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Cunningham GR, Stephens-Shields AJ, Rosen RC, Wang C, Bhasin S, Matsumoto AM, Parsons JK, Gill TM, Molitch ME, Farrar JT, Cella D, Barrett-Connor E, Cauley JA, Cifelli D, Crandall JP, Ensrud KE, Gallagher L, Zeldow B, Lewis CE, Pahor M, Swerdloff RS, Hou X, Anton S, Basaria S, Diem SJ, Tabatabaie V, Ellenberg SS, Snyder PJ. Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels. J Clin Endocrinol Metab 2016; 101:3096-104. [PMID: 27355400 PMCID: PMC4971331 DOI: 10.1210/jc.2016-1645] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial results of the Sexual Function Trial showed that T improved sexual activity, sexual desire, and erectile function. OBJECTIVE To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes. DESIGN A placebo-controlled trial. SETTING Twelve academic medical centers in the United States. PARTICIPANTS A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month. METHODS Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function. RESULTS Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T. CONCLUSIONS In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.
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Affiliation(s)
- Glenn R Cunningham
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Alisa J Stephens-Shields
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Raymond C Rosen
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Christina Wang
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Shalender Bhasin
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Alvin M Matsumoto
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - J Kellogg Parsons
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Thomas M Gill
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Mark E Molitch
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - John T Farrar
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - David Cella
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Elizabeth Barrett-Connor
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Jane A Cauley
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Denise Cifelli
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Jill P Crandall
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Kristine E Ensrud
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Laura Gallagher
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Bret Zeldow
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Cora E Lewis
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Marco Pahor
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Ronald S Swerdloff
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Xiaoling Hou
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Stephen Anton
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Shehzad Basaria
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Susan J Diem
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Vafa Tabatabaie
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Susan S Ellenberg
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
| | - Peter J Snyder
- Departments of Medicine and Molecular and Cellular Biology (G.R.C.), Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Research Program in Men's Health: Aging and Metabolism (S.Bh., S.Ba.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Geriatric Research, Education, and Clinical Center (A.M.M.), Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology & Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108-1597; Department of Urology (J.K.P.), Moores Comprehensive Cancer Center, University of California, San Diego, California 92093; Division of Geriatric Medicine (T.M.G.), Yale School of Medicine, New Haven, Connecticut 06510; Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), and Department of Medical Social Sciences (D.C.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology (E.B.-C.), Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California 92093-0607; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Center for Clinical Epidemiology and Biostatistics (D.C., L.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Divisions of Endocrinology and Geriatrics (
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Morales A, Bebb RA, Manjoo P, Assimakopoulos P, Axler J, Collier C, Elliott S, Goldenberg L, Gottesman I, Grober ED, Guyatt GH, Holmes DT, Lee JC. Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline. CMAJ 2015; 187:1369-1377. [PMID: 26504097 DOI: 10.1503/cmaj.150033] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Alvaro Morales
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta.
| | - Richard A Bebb
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Priya Manjoo
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Peter Assimakopoulos
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - John Axler
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Christine Collier
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Stacy Elliott
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Larry Goldenberg
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Irv Gottesman
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Ethan D Grober
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Gordon H Guyatt
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Daniel T Holmes
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
| | - Jay C Lee
- Department of Urology (Morales), Queen's University, Kingston, Ont.; Division of Endocrinology and Department of Urologic Sciences (Bebb), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Endocrinology (Manjoo), University of British Columbia, and Department of Medicine (Manjoo), Vancouver Island Health Authority, Vancouver, BC; McGill University and Jewish General Hospital (Assimakopoulos), Montréal, Que.; Department of Family and Community Medicine (Axler), University of Toronto, Toronto, Ont.; Department of Pathology and Molecular Medicine (Collier), Queen's University, Kingston, Ont.; Departments of Psychiatry (Elliott) and Urologic Sciences (Elliott, Goldenberg), University of British Columbia, Vancouver, BC; Canadian Men's Health Foundation (Goldenberg), Vancouver, BC; Faculty of Medicine (Gottesman), University of Toronto, Credit Valley Hospital, Toronto, Ont.; Division of Urology (Grober), Department of Surgery, University of Toronto, Mount Sinai Hospital and Women's College Hospital, Toronto, Ont.; Departments of Clinical Epidemiology and Biostatistics and of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Department of Pathology and Laboratory Medicine (Holmes), University of British Columbia and St. Paul's Hospital, Vancouver, BC; Division of Urology (Lee), Department of Surgery, University of Calgary, Calgary, Alta
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