UCLA Urology has received a $1.9 million award to develop ways to improve the decision-making process for men diagnosed with prostate cancer, enabling them to make informed treatment choices with which they're more satisfied. The award, granted in June by the Patient-Centered Outcomes Research Institute, will fund research on shared decision-making, a process by which patients and their physicians collaborate more effectively on medical decisions about prostate cancer treatment.
"With the complexity of prostate cancer treatment, it's vital for patients to be as involved as possible in the decisions that greatly affect their health," said Dr. Christopher Saigal, vice chair of urology at UCLA Health, who is leading the study. "This award allows us to do work aimed at enabling a man with prostate cancer to feel secure that he has made the best decision for himself. It will also help us learn how to make shared decision-making a part of routine care for men with prostate cancer, across a variety of care settings.”
Men diagnosed with prostate cancer face a variety of treatment options that are not always so clear-cut, each with its own set of trade-offs and side effects that may significantly impact their lifestyle. An estimated 15 percent of men treated for prostate cancer later come to regret their treatment choice, research shows.
The project will investigate the use of an online tool Saigal created called WiserCare, a software program that collects information about a patient with prostate cancer and predicts prognosis with various treatments. The program enables patients to input answers to questions and scenarios about their preferences and personal values, then uses an algorithm to develop a ranked list of individualized treatment options appropriate for the patient in light of their personal values.
For example, a patient with low risk prostate cancer might find that he matches best to a less aggressive treatment approach in the event preserving sexual health is highly important to him, compared to other treatment goals. He can then use the personalized WiserCare report in an informed decision-making process with his doctor.
"Different outcomes are important to different people, and there's no blanket approach to treating prostate cancer," Saigal said. "With our tool, our hope is that men with prostate cancer are better able to understand the options available to them and to then choose a treatment they'll be satisfied with in the long term."
About 1,500 patients at UCLA have used the WiserCare program, which is also in use for other types of medical conditions at NorthShore University HealthSystem, Northwestern Medicine and OSF HealthCare – all located in Illinois.
With the funding the award provides, Saigal and colleagues will measure the tool's adoption and learn how best to scale up its use in different care settings, including at Olive View-UCLA Medical Center and Vanderbilt University. The team will also measure its effectiveness in reducing decisional conflict, its impact on patient satisfaction, and its ability to promote shared decision-making. They will also update the WiserCare prostate cancer module with the latest outcome data available through PCORI-funded research.
“PCORI is committed to making sure research findings from our studies are easily accessible and used in practice to improve patient’s health. This project has received funding from PCORI to disseminate and implement their findings toward this goal,” said Jean Slutsky, PCORI’s chief engagement and dissemination officer.
Patient-Centered Outcomes Research Institute is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, caregivers, and clinicians with the evidence-based information needed to make better informed health care decisions.