Objectives Several patient‐reported outcome measures (PROMs) are available for the assessment of quality of life (QoL), anxiety and depression for testicular cancer (TCa); however, these PROMs have uncertain validation of their psychometric properties for TCa‐only cohorts. This systematic review aims to critically analyse and evaluate the psychometric properties of these QoL, anxiety and depression PROMs. Methods PubMed, EMBASE and PsycInfo were searched by two independent reviewers from inception to August 2020. Evaluative studies that assessed measurement properties of PROM(s) tools used for measuring QoL, anxiety and depression in TCa patients were included. The COnsensus‐based Standards for the selection of health status Measurement Instruments (COSMIN) updated criteria for good measurement properties were used in the evaluation of PROM psychometric quality. This systematic review was registered on the PROSPERO database (CRD42020160232). Results Of 4,305 abstracts screened, a final eight full‐text articles were included in this review. Five general and two TCa‐specific PROMs were identified (depression, n = 1; anxiety and depression, n = 2; QoL, n = 4). All studies were incomplete in the validation of nine measurement properties and the modal methodological quality was ‘indeterminate’. The European Organisation for Research and Treatment of Cancer Quality ‐Testicular Cancer 26 questionnaire and CAYA‐T had the highest psychometric validation with three out of nine measurement properties being ‘sufficient’. Conclusion This systematic review identifies a paucity of PROM‐validation studies assessing anxiety, depression and QoL in TCa‐only cohorts. We recommend further comprehensive and standardised psychometric validation studies of QoL, anxiety and depression PROMs in TCa‐only study populations.
IntroductionIn the absence of guidelines clinicians must make medical decisions using reliable evidence. This requires knowledge of research concepts and critical appraisal skills. Yet, it is recognized that training in this area is often lacking and widely varied. This paper’s aim is to survey medical students and clinicians to identify attitudes towards research education and overall confidence. MethodsA national cross-sectional study using a ten-point survey was distributed from February-March 2021. Eligible respondents were United Kingdom senior medical students in final or penultimate years and doctors pre-specialty training. Respondents were categorized into three groups: medical students, clinicians, and clinical academics.Results 139 eligible respondents completed our survey of which 58 were senior medical students across 9 medical schools. All medical students were in penultimate or final years of their medical courses. Also 81 doctors responded, 20% (n=16) of whom were clinical academics. Only 48% of medical students, 60% of clinicians and 65% of clinical academics said they’d received formal educational teaching during medical school as part of the curriculum. This increased to 72% for students who had intercalated or studied degrees previously. Clinical academics consistently reported having received the most training. Clinical academics also had the most confidence in understanding research concepts; study types, PICOS, P-value, null hypothesis, types of error, and types of bias. Medical students who intercalated were more confident in critical appraisal concepts with the majority rating themselves as ‘somewhat confident’ in 5 of the 6 research concepts compared to students who did not intercalate who rated themselves as ‘somewhat confident’ in 3 of the 6 concepts.Discussion The results show there is a general lack of teaching and confidence in evidence-based methods. Medical schools must address this to develop doctors who can make well-informed clinical decisions. Further action is required to standardize a research curriculum.
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