalescence; statistical model; outcomes; chi square distribution; procedures; humans; human; male; surveys and questionnaires |
| Journal Title: | Urologic Oncology: Seminars and Original Investigations |
| Volume: | 36 |
| Issue: | 2 |
| ISSN: | 1078-1439 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2018-02-01 |
| Start Page: | 80e.1 |
| End Page: | 80.e6 |
| Language: | English |
| DOI: | 10.1016/j.urolonc.2017.09.017 |
| PUBMED: | 29031420 |
| PROVIDER: | scopus |
| PMCID: | PMC6309189 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 December 2018 -- Source: Scopus |
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