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Gambert, Steven

doi:10.1023/a:1015290429403

Cited by 18 publications

(4 citation statements)

References 15 publications

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“…PSA screening is, however, controversial [ 20 ]. It detects many clinically insignificant tumors which would never have caused symptoms but also sometimes misses the presence of a significant PCa [ 21 ]. The American Urological Association and US Preventive Services Task Force guidelines have suggested ages 55 to 69 to be the key age range for offering PSA to average-risk men while European urology guidelines, among others, recommend an individualised risk-adapted strategy for PSA screening in well-informed men aged over 50 years, and men aged over 45 years if they have a PCa family history [ 19 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

Does greater patient involvement in healthcare decision-making affect malpractice complaints? A large case vignette survey

et al. 2021

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Background Although research findings consistently find poor communication about medical procedures to be a key predictor of patient complaints, compensation claims, and malpractice lawsuits (“complaints”), there is insufficient evidence to determine if greater patient involvement could actually affect the inclination to complain. Objectives We conducted an experimental case vignette survey that explores whether greater patient involvement in decision-making is likely to influence the intention to complain given different decisions and consequences. Methods Randomized, national case vignette survey with various levels of patient involvement, decisions, and outcomes in a representative Danish sample of men. We used prostate specific antigen (PSA) screening in men aged 45 to 70 years as the intervention illustrated in 30 different versions of a mock clinical encounter. Versions differed in the amount of patient involvement, the decision made (PSA test or no PSA test), and the clinical outcomes (no cancer detected, detection of treatable cancer, and detection of non-treatable cancer). We measured respondents’ inclination to complain about care in response to the scenarios on a 5-point Likert scale (from 1: very unlikely to 5: very likely). Results The response rate was 30% (6,756 of 22,288). Across all scenarios, the likelihood of complaint increased if the clinical outcome was poor (untreatable cancer). Compared with scenarios that involved shared decision-making (SDM), neutral information, or nudging in favor of screening, the urge to complain increased if the patient was excluded from decision-making or if the doctor had nudged the patient to decline screening (mean Likert differences .12 to .16, p < .001). With neutral involvement or nudging in favor of intervention, the desire to complain depended highly on the decision reached and on the patient’s course. This dependence was smaller with SDM. Conclusions Greater patient involvement in decision-making appears to be associated with less intention to complain about health care, with SDM resulting in the greatest reduction in complaint likelihood.

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Section: Methodsmentioning

confidence: 99%

Does greater patient involvement in healthcare decision-making affect malpractice complaints? A large case vignette survey

et al. 2021

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“…Men who have immediate families with PCa are about 50% more likely to develop this disease [ 51 , 52 ]. Lifestyle modifications, including smoking cessation, exercise, and weight control are preventative steps an individual can take to decrease the risk of PCa occurrence, but early screening for PCa is one of the most important steps to prevent the aggressive and advanced form of the disease [ 53 ].…”

Section: Causal Inflammatory Drivers Of Prostate Carcinogenesismentioning

confidence: 99%

The Molecular Basis and Clinical Consequences of Chronic Inflammation in Prostatic Diseases: Prostatitis, Benign Prostatic Hyperplasia, and Prostate Cancer

Oseni

Naar

Pavlović

et al. 2023

Cancers

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Chronic inflammation is now recognized as one of the major risk factors and molecular hallmarks of chronic prostatitis, benign prostatic hyperplasia (BPH), and prostate tumorigenesis. However, the molecular mechanisms by which chronic inflammation signaling contributes to the pathogenesis of these prostate diseases are poorly understood. Previous efforts to therapeutically target the upstream (e.g., TLRs and IL1-Rs) and downstream (e.g., NF-κB subunits and cytokines) inflammatory signaling molecules in people with these conditions have been clinically ambiguous and unsatisfactory, hence fostering the recent paradigm shift towards unraveling and understanding the functional roles and clinical significance of the novel and relatively underexplored inflammatory molecules and pathways that could become potential therapeutic targets in managing prostatic diseases. In this review article, we exclusively discuss the causal and molecular drivers of prostatitis, BPH, and prostate tumorigenesis, as well as the potential impacts of microbiome dysbiosis and chronic inflammation in promoting prostate pathologies. We specifically focus on the importance of some of the underexplored druggable inflammatory molecules, by discussing how their aberrant signaling could promote prostate cancer (PCa) stemness, neuroendocrine differentiation, castration resistance, metabolic reprogramming, and immunosuppression. The potential contribution of the IL1R-TLR-IRAK-NF-κBs signaling molecules and NLR/inflammasomes in prostate pathologies, as well as the prospective benefits of selectively targeting the midstream molecules in the various inflammatory cascades, are also discussed. Though this review concentrates more on PCa, we envision that the information could be applied to other prostate diseases. In conclusion, we have underlined the molecular mechanisms and signaling pathways that may need to be targeted and/or further investigated to better understand the association between chronic inflammation and prostate diseases.

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“…Due to the low probability of the PSA test correctly identifying men who do not have prostate cancer (specificity), many men may be falsely identified (false positives) as possibly having prostate cancer and then subjected to unnecessary biopsies [ 77 ]. Differences in the accuracy of the PSA test are partially due to the PSA threshold used to signal a need for further testing for prostate cancer, as some thresholds may increase the detection of cancers that are unlikely to cause health concerns even if left untreated [ 78 ]. The American Cancer Society completed a series of systematic reviews and found that PSA screening for any prostate cancer with a cutoff of 4.0 ng/mL resulted in 21% of screening tests that identified prostate cancer being truly positive (sensitivity) and 91% of screening tests that did not identify prostate cancer being truly negative (specificity) [ 79 ].…”

Section: Purpose and Backgroundmentioning

confidence: 99%

Screening for prostate cancer: protocol for updating multiple systematic reviews to inform a Canadian Task Force on Preventive Health Care guideline update

et al. 2022

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Purpose To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening for prostate cancer in adults aged 18 years and older in primary care. This protocol outlines the planned scope and methods for a series of systematic reviews. Methods Updates of two systematic reviews and a de novo review will be conducted to synthesize the evidence on the benefits and harms of screening for prostate cancer with a prostate-specific antigen (PSA) and/or digital rectal examination (DRE) (with or without additional information) and patient values and preferences. Outcomes for the benefits of screening include reduced prostate cancer mortality, all-cause mortality, and incidence of metastatic prostate cancer. Outcomes for the harms of screening include false-positive screening tests, overdiagnosis, complications due to biopsy, and complications of treatment including incontinence (urinary or bowel), and erectile dysfunction. The quality of life or functioning (overall and disease-specific) and psychological effects outcomes are considered as a possible benefit or harm. Outcomes for the values and preferences review include quantitative or qualitative information regarding the choice to screen or intention to undergo screening. For the reviews on benefits or harms, we will search for randomized controlled trials, quasi-randomized, and controlled studies in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. For the review on values and preferences, we will search for experimental or observational studies in MEDLINE, Embase, and PsycInfo. For all reviews, we will also search websites of relevant organizations, gray literature, and reference lists of included studies. Title and abstract screening, full-text review, data extraction, and risk of bias assessments will be completed independently by pairs of reviewers with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach will be used to assess the certainty of the evidence for each outcome. Discussion The series of systematic reviews will be used by the Canadian Task Force on Preventive Health Care to update their 2014 guideline on screening for prostate cancer in adults aged 18 years and older. Systematic review registration This review has been registered with PROSPERO (CRD42022314407) and is available on the Open Science Framework (osf.io/dm32k).

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Untitled

Cited by 18 publications

References 15 publications

Does greater patient involvement in healthcare decision-making affect malpractice complaints? A large case vignette survey

Does greater patient involvement in healthcare decision-making affect malpractice complaints? A large case vignette survey

The Molecular Basis and Clinical Consequences of Chronic Inflammation in Prostatic Diseases: Prostatitis, Benign Prostatic Hyperplasia, and Prostate Cancer

Screening for prostate cancer: protocol for updating multiple systematic reviews to inform a Canadian Task Force on Preventive Health Care guideline update

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