PORT-II FOR PROSTATIC DISEASES

前列腺疾病的 PORT-II

• 批准号: 2236856
• 负责人: MICHAEL J BARRY
• 金额: $ 115.18万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-01 至 1999-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2236856
• 关键词: PORT; II; PROSTATIC; DISEASES

This proposal describes a PORT-II for prostate diseases, which would continue the work of a Patient Outcome Research Team for prostate diseases (PORT-I) funded by AHCPR from 1989-1994 for five more years. Benign prostatic hyperplasia (BPH) and carcinoma of the prostate (CAP) are two exceedingly common diseases of older men; 40% of men will eventually be diagnosed with BPH and 13% with CAP. The goals of the project are to define the current pattern of screening, diagnosis, and treatment of prostate disease among primary care physicians and urologists, to better define the effectiveness and cost of screening for CAP with the tumor marker prostate specific antigen (PSA), to better define the effectiveness of aggressive treatment of clinically localized prostate cancer with radical prostatectomy or radiation therapy, and to define and optimize outcomes for men with prostatic diseases seen in primary care settings. The methods used to address the goals will include a nationwide survey of primary care physicians and urologists; the development and simulation of a stochastic model of screening for CAP; a multi-institutional retrospective cohort study of approximately 3000 men treated with expectant management radical prostatectomy, or radiation therapy with a minimum of ten years of follow-up; and a comparison of the population- based rates of metastatic disease and death in Connecticut (a region where treatment of CAP is less aggressive) and the Seattle area (a region where CAP treatment is more aggressive). In addition, a randomized trial of an educational program for patients and physicians to help improve management of prostate disease will be conducted in a network of primary care practices, the Dartmouth COOP. As a by-product of this trial, we would determine the outcomes for men with BPH treated with medication (5-alpha reductase inhibitors or alpha-I adrenergic receptor antagonists) or a strategy of "watchful waiting", and uncover the true demand for PSA testing among well-informed men in primary care settings. Finally, we would continue the process, begun in PORT-I, of monitoring new developments in the field of prostatic diseases, keeping up with changes in practice patterns through claims data updates, standardizing measurements that capture treatment outcomes from the patient's perspective, initiating early assessments of emerging technologies, participating in the design and conduct of clinical effectiveness trials, and disseminating results to providers, patients, and policy-makers.

该建议描述了前列腺疾病的端口II，这将 继续前列腺疾病的患者结果研究小组的工作 （port-i）由AHCPR从1989 - 1994年资助了五年。良性 前列腺增生（BPH）和前列腺癌（CAP）为两个 老年男性的极为常见疾病； 40％的男人最终会 被诊断为BPH，CAP诊断为13％。该项目的目标是 定义当前筛查，诊断和处理的模式 初级保健医师和泌尿科医生中的前列腺疾病，以更好 定义用肿瘤的CAP筛选的有效性和成本 标记前列腺特异性抗原（PSA），以更好地定义有效性 对临床局部前列腺癌的积极治疗 根治性前列腺切除术或放射治疗，并定义和优化 在初级保健环境中看到的前列腺疾病男性的结果。 用于解决目标的方法将包括全国范围的调查 初级保健医师和泌尿科医生；的发展和模拟 CAP筛选的随机模型；多机构 大约3000名接受治疗的男性的回顾性队列研究 预期管理根治性前列腺切除术或带有辐射疗法 至少有十年的随访；以及人口的比较 基于康涅狄格州转移性疾病和死亡的率（一个地区 帽子的处理不太侵略性）和西雅图地区（一个地区 帽子治疗更具侵略性）。此外，一个随机试验 针对患者和医生的教育计划，以帮助改善管理 前列腺疾病将在初级保健网络中进行 练习，达特茅斯鸡舍。作为该试验的副产品，我们将 确定用药物治疗的BPH男性的结果（5-alpha 还原酶抑制剂或α-I肾上腺素能受体拮抗剂）或A “注意等待”的策略，并发现对PSA的真正需求 在初级保健环境中的知名男性进行测试。 最后，我们将继续从port-i开始监视新的过程 前列腺疾病领域的发展，跟上变化 在实践中通过索赔数据更新，标准化的模式 捕获患者的治疗结果的测量 观点，启动对新兴技术的早期评估， 参加临床有效性试验的设计和行为， 并向提供者，患者和决策者传播结果。