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Teodorowski P, Jones E, Tahir N, Ahmed S, Rodgers SE, Frith L. Public Involvement and Engagement in Big Data Research: Scoping Review. J Particip Med 2024; 16:e56673. [PMID: 39150751 PMCID: PMC11364952 DOI: 10.2196/56673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/06/2024] [Accepted: 06/22/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND The success of big data initiatives depends on public support. Public involvement and engagement could be a way of establishing public support for big data research. OBJECTIVE This review aims to synthesize the evidence on public involvement and engagement in big data research. METHODS This scoping review mapped the current evidence on public involvement and engagement activities in big data research. We searched 5 electronic databases, followed by additional manual searches of Google Scholar and gray literature. In total, 2 public contributors were involved at all stages of the review. RESULTS A total of 53 papers were included in the scoping review. The review showed the ways in which the public could be involved and engaged in big data research. The papers discussed a broad range of involvement activities, who could be involved or engaged, and the importance of the context in which public involvement and engagement occur. The findings show how public involvement, engagement, and consultation could be delivered in big data research. Furthermore, the review provides examples of potential outcomes that were produced by involving and engaging the public in big data research. CONCLUSIONS This review provides an overview of the current evidence on public involvement and engagement in big data research. While the evidence is mostly derived from discussion papers, it is still valuable in illustrating how public involvement and engagement in big data research can be implemented and what outcomes they may yield. Further research and evaluation of public involvement and engagement in big data research are needed to better understand how to effectively involve and engage the public in big data research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-https://doi.org/10.1136/bmjopen-2021-050167.
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Affiliation(s)
- Piotr Teodorowski
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Elisa Jones
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, United Kingdom
| | - Naheed Tahir
- National Institute for Health and Care Research Applied Research Collaboration North West Coast, Liverpool, United Kingdom
| | - Saiqa Ahmed
- National Institute for Health and Care Research Applied Research Collaboration North West Coast, Liverpool, United Kingdom
| | - Sarah E Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, United Kingdom
| | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester, Manchester, United Kingdom
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Sibert NT, Soff J, La Ferla S, Quaranta M, Kremer A, Kowalski C. Transforming a Large-Scale Prostate Cancer Outcomes Dataset to the OMOP Common Data Model-Experiences from a Scientific Data Holder's Perspective. Cancers (Basel) 2024; 16:2069. [PMID: 38893186 PMCID: PMC11171220 DOI: 10.3390/cancers16112069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/13/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
To enhance international and joint research collaborations in prostate cancer research, data from different sources should use a common data model (CDM) that enables researchers to share their analysis scripts and merge results. The OMOP CDM maintained by OHDSI is such a data model developed for a federated data analysis with partners from different institutions that want to jointly investigate research questions using clinical care data. The German Cancer Society as the scientific lead of the Prostate Cancer Outcomes (PCO) study gathers data from prostate cancer care including routine oncological care data and survey data (incl. patient-reported outcomes) and uses a common data specification (called OncoBox Research Prostate) for this purpose. To further enhance research collaborations outside the PCO study, the purpose of this article is to describe the process of transferring the PCO study data to the internationally well-established OMOP CDM. This process was carried out together with an IT company that specialised in supporting research institutions to transfer their data to OMOP CDM. Of n = 49,692 prostate cancer cases with 318 data fields each, n = 392 had to be excluded during the OMOPing process, and n = 247 of the data fields could be mapped to OMOP CDM. The resulting PostgreSQL database with OMOPed PCO study data is now ready to use within larger research collaborations such as the EU-funded EHDEN and OPTIMA consortium.
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Affiliation(s)
- Nora Tabea Sibert
- Health Services Research Department, German Cancer Society, 14057 Berlin, Germany; (J.S.); (C.K.)
| | - Johannes Soff
- Health Services Research Department, German Cancer Society, 14057 Berlin, Germany; (J.S.); (C.K.)
| | - Sebastiano La Ferla
- ITTM SA, Esch-sur-Alzette, 4354 Esch-sur-Alzette, Luxembourg; (S.L.F.); (M.Q.); (A.K.)
| | - Maria Quaranta
- ITTM SA, Esch-sur-Alzette, 4354 Esch-sur-Alzette, Luxembourg; (S.L.F.); (M.Q.); (A.K.)
| | - Andreas Kremer
- ITTM SA, Esch-sur-Alzette, 4354 Esch-sur-Alzette, Luxembourg; (S.L.F.); (M.Q.); (A.K.)
| | - Christoph Kowalski
- Health Services Research Department, German Cancer Society, 14057 Berlin, Germany; (J.S.); (C.K.)
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Rajwa P, Borkowetz A, Abbott T, Alberti A, Bjartell A, Brash JT, Campi R, Chilelli A, Conover M, Constantinovici N, Davies E, De Meulder B, Eid S, Gacci M, Golozar A, Hafeez H, Haque S, Hijazy A, Hulsen T, Josefsson A, Khalid S, Kolde R, Kotik D, Kurki S, Lambrecht M, Leung CH, Moreno J, Nicoletti R, Nieboer D, Oja M, Palanisamy S, Prinsen P, Reich C, Raffaele Resta G, Ribal MJ, Gómez Rivas J, Smith E, Snijder R, Steinbeisser C, Vandenberghe F, Cornford P, Evans-Axelsson S, N'Dow J, Willemse PPM. Research Protocol for an Observational Health Data Analysis on the Adverse Events of Systemic Treatment in Patients with Metastatic Hormone-sensitive Prostate Cancer: Big Data Analytics Using the PIONEER Platform. EUR UROL SUPPL 2024; 63:81-88. [PMID: 38572301 PMCID: PMC10987796 DOI: 10.1016/j.euros.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/05/2024] Open
Abstract
Combination therapies in metastatic hormone-sensitive prostate cancer (mHSPC), which include the addition of an androgen receptor signaling inhibitor and/or docetaxel to androgen deprivation therapy, have been a game changer in the management of this disease stage. However, these therapies come with their fair share of toxicities and side effects. The goal of this observational study is to report drug-related adverse events (AEs), which are correlated with systemic combination therapies for mHSPC. Determining the optimal treatment option requires large cohorts to estimate the tolerability and AEs of these combination therapies in "real-life" patients with mHSPC, as provided in this study. We use a network of databases that includes population-based registries, electronic health records, and insurance claims, containing the overall target population and subgroups of patients defined by unique certain characteristics, demographics, and comorbidities, to compute the incidence of common AEs associated with systemic therapies in the setting of mHSPC. These data sources are standardised using the Observational Medical Outcomes Partnership Common Data Model. We perform the descriptive statistics as well as calculate the AE incidence rate separately for each treatment group, stratified by age groups and index year. The time until the first event is estimated using the Kaplan-Meier method within each age group. In the case of episodic events, the anticipated mean cumulative counts of events are calculated. Our study will allow clinicians to tailor optimal therapies for mHSPC patients, and they will serve as a basis for comparative method studies.
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Affiliation(s)
- Pawel Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Angelika Borkowetz
- Department of Urology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Abbott
- European Association of Urology, Nijmegen, The Netherlands
| | - Andrea Alberti
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Anders Bjartell
- Department of Translational Medicine, Lund University, Lund, Sweden
| | | | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | | | | | | | | | | | | | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Asieh Golozar
- Odysseus Data Services, New York, NY, USA
- OHDSI Center, Northeastern University, Boston, MA, USA
| | - Haroon Hafeez
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Peshawar, Pakistan
| | | | | | - Tim Hulsen
- Department of Hospital Services & Informatics, Philips Research, Eindhoven, The Netherlands
| | - Andreas Josefsson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Center for Molecular Medicine, Umeå University, Umeå, Sweden
| | | | - Raivo Kolde
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Daniel Kotik
- Center for Advanced Systems Understanding, Görlitz, Germany
- Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | | | | | - Chi-Ho Leung
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Rossella Nicoletti
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Daan Nieboer
- Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marek Oja
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | | | - Peter Prinsen
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Christian Reich
- Odysseus Data Services, New York, NY, USA
- OHDSI Center, Northeastern University, Boston, MA, USA
| | - Giulio Raffaele Resta
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Maria J. Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Juan Gómez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Emma Smith
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands
| | | | | | | | | | | | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - Peter-Paul M. Willemse
- Department of Urology, Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Gandaglia G, Pellegrino F, Golozar A, De Meulder B, Abbott T, Achtman A, Imran Omar M, Alshammari T, Areia C, Asiimwe A, Beyer K, Bjartell A, Campi R, Cornford P, Falconer T, Feng Q, Gong M, Herrera R, Hughes N, Hulsen T, Kinnaird A, Lai LYH, Maresca G, Mottet N, Oja M, Prinsen P, Reich C, Remmers S, Roobol MJ, Sakalis V, Seager S, Smith EJ, Snijder R, Steinbeisser C, Thurin NH, Hijazy A, van Bochove K, Van den Bergh RCN, Van Hemelrijck M, Willemse PP, Williams AE, Zounemat Kermani N, Evans-Axelsson S, Briganti A, N'Dow J. Clinical Characterization of Patients Diagnosed with Prostate Cancer and Undergoing Conservative Management: A PIONEER Analysis Based on Big Data. Eur Urol 2024; 85:457-465. [PMID: 37414703 DOI: 10.1016/j.eururo.2023.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/18/2023] [Accepted: 06/19/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Conservative management is an option for prostate cancer (PCa) patients either with the objective of delaying or even avoiding curative therapy, or to wait until palliative treatment is needed. PIONEER, funded by the European Commission Innovative Medicines Initiative, aims at improving PCa care across Europe through the application of big data analytics. OBJECTIVE To describe the clinical characteristics and long-term outcomes of PCa patients on conservative management by using an international large network of real-world data. DESIGN, SETTING, AND PARTICIPANTS From an initial cohort of >100 000 000 adult individuals included in eight databases evaluated during a virtual study-a-thon hosted by PIONEER, we identified newly diagnosed PCa cases (n = 527 311). Among those, we selected patients who did not receive curative or palliative treatment within 6 mo from diagnosis (n = 123 146). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Patient and disease characteristics were reported. The number of patients who experienced the main study outcomes was quantified for each stratum and the overall cohort. Kaplan-Meier analyses were used to estimate the distribution of time to event data. RESULTS AND LIMITATIONS The most common comorbidities were hypertension (35-73%), obesity (9.2-54%), and type 2 diabetes (11-28%). The rate of PCa-related symptomatic progression ranged between 2.6% and 6.2%. Hospitalization (12-25%) and emergency department visits (10-14%) were common events during the 1st year of follow-up. The probability of being free from both palliative and curative treatments decreased during follow-up. Limitations include a lack of information on patients and disease characteristics and on treatment intent. CONCLUSIONS Our results allow us to better understand the current landscape of patients with PCa managed with conservative treatment. PIONEER offers a unique opportunity to characterize the baseline features and outcomes of PCa patients managed conservatively using real-world data. PATIENT SUMMARY Up to 25% of men with prostate cancer (PCa) managed conservatively experienced hospitalization and emergency department visits within the 1st year after diagnosis; 6% experienced PCa-related symptoms. The probability of receiving therapies for PCa decreased according to time elapsed after the diagnosis.
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Affiliation(s)
- Giorgio Gandaglia
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands; Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Francesco Pellegrino
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Asieh Golozar
- Odysseus Data Services, New York, NY, USA; OHDSI Center, Northeastern University, Boston, MA, USA
| | | | | | | | - Muhammad Imran Omar
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands; Academic Urology Unit, University of Aberdeen, Scotland, UK
| | | | | | | | - Katharina Beyer
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Anders Bjartell
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - Riccardo Campi
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Thomas Falconer
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Qi Feng
- Astellas Pharma, Inc., Northbrook, IL, USA
| | - Mengchun Gong
- Nanfang Hospital, Southern Medical University, Guangzhou, China; DHC Technologies, Beijing, China
| | | | | | - Tim Hulsen
- Philips Research, Department of Hospital Services & Informatics, Eindhoven, The Netherlands
| | | | | | | | - Nicolas Mottet
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands
| | - Marek Oja
- Institute of Computer Science, University of Tartu, Tartu, Estonia; STACC, Tartu, Estonia
| | - Peter Prinsen
- Netherlands Comprehensive Cancer Organization, Eindhoven, The Netherlands
| | | | - Sebastiaan Remmers
- Erasmus University Medical Centre, Cancer Institute, Rotterdam, The Netherlands
| | - Monique J Roobol
- Erasmus University Medical Centre, Cancer Institute, Rotterdam, The Netherlands
| | - Vasileios Sakalis
- Department of Urology, General Hospital of Thessaloniki Agios Pavlos, Thessaloniki, Greece
| | | | - Emma J Smith
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands
| | | | | | - Nicolas H Thurin
- INSERM CIC-P 1401, Bordeaux PharmacoEpi, Université de Bordeaux, Bordeaux, France
| | | | | | | | | | - Peter-Paul Willemse
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands; Department of Urology, Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andrew E Williams
- The Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, Boston, MA, USA
| | | | | | - Alberto Briganti
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands; Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - James N'Dow
- Guidelines Office, European Association of Urology, Arnhem, The Netherlands; Academic Urology Unit, University of Aberdeen, Scotland, UK
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Lawlor A, Lin C, Gómez Rivas J, Ibáñez L, Abad López P, Willemse PP, Imran Omar M, Remmers S, Cornford P, Rajwa P, Nicoletti R, Gandaglia G, Yuen-Chun Teoh J, Moreno Sierra J, Golozar A, Bjartell A, Evans-Axelsson S, N'Dow J, Zong J, Ribal MJ, Roobol MJ, Van Hemelrijck M, Beyer K. Predictive Models for Assessing Patients' Response to Treatment in Metastatic Prostate Cancer: A Systematic Review. EUR UROL SUPPL 2024; 63:126-135. [PMID: 38596781 PMCID: PMC11001619 DOI: 10.1016/j.euros.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/05/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Background and objective The treatment landscape of metastatic prostate cancer (mPCa) has evolved significantly over the past two decades. Despite this, the optimal therapy for patients with mPCa has not been determined. This systematic review identifies available predictive models that assess mPCa patients' response to treatment. Methods We critically reviewed MEDLINE and CENTRAL in December 2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Only quantitative studies in English were included with no time restrictions. The quality of the included studies was assessed using the PROBAST tool. Data were extracted following the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews criteria. Key findings and limitations The search identified 616 citations, of which 15 studies were included in our review. Nine of the included studies were validated internally or externally. Only one study had a low risk of bias and a low risk concerning applicability. Many studies failed to detail model performance adequately, resulting in a high risk of bias. Where reported, the models indicated good or excellent performance. Conclusions and clinical implications Most of the identified predictive models require additional evaluation and validation in properly designed studies before these can be implemented in clinical practice to assist with treatment decision-making for men with mPCa. Patient summary In this review, we evaluate studies that predict which treatments will work best for which metastatic prostate cancer patients. We found that existing studies need further improvement before these can be used by health care professionals.
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Affiliation(s)
- Ailbhe Lawlor
- Translational Oncology and Urology Research (TOUR), King’s College London, London, UK
| | - Carol Lin
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Juan Gómez Rivas
- Department of Urology, Health Research Institute, Hospital Clinico San Carlos, Madrid, Spain
| | - Laura Ibáñez
- Department of Urology, Health Research Institute, Hospital Clinico San Carlos, Madrid, Spain
| | - Pablo Abad López
- Department of Urology, Hospital Universitario La Paz, Madrid, Spain
| | - Peter-Paul Willemse
- Department of Oncological Urology, University Medical Center, Utrecht Cancer Center, Utrecht, The Netherlands
| | | | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Pawel Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Rossella Nicoletti
- Department of Experimental and Clinical Biomedical Science, University of Florence, Florence, Italy
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Giorgio Gandaglia
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
- OHDSI Center, Northeastern University, Boston, MA, USA
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Jesús Moreno Sierra
- Department of Urology, Health Research Institute, Hospital Clinico San Carlos, Madrid, Spain
| | - Asieh Golozar
- OHDSI Center, Northeastern University, Boston, MA, USA
- Odysseus Data Services, New York, NY, USA
| | - Anders Bjartell
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | | | - James N'Dow
- European Association of Urology, Guidelines Office, Arnhem, The Netherlands
| | - Jihong Zong
- Bayer Healthcare, Global Medical Affairs Oncology, Whippany, NJ, USA
| | - Maria J. Ribal
- European Association of Urology, Guidelines Office, Arnhem, The Netherlands
| | - Monique J. Roobol
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), King’s College London, London, UK
| | - Katharina Beyer
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - on behalf of the PIONEER Consortium
- Translational Oncology and Urology Research (TOUR), King’s College London, London, UK
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Urology, Health Research Institute, Hospital Clinico San Carlos, Madrid, Spain
- Department of Urology, Hospital Universitario La Paz, Madrid, Spain
- Department of Oncological Urology, University Medical Center, Utrecht Cancer Center, Utrecht, The Netherlands
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
- Liverpool University Hospitals NHS Trust, Liverpool, UK
- Department of Urology, Medical University of Silesia, Zabrze, Poland
- Department of Experimental and Clinical Biomedical Science, University of Florence, Florence, Italy
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
- OHDSI Center, Northeastern University, Boston, MA, USA
- Odysseus Data Services, New York, NY, USA
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Bayer AB, Medical Affairs Oncology, Stockholm, Sweden
- European Association of Urology, Guidelines Office, Arnhem, The Netherlands
- Bayer Healthcare, Global Medical Affairs Oncology, Whippany, NJ, USA
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Hashemi Gheinani A, Kim J, You S, Adam RM. Bioinformatics in urology - molecular characterization of pathophysiology and response to treatment. Nat Rev Urol 2024; 21:214-242. [PMID: 37604982 DOI: 10.1038/s41585-023-00805-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/23/2023]
Abstract
The application of bioinformatics has revolutionized the practice of medicine in the past 20 years. From early studies that uncovered subtypes of cancer to broad efforts spearheaded by the Cancer Genome Atlas initiative, the use of bioinformatics strategies to analyse high-dimensional data has provided unprecedented insights into the molecular basis of disease. In addition to the identification of disease subtypes - which enables risk stratification - informatics analysis has facilitated the identification of novel risk factors and drivers of disease, biomarkers of progression and treatment response, as well as possibilities for drug repurposing or repositioning; moreover, bioinformatics has guided research towards precision and personalized medicine. Implementation of specific computational approaches such as artificial intelligence, machine learning and molecular subtyping has yet to become widespread in urology clinical practice for reasons of cost, disruption of clinical workflow and need for prospective validation of informatics approaches in independent patient cohorts. Solving these challenges might accelerate routine integration of bioinformatics into clinical settings.
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Affiliation(s)
- Ali Hashemi Gheinani
- Department of Urology, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Urology, Inselspital, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Jina Kim
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sungyong You
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Rosalyn M Adam
- Department of Urology, Boston Children's Hospital, Boston, MA, USA.
- Department of Surgery, Harvard Medical School, Boston, MA, USA.
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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Russell B, Beyer K, Lawlor A, Roobol MJ, Venderbos LD, Remmers S, Briers E, MacLennan SJ, MacLennan S, Omar MI, Van Hemelrijck M. Survivorship Data in Prostate Cancer: Where Are We and Where Do We Need To Be? EUR UROL SUPPL 2024; 59:27-29. [PMID: 38298764 PMCID: PMC10829596 DOI: 10.1016/j.euros.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 02/02/2024] Open
Abstract
Cancer survivorship was recently identified as a prostate cancer (PCa) research priority by PIONEER, a European network of excellence for big data in PCa. Despite being a research priority, cancer survivorship lacks a clear and agreed definition, and there is a distinct paucity of patient-reported outcome (PRO) data available on the subject. Data collection on cancer survivorship depends on the availability and implementation of (validated) routinely collected patient-reported outcome measures (PROMs). There have been recent advances in the availability of such PROMs. For instance, the European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) is developing survivorship questionnaires. This provides an excellent first step in improving the data available on cancer survivorship. However, we propose that an agreed, standardised definition of (prostate) cancer survivorship must first be established. Only then can real-world data on survivorship be collected to strengthen our knowledge base. With more men than ever surviving PCa, this type of research is imperative to ensure that the quality of life of these men is considered as much as their quantity of life. Patient summary As there are more prostate cancer survivors than ever before, research into cancer survivorship is crucial. We highlight the importance of such research and provide recommendations on how to carry it out. The first step should be establishing agreement on a standardised definition of survivorship. From this, patient-reported outcome measures can then be used to collect important survivorship data.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research, King’s College London, London, UK
| | - Katharina Beyer
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Ailbhe Lawlor
- Translational Oncology and Urology Research, King’s College London, London, UK
| | - Monique J. Roobol
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Lionne D.F. Venderbos
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
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Oja M, Tamm S, Mooses K, Pajusalu M, Talvik HA, Ott A, Laht M, Malk M, Lõo M, Holm J, Haug M, Šuvalov H, Särg D, Vilo J, Laur S, Kolde R, Reisberg S. Transforming Estonian health data to the Observational Medical Outcomes Partnership (OMOP) Common Data Model: lessons learned. JAMIA Open 2023; 6:ooad100. [PMID: 38058679 PMCID: PMC10697784 DOI: 10.1093/jamiaopen/ooad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023] Open
Abstract
Objective To describe the reusable transformation process of electronic health records (EHR), claims, and prescriptions data into Observational Medical Outcome Partnership (OMOP) Common Data Model (CDM), together with challenges faced and solutions implemented. Materials and Methods We used Estonian national health databases that store almost all residents' claims, prescriptions, and EHR records. To develop and demonstrate the transformation process of Estonian health data to OMOP CDM, we used a 10% random sample of the Estonian population (n = 150 824 patients) from 2012 to 2019 (MAITT dataset). For the sample, complete information from all 3 databases was converted to OMOP CDM version 5.3. The validation was performed using open-source tools. Results In total, we transformed over 100 million entries to standard concepts using standard OMOP vocabularies with the average mapping rate 95%. For conditions, observations, drugs, and measurements, the mapping rate was over 90%. In most cases, SNOMED Clinical Terms were used as the target vocabulary. Discussion During the transformation process, we encountered several challenges, which are described in detail with concrete examples and solutions. Conclusion For a representative 10% random sample, we successfully transferred complete records from 3 national health databases to OMOP CDM and created a reusable transformation process. Our work helps future researchers to transform linked databases into OMOP CDM more efficiently, ultimately leading to better real-world evidence.
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Affiliation(s)
- Marek Oja
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Sirli Tamm
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Kerli Mooses
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Maarja Pajusalu
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Harry-Anton Talvik
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
- STACC, 51009 Tartu, Estonia
| | - Anne Ott
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Marianna Laht
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Maria Malk
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Marcus Lõo
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Johannes Holm
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Markus Haug
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Hendrik Šuvalov
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Dage Särg
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
- STACC, 51009 Tartu, Estonia
| | - Jaak Vilo
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
- STACC, 51009 Tartu, Estonia
| | - Sven Laur
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Raivo Kolde
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
| | - Sulev Reisberg
- Institute of Computer Science, University of Tartu, 51009 Tartu, Estonia
- STACC, 51009 Tartu, Estonia
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9
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Omar MI, MacLennan S, Ribal MJ, Roobol MJ, Dimitropoulos K, van den Broeck T, MacLennan SJ, Axelsson SE, Gandaglia G, Willemse PP, Mastris K, Ransohoff JB, Devecseri Z, Abbott T, De Meulder B, Bjartell A, Asiimwe A, N'Dow J. Unanswered questions in prostate cancer - findings of an international multi-stakeholder consensus by the PIONEER consortium. Nat Rev Urol 2023:10.1038/s41585-023-00748-9. [PMID: 37012441 DOI: 10.1038/s41585-023-00748-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 04/05/2023]
Abstract
PIONEER is a European network of excellence for big data in prostate cancer consisting of 37 private and public stakeholders from 9 countries across Europe. Many progresses have been done in prostate cancer management, but unanswered questions in the field still exist, and big data could help to answer these questions. The PIONEER consortium conducted a two-round modified Delphi survey aiming at building consensus between two stakeholder groups - health-care professionals and patients with prostate cancer - about the most important questions in the field of prostate cancer to be answered using big data. Respondents were asked to consider what would be the effect of answering the proposed questions on improving diagnosis and treatment outcomes for patients with prostate cancer and to score these questions on a scale of 1 (not important) to 9 (critically important). The mean percentage of participants who scored each of the proposed questions as critically important was calculated across the two stakeholder groups and used to rank the questions and identify the highest scoring questions in the critically important category. The identification of questions in prostate cancer that are important to various stakeholders will help the PIONEER consortium to provide answers to these questions to improve the clinical care of patients with prostate cancer.
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Affiliation(s)
- Muhammad Imran Omar
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK.
- Guidelines Office, European Association of Urology, Arnhem, Netherlands.
| | | | - Maria J Ribal
- Guidelines Office, European Association of Urology, Arnhem, Netherlands
| | | | | | | | | | | | - Giorgio Gandaglia
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Ken Mastris
- European Cancer Patient Coalition, Brussels, Belgium
| | | | | | | | | | - Anders Bjartell
- Department of Translational Medicine, Lund University, Lund, Sweden
| | | | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
- Guidelines Office, European Association of Urology, Arnhem, Netherlands
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10
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Moore CM, King LE, Withington J, Amin MB, Andrews M, Briers E, Chen RC, Chinegwundoh FI, Cooperberg MR, Crowe J, Finelli A, Fitch MI, Frydenberg M, Giganti F, Haider MA, Freeman J, Gallo J, Gibbs S, Henry A, James N, Kinsella N, Lam TBL, Lichty M, Loeb S, Mahal BA, Mastris K, Mitra AV, Merriel SWD, van der Kwast T, Van Hemelrijck M, Palmer NR, Paterson CC, Roobol MJ, Segal P, Schraidt JA, Short CE, Siddiqui MM, Tempany CMC, Villers A, Wolinsky H, MacLennan S. Best Current Practice and Research Priorities in Active Surveillance for Prostate Cancer-A Report of a Movember International Consensus Meeting. Eur Urol Oncol 2023; 6:160-182. [PMID: 36710133 DOI: 10.1016/j.euo.2023.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/06/2022] [Accepted: 01/04/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Active surveillance (AS) is recommended for low-risk and some intermediate-risk prostate cancer. Uptake and practice of AS vary significantly across different settings, as does the experience of surveillance-from which tests are offered, and to the levels of psychological support. OBJECTIVE To explore the current best practice and determine the most important research priorities in AS for prostate cancer. DESIGN, SETTING, AND PARTICIPANTS A formal consensus process was followed, with an international expert panel of purposively sampled participants across a range of health care professionals and researchers, and those with lived experience of prostate cancer. Statements regarding the practice of AS and potential research priorities spanning the patient journey from surveillance to initiating treatment were developed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Panel members scored each statement on a Likert scale. The group median score and measure of consensus were presented to participants prior to discussion and rescoring at panel meetings. Current best practice and future research priorities were identified, agreed upon, and finally ranked by panel members. RESULTS AND LIMITATIONS There was consensus agreement that best practice includes the use of high-quality magnetic resonance imaging (MRI), which allows digital rectal examination (DRE) to be omitted, that repeat standard biopsy can be omitted when MRI and prostate-specific antigen (PSA) kinetics are stable, and that changes in PSA or DRE should prompt MRI ± biopsy rather than immediate active treatment. The highest ranked research priority was a dynamic, risk-adjusted AS approach, reducing testing for those at the least risk of progression. Improving the tests used in surveillance, ensuring equity of access and experience across different patients and settings, and improving information and communication between and within clinicians and patients were also high priorities. Limitations include the use of a limited number of panel members for practical reasons. CONCLUSIONS The current best practice in AS includes the use of high-quality MRI to avoid DRE and as the first assessment for changes in PSA, with omission of repeat standard biopsy when PSA and MRI are stable. Development of a robust, dynamic, risk-adapted approach to surveillance is the highest research priority in AS for prostate cancer. PATIENT SUMMARY A diverse group of experts in active surveillance, including a broad range of health care professionals and researchers and those with lived experience of prostate cancer, agreed that best practice includes the use of high-quality magnetic resonance imaging, which can allow digital rectal examination and some biopsies to be omitted. The highest research priority in active surveillance research was identified as the development of a dynamic, risk-adjusted approach.
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Affiliation(s)
- Caroline M Moore
- Division of Surgical and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospitals Trust, London, UK.
| | | | - John Withington
- Division of Surgical and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospitals Trust, London, UK
| | - Mahul B Amin
- Department of Pathology and Lab Medicine, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Urology, USC Keck School of Medicine, Los Angeles, CA, USA
| | | | | | - Ronald C Chen
- Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Francis I Chinegwundoh
- Department of Urology, Barts Health NHS Trust, London, UK; City University of London, London, UK
| | - Matthew R Cooperberg
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Urology, University of California at San Francisco, San Francisco, CA, USA
| | - Jane Crowe
- Australian Prostate Centre, North Melbourne, Victoria, Australia
| | - Antonio Finelli
- Department of Surgery (Urology), Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; Department of Urology, Cabrini Institute, Cabrini Health, Melbourne, Victoria, Australia
| | - Francesco Giganti
- Division of Surgical and Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Masoom A Haider
- Joint Department of Medical Imaging, University Health Network, Sinai Health System and University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | | | - Joseph Gallo
- Active Surveillance Patients International, East Stroudsburg, PA, USA
| | | | | | - Nicholas James
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Netty Kinsella
- Translational Oncology and Urology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK; Department of Urology, Royal Marsden Hospital, London, UK
| | - Thomas B L Lam
- Academic Urology Unit, Aberdeen University, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Mark Lichty
- Active Surveillance Patients International, East Stroudsburg, PA, USA
| | - Stacy Loeb
- Department of Urology, New York University, New York, NY, USA; Department of Population Health, New York University, New York, NY, USA; Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Brandon A Mahal
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | | | - Anita V Mitra
- Cancer Services, University College London Hospitals, NHS, London, UK
| | - Samuel W D Merriel
- Exeter Collaboration for Academic Primary Care (APEx), University of Exeter, Exeter, UK; Centre for Primary Care & Health Services Research, University of Manchester, Manchester, UK
| | - Theodorus van der Kwast
- Department of Pathology, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Nynikka R Palmer
- Department of Medicine, Zuckerberg San Francisco General Hospital. University of California San Francisco School of Medicine; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco; Department of Urology, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Catherine C Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Canberra Health Services and ACT Health, Synergy Nursing and Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Monique J Roobol
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Phillip Segal
- Prostate Cancer Support Toronto, Toronto, ON, Canada
| | | | - Camille E Short
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia; Melbourne Centre for Behaviour Change, University of Melbourne, Melbourne, Victoria, Australia
| | - M Minhaj Siddiqui
- Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Clare M C Tempany
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Arnaud Villers
- Department of Urology Univ. Lille, CHU Lille, Department of Urology F-59000 Lille, France
| | - Howard Wolinsky
- Answer Cancer Foundation, Tumacacori, Arizona, USA; TheActiveSurveillor.com, Flossmoor, Illinois, USA
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11
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Quist SW, Paulissen JHJ, Wyndaele DNJ, Nagarajah J, Freriks RD. Costs of radium-223 and the pharmacy preparation 177Lu-PSMA-I&T for metastatic castration-resistant prostate cancer in Dutch hospitals. J Med Econ 2023; 26:366-375. [PMID: 36905581 DOI: 10.1080/13696998.2023.2183618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE The radiopharmaceuticals radium-223 and the pharmacy preparation 177Lu-PSMA-I&T are reimbursed in the Netherlands for metastatic castration-resistant prostate cancer (mCRPC) treatment. Although shown to be life-prolonging in patients with mCRPC, the treatment procedures associated with these radiopharmaceuticals can be challenging for both patients and hospitals. This study investigates the costs of mCRPC treatment in Dutch hospitals for currently reimbursed radiopharmaceuticals with a demonstrated overall survival benefit. METHODS A cost model that calculated the direct medical per-patient costs of radium-223 and 177Lu-PSMA-I&T was developed, following clinical trial regimens. The model considered six 4-weekly administrations (i.e. ALSYMPCA regimen) of radium-223. Regarding 177Lu-PSMA-I&T, the model used both the VISION regimen (i.e. five 6-weekly administrations) and the SPLASH regimen (i.e. four 8-weekly administrations). Based on health insurance claims, we also estimated the coverage a hospital would receive for providing treatment. No fitting health insurance claim for 177Lu-PSMA-I&T is currently available; therefore, we calculated a break-even value for a potential health insurance claim that would exactly counterbalance the per-patient costs and coverage. RESULTS Radium-223 administration is associated with per-patient costs of €30,905, and these costs are fully covered by the coverage a hospital receives. The per-patient costs of 177Lu-PSMA-I&T range between €35,866 and €47,546 per administration period, depending on the regimen. Current healthcare insurance claims do not fully cover the costs of providing 177Lu-PSMA-I&T: hospitals must pay €4,414-€4,922 for each patient out of their own budget. The break-even value for the potential insurance claim covering 177Lu-PSMA-I&T administration with a VISION (SPLASH) regimen is €1,073 (€1,215). CONCLUSION This study shows that, without consideration of the treatment effect, radium-223 treatment for mCRPC leads to lower per-patient costs than treatment with 177Lu-PSMA-I&T. The detailed overview of the costs associated with radiopharmaceutical treatment provided by this study is relevant for both hospitals and healthcare insurers.
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Affiliation(s)
- S W Quist
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Asc Academics, Groningen, The Netherlands
| | - J H J Paulissen
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Asc Academics, Groningen, The Netherlands
| | - D N J Wyndaele
- Department of Nuclear Medicine, Catherina Hospital Eindhoven, Eindhoven, The Netherlands
| | - J Nagarajah
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R D Freriks
- Asc Academics, Groningen, The Netherlands
- Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
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12
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MacLennan S, Duncan E, Skolarus TA, Roobol MJ, Kasivisvanathan V, Gallagher K, Gandaglia G, Sakalis V, Smith EJ, Plass K, Ribal MJ, N'Dow J, Briganti A. Improving Guideline Adherence in Urology. Eur Urol Focus 2022; 8:1545-1552. [PMID: 34702647 DOI: 10.1016/j.euf.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/24/2021] [Accepted: 10/05/2021] [Indexed: 01/25/2023]
Abstract
CONTEXT Clinical practice guidelines (CPGs) distil an evidence base into recommendations. CPG adherence is associated with better patient outcomes. However, preparation and dissemination of CPGs are a costly task involving multiple skilled personnel. Furthermore, dissemination alone does not ensure CPG adherence. Reasons for nonadherence are often complex, but understanding practice variations and reasons for nonadherence is key to improving CPG adherence and harmonising clinically appropriate and cost-effective care. OBJECTIVE To overview approaches to improving guideline adherence, to provide urology-specific examples of knowledge-practice gaps, and to highlight potential solutions informed by implementation science. EVIDENCE ACQUISITION Three common approaches to implementation science (the Knowledge-To-Action framework, the Consolidated Framework for Implementation Research, and the Behaviour Change Wheel), are summarised. EVIDENCE SYNTHESIS Three implementation problems in urology are illustrated: underuse of single instillation of intravesical chemotherapy in non-muscle-invasive bladder cancer, overuse of androgen deprivation therapy in localised prostate cancer, and guideline-discordant imaging in prostate cancer. Research using implementation science approaches to address these implementation problems is discussed. CONCLUSIONS Urologists, patients, health care providers, funders, and other key stakeholders must commit to reliably capturing and reporting data on patient outcomes, practice variations, guideline adherence, and the impact of adherence on outcomes. Leverage of implementation science frameworks is a sound next step towards improving guideline adherence and the associated benefits of evidence-based care. PATIENT SUMMARY Clinical practice guideline documents are created by expert panels. These documents provide overviews of the evidence for the tests and treatments used in patient care. They also provide recommendations and it is expected that in most circumstances clinicians will follow these recommendations. Sometimes, health care professionals cannot or do not follow these recommendations and it is not always clear why. In this review article we look at some examples of research approaches to addressing this problem of nonadherence and we provide some examples specific to urology.
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Affiliation(s)
- Steven MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, The University of Aberdeen, Aberdeen, UK; European Association of Urology Guidelines Office and Methodology Committee, Arnhem, The Netherlands.
| | - Eilidh Duncan
- Health Services Research Unit, Institute of Applied Health Sciences, The University of Aberdeen, Aberdeen, UK
| | - Ted A Skolarus
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Veeru Kasivisvanathan
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Kevin Gallagher
- Department of Urology, Western General Hospital, Edinburgh, UK
| | - Giorgio Gandaglia
- Department of Urology, University Vita e Salute-San Raffaele, Milan, Italy
| | - Vasileios Sakalis
- Department of Urology, General Hospital Agios Pavlos, Thessaloniki, Greece
| | - Emma Jane Smith
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Karin Plass
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Maria J Ribal
- European Association of Urology Guidelines Office, Arnhem, The Netherlands; Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - James N'Dow
- Academic Urology Unit, Institute of Applied Health Sciences, The University of Aberdeen, Aberdeen, UK; European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Alberto Briganti
- Department of Urology, University Vita e Salute-San Raffaele, Milan, Italy; European Association of Urology Guidelines Office, Arnhem, The Netherlands
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13
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Ratti MM, Gandaglia G, Alleva E, Leardini L, Sisca ES, Derevianko A, Furnari F, Mazzoleni Ferracini S, Beyer K, Moss C, Pellegrino F, Sorce G, Barletta F, Scuderi S, Omar MI, MacLennan S, Williamson PR, Zong J, MacLennan SJ, Mottet N, Cornford P, Aiyegbusi OL, Van Hemelrijck M, N'Dow J, Briganti A. Standardising the Assessment of Patient-reported Outcome Measures in Localised Prostate Cancer. A Systematic Review. Eur Urol Oncol 2021; 5:153-163. [PMID: 34785188 DOI: 10.1016/j.euo.2021.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/30/2021] [Accepted: 10/15/2021] [Indexed: 01/27/2023]
Abstract
CONTEXT Prostate cancer (PCa) is the second most common cancer among men worldwide. Urinary, bowel, and sexual function, as well as hormonal symptoms and health-related quality of life (HRQoL), were prioritised by patients and professionals as part of a core outcome set for localised PCa regardless of treatment type. OBJECTIVE To systematically review the measurement properties of patient-reported outcome measures (PROMs) used in localised PCa and recommend PROMs for use in routine practice and research settings. EVIDENCE ACQUISITION The psychometric properties of PROMs measuring functional and HRQoL domains used in randomised controlled trials including patients with localised PCa were assessed according to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. MEDLINE and Embase were searched to identify publications evaluating psychometric properties of the PROMs. The characteristics and methodological quality of the studies included were extracted, tabulated, and assessed according to the COSMIN criteria. EVIDENCE SYNTHESIS Overall, 27 studies evaluating psychometric properties of the Expanded Prostate Cancer Index Composite (EPIC), University of California-Los Angeles Prostate Cancer Index (UCLA-PCI), European Organisation for Research and Treatment of Cancer (EORTC) quality of life core 30 (QLQ-C30) and prostate cancer 25 (QLQ-PR25) modules, International Index of Erectile Function (IIEF), and the 36-item (SF-36) and 12-item Short-Form health survey (SF-12) PROMs were identified and included in the systematic review. EPIC and EORTC QLQ-C30, a general module that assesses patients' physical, psychological, and social functions, were characterised by high internal consistency (Cronbach's α 0.46-0.96 and 0.68-0.94 respectively) but low content validity. EORTC QLQ-PR25, which is primarily designed to assess PCa-specific HRQoL, had moderate content validity and internal consistency (Cronbach's α 0.39-0.87). UCLA-PCI was characterised by moderate content validity and high internal consistency (Cronbach's α 0.21-0.94). However, it does not directly assess hormonal symptoms, whereas EORTC QLQ-PR25 does. CONCLUSION The tools with the best evidence for psychometric properties and feasibility for use in routine practice and research settings to assess PROMs in patients with localised PCa were EORTC QLQ-C30 and QLQ-PR25. Since EORTC QLQ-C30 is a general module that does not directly assess PCa-specific issues, it should be adopted in conjunction with the QLQ-PR25 module. PATIENT SUMMARY We reviewed and appraised the measurement properties of patient-reported outcome measure questionnaires used for patients with localised prostate cancer. We found good evidence to suggest that two questionnaires (EORTC QLQ-C30 and QLQ-PR25) can be used to measure urinary, bowel, and sexual functions and health-related quality of life.
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Affiliation(s)
- Maria Monica Ratti
- Department of Medicine and Surgery, Vita Salute San Raffaele University, Milan, Italy; Department of Clinical and Health Psychology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Giorgio Gandaglia
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Eugenia Alleva
- Department of Medicine and Surgery, Vita Salute San Raffaele University, Milan, Italy
| | - Luca Leardini
- Department of Clinical and Health Psychology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Elena Silvia Sisca
- Department of Clinical and Health Psychology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Alexandra Derevianko
- Department of Clinical and Health Psychology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Federica Furnari
- Department of Clinical and Health Psychology, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Katharina Beyer
- Translational and Oncology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Charlotte Moss
- Translational and Oncology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Francesco Pellegrino
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Gabriele Sorce
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Francesco Barletta
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Simone Scuderi
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, University of Liverpool, Liverpool Health Partners, Liverpool, UK
| | - Jihong Zong
- Global Epidemiology, Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, USA
| | | | - Nicolas Mottet
- Department of Urology, University Hospital, St. Etienne, France
| | | | - Olalekan Lee Aiyegbusi
- Centre for Patient-Reported Outcomes Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Mieke Van Hemelrijck
- Translational and Oncology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
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Beyer K, MacLennan SJ, Moris L, Lardas M, Mastris K, Hooker G, Greene R, Briers E, Omar MI, Healey J, Tripathee S, Gandaglia G, Venderbos LDF, Smith EJ, Bjorkqvist J, Asiimwe A, Huber J, Roobol MJ, Zong J, Bjartell A, N'Dow J, Briganti A, MacLennan S, Van Hemelrijck M. The Key Role of Patient Involvement in the Development of Core Outcome Sets in Prostate Cancer. Eur Urol Focus 2021; 7:943-946. [PMID: 34602368 DOI: 10.1016/j.euf.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/01/2021] [Accepted: 09/10/2021] [Indexed: 11/18/2022]
Abstract
Patients are the stewards of their own care and hence their voice is important when designing and implementing research. Patients should be involved not only as participants in research that impacts their care, as the recipients of that care and any associated harms, but also as research collaborators in prioritising important questions from the patient perspective and designing the research and the ways in which is it most appropriate to involve patients. The PIONEER Consortium, an international multistakeholder collaboration lead by the European Association of Urology, has developed a core outcome set (COS) for localised and metastatic prostate cancer relevant to all stakeholders in particular patients. Throughout the work of PIONEER, patient representatives were involved as collaborators in setting the research agenda, and a wider group of patients was involved as participants in developing COSs, for instance in consensus meetings on choosing important outcomes and appropriate definitions. This publication showcases the process for COS development and highlights the most important recommendations to ultimately inform future research projects co-created between patients and other stakeholders. PATIENT SUMMARY: An important step in involving patients in the selection of outcomes for clinical trials, clinical audits, and real-world evidence is the development of a core outcome set (COS) that is relevant to all stakeholders. This report highlights the patient participation throughout our PIONEER COS development. TAKE HOME MESSAGE: An important step in involving patients in the selection of outcomes for clinical trials, clinical audits, and real-world evidence is to develop a core outcome set (COS) that is relevant to all stakeholders. As part of the work of the PIONEER Consortium, we aim to highlight the patient participation throughout our PIONEER COS development.
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Affiliation(s)
- Katharina Beyer
- Translational and Oncology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Sara J MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Lisa Moris
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Michael Lardas
- Department of Urology, Metropolitan general, Athens, Greece
| | - Ken Mastris
- European Cancer Patient Coalition, Brussels, Belgium
| | | | | | - Erik Briers
- EAU Guidelines Office Prostate Cancer Panel, Hasselt, Belgium
| | - Muhammad Imran Omar
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Jemma Healey
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Sheela Tripathee
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Giorgio Gandaglia
- Department of Urology, University Vita e Salute-San Raffaele, Milan, Italy
| | - Lionne D F Venderbos
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Emma J Smith
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | | | - Alex Asiimwe
- Department of Epidemiology, Bayer AG, Berlin, Germany
| | - Johannes Huber
- Department of Urology, University Dresden, Dresden, Germany
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jihong Zong
- Global Medical Affairs Oncology, Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, USA
| | - Anders Bjartell
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - James N'Dow
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Alberto Briganti
- Department of Urology, University Vita e Salute-San Raffaele, Milan, Italy
| | - Steven MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Mieke Van Hemelrijck
- Translational and Oncology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
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MacLennan S, Williamson PR. The need for core outcome sets in urological cancer research. Transl Androl Urol 2021; 10:2832-2835. [PMID: 34295767 PMCID: PMC8261447 DOI: 10.21037/tau-20-1323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/29/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Steven MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,European Association of Urology Guidelines Office Methodology Committee, Arnhem, The Netherlands
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, University of Liverpool and Liverpool Health Partners, Liverpool, UK
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Donaldson JF, McClinton S. Evidence and clinical trials in Endourology: where are we going. Curr Opin Urol 2021; 31:120-124. [PMID: 33399369 DOI: 10.1097/mou.0000000000000851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW There is an ongoing explosion in the amount and quality, of research in the field of Endourology. From a solid basis of systematic reviews and small, single centre trials it has been possible to design large randomised controlled trials in the UK and in the USA. This review will describe some of the more recent trials (small and large) that are helping to provide a solid evidence base for our practice in Endourology. ONGOING STUDIES Randomised controlled trial (RCTs) include: The Therapeutic Interventions for Stones in the Ureter (TISU), the Percutaneous nephrolithotomy, flexible Ureterorenoscopy and extracorporeal Shockwave lithotripsy for lower pole kidney stones (PURE RCTs) and the Prevention of Urinary Stones with Hydration (PUSH). Quality of life (QoL) measures and studies include: the Wisconsin Stone QoL Questionnaire, the Cambridge Renal Stone PROM, the Cambridge Ureteral Stone PROM, the Urinary stone and Intervention QoL questionnaire and the Study to Enhance Understanding of sTent-associated Symptoms (STENTS). The Core Outcome Set in Trials on treatments for Renal and UreteriC sTones (COSTRUCT) study aims to define a core outcome set to be used in future trials. SUMMARY On-going studies will provide higher quality evidence on the treatment of ureteric and renal stones to inform treatment decision making and guideline recommendations. They will also guide decisions relating to prevention and recurrence and give insight into the true impact of urinary stones and endourological interventions on patients' quality of life. Future studies will incorporate big data and artificial intelligence.
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Affiliation(s)
- James Fergus Donaldson
- Academic Urology Unit, University of Aberdeen.,Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Samuel McClinton
- Academic Urology Unit, University of Aberdeen.,Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
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Hameed BMZ, Shah M, Naik N, Ibrahim S, Somani B, Rice P, Soomro N, Rai BP. Contemporary application of artificial intelligence in prostate cancer: an i-TRUE study. Ther Adv Urol 2021; 13:1756287220986640. [PMID: 33633799 PMCID: PMC7841858 DOI: 10.1177/1756287220986640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/16/2020] [Indexed: 01/04/2023] Open
Abstract
Artificial intelligence (AI) involves technology that is able to emulate tasks previously carried out by humans. The growing incidence, novel diagnostic strategies and newer available therapeutic options have had resource and economic impacts on the healthcare organizations providing prostate cancer care. AI has the potential to be an adjunct to and, in certain cases, a replacement for human input in prostate cancer care delivery. Automation can also address issues such as inter- and intra-observer variability and has the ability to deliver analysis of large volume datasets quickly and accurately. The continuous training and testing of AI algorithms will facilitate development of futuristic AI models that will have integral roles to play in diagnostics, enhanced training and surgical outcomes and developments of prostate cancer predictive tools. These AI related innovations will enable clinicians to provide individualized care. Despite its potential benefits, it is vital that governance with AI related care is maintained and responsible adoption is achieved.
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Affiliation(s)
- B M Zeeshan Hameed
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Milap Shah
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
| | - Sufyan Ibrahim
- i-TRUE: International Training and Research in Uro-oncology and Endourology, Manipal, Karnataka, India
| | - Bhaskar Somani
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Patrick Rice
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Naeem Soomro
- Department of Urology, Freeman Hospital, Newcastle, UK
| | - Bhavan Prasad Rai
- i-TRUE: International Training and Research in Uro-oncology and Endourology, Manipal, Karnataka, India
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