Participation Bias in a Prostate Cancer Quality of Life Survey
CUA Online Library. Kim B. 06/22/13; 31432; UP-53
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Abstract
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RETENTION BIAS IN A PROSTATE CANCER QUALITY OF LIFE STUDY
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D.*, Richard Contreras, M.S.*, Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S.*, Steven J. Jacobsen, M.D. Ph.D.*, Gary W. Chien, M.D.: Los Angeles, CA
Purpose: There are several different treatment options for localized prostate cancer which demonstrate similar oncologic efficacy. Prostate cancer treatments have associated morbidities which impact health-related quality of life (HRQOL). Surveys provide a simple and standardized method for measuring HRQOL, but may be marred due to retention bias. This may occur when specific factors that impact a patient’s disease process or experience also influence their willingness or ability to continue participating in a study. The study objective was to identify potential demographic and clinical factors associated with retention in a prostate cancer HRQOL survey administered to men recently diagnosed with the disease.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were prospectively enrolled at 14 hospitals within the Kaiser Permanente Southern California medical region. Men completed the Expanded Prostate Cancer Index Composite (EPIC-26) at the time of their prostate biopsy appointment (baseline) and then at specific follow-up intervals after initiating treatment (1, 3, 6, 12, 18, and 24 months). Surveys were administered in either English or Spanish, depending on the respondent’s primary language. Select demographic and clinical parameters were compared between \"participants\" (those that completed a baseline and any follow-up survey) and \"drop-outs\" (those that completed only a baseline survey) using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, with a retention rate of 67.2% (1637 participants; 799 dropouts). Men who participated tended to be older, partnered, primarily English-speaking, Caucasian, and living in regions with higher education and income levels (p<0.05). Men with a positive family history for prostate cancer were also more likely to continue in the study (p=0.002). Prostate specific antigen (PSA) levels, biopsy Gleason sum, Charlson co-morbidity index, body mass index (BMI), and smoking status were similar amongst study participants and drop-outs.
Conclusions: The study revealed that there are significantly more demographic characteristics that influence participation than clinical factors. The data also suggests that the survey results will have to be interpreted in light of these demographic differences, as they may be associated with quality of life. Moreover, this information can be used for targeted retention efforts in this and other prostate cancer HRQOL studies.
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D.*, Richard Contreras, M.S.*, Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S.*, Steven J. Jacobsen, M.D. Ph.D.*, Gary W. Chien, M.D.: Los Angeles, CA
Purpose: There are several different treatment options for localized prostate cancer which demonstrate similar oncologic efficacy. Prostate cancer treatments have associated morbidities which impact health-related quality of life (HRQOL). Surveys provide a simple and standardized method for measuring HRQOL, but may be marred due to retention bias. This may occur when specific factors that impact a patient’s disease process or experience also influence their willingness or ability to continue participating in a study. The study objective was to identify potential demographic and clinical factors associated with retention in a prostate cancer HRQOL survey administered to men recently diagnosed with the disease.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were prospectively enrolled at 14 hospitals within the Kaiser Permanente Southern California medical region. Men completed the Expanded Prostate Cancer Index Composite (EPIC-26) at the time of their prostate biopsy appointment (baseline) and then at specific follow-up intervals after initiating treatment (1, 3, 6, 12, 18, and 24 months). Surveys were administered in either English or Spanish, depending on the respondent’s primary language. Select demographic and clinical parameters were compared between \"participants\" (those that completed a baseline and any follow-up survey) and \"drop-outs\" (those that completed only a baseline survey) using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, with a retention rate of 67.2% (1637 participants; 799 dropouts). Men who participated tended to be older, partnered, primarily English-speaking, Caucasian, and living in regions with higher education and income levels (p<0.05). Men with a positive family history for prostate cancer were also more likely to continue in the study (p=0.002). Prostate specific antigen (PSA) levels, biopsy Gleason sum, Charlson co-morbidity index, body mass index (BMI), and smoking status were similar amongst study participants and drop-outs.
Conclusions: The study revealed that there are significantly more demographic characteristics that influence participation than clinical factors. The data also suggests that the survey results will have to be interpreted in light of these demographic differences, as they may be associated with quality of life. Moreover, this information can be used for targeted retention efforts in this and other prostate cancer HRQOL studies.
RETENTION BIAS IN A PROSTATE CANCER QUALITY OF LIFE STUDY
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D.*, Richard Contreras, M.S.*, Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S.*, Steven J. Jacobsen, M.D. Ph.D.*, Gary W. Chien, M.D.: Los Angeles, CA
Purpose: There are several different treatment options for localized prostate cancer which demonstrate similar oncologic efficacy. Prostate cancer treatments have associated morbidities which impact health-related quality of life (HRQOL). Surveys provide a simple and standardized method for measuring HRQOL, but may be marred due to retention bias. This may occur when specific factors that impact a patient’s disease process or experience also influence their willingness or ability to continue participating in a study. The study objective was to identify potential demographic and clinical factors associated with retention in a prostate cancer HRQOL survey administered to men recently diagnosed with the disease.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were prospectively enrolled at 14 hospitals within the Kaiser Permanente Southern California medical region. Men completed the Expanded Prostate Cancer Index Composite (EPIC-26) at the time of their prostate biopsy appointment (baseline) and then at specific follow-up intervals after initiating treatment (1, 3, 6, 12, 18, and 24 months). Surveys were administered in either English or Spanish, depending on the respondent’s primary language. Select demographic and clinical parameters were compared between \"participants\" (those that completed a baseline and any follow-up survey) and \"drop-outs\" (those that completed only a baseline survey) using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, with a retention rate of 67.2% (1637 participants; 799 dropouts). Men who participated tended to be older, partnered, primarily English-speaking, Caucasian, and living in regions with higher education and income levels (p<0.05). Men with a positive family history for prostate cancer were also more likely to continue in the study (p=0.002). Prostate specific antigen (PSA) levels, biopsy Gleason sum, Charlson co-morbidity index, body mass index (BMI), and smoking status were similar amongst study participants and drop-outs.
Conclusions: The study revealed that there are significantly more demographic characteristics that influence participation than clinical factors. The data also suggests that the survey results will have to be interpreted in light of these demographic differences, as they may be associated with quality of life. Moreover, this information can be used for targeted retention efforts in this and other prostate cancer HRQOL studies.
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D.*, Richard Contreras, M.S.*, Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S.*, Steven J. Jacobsen, M.D. Ph.D.*, Gary W. Chien, M.D.: Los Angeles, CA
Purpose: There are several different treatment options for localized prostate cancer which demonstrate similar oncologic efficacy. Prostate cancer treatments have associated morbidities which impact health-related quality of life (HRQOL). Surveys provide a simple and standardized method for measuring HRQOL, but may be marred due to retention bias. This may occur when specific factors that impact a patient’s disease process or experience also influence their willingness or ability to continue participating in a study. The study objective was to identify potential demographic and clinical factors associated with retention in a prostate cancer HRQOL survey administered to men recently diagnosed with the disease.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were prospectively enrolled at 14 hospitals within the Kaiser Permanente Southern California medical region. Men completed the Expanded Prostate Cancer Index Composite (EPIC-26) at the time of their prostate biopsy appointment (baseline) and then at specific follow-up intervals after initiating treatment (1, 3, 6, 12, 18, and 24 months). Surveys were administered in either English or Spanish, depending on the respondent’s primary language. Select demographic and clinical parameters were compared between \"participants\" (those that completed a baseline and any follow-up survey) and \"drop-outs\" (those that completed only a baseline survey) using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, with a retention rate of 67.2% (1637 participants; 799 dropouts). Men who participated tended to be older, partnered, primarily English-speaking, Caucasian, and living in regions with higher education and income levels (p<0.05). Men with a positive family history for prostate cancer were also more likely to continue in the study (p=0.002). Prostate specific antigen (PSA) levels, biopsy Gleason sum, Charlson co-morbidity index, body mass index (BMI), and smoking status were similar amongst study participants and drop-outs.
Conclusions: The study revealed that there are significantly more demographic characteristics that influence participation than clinical factors. The data also suggests that the survey results will have to be interpreted in light of these demographic differences, as they may be associated with quality of life. Moreover, this information can be used for targeted retention efforts in this and other prostate cancer HRQOL studies.
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