Predictors of Individual Response to Placebo or Tadalafil 5mg among Men with Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: An Integrated Clinical Data Mining Analysis

Fusco, Ferdinando; d'Anzeo, Gianluca; Henneges, Carsten; Rossi, Andrea; Büttner, H.; Nickel, J. Curtis

doi:10.1371/journal.pone.0135484

Cited by 7 publications

(5 citation statements)

References 37 publications

(46 reference statements)

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“…However, there were no statistically significant differences observed between Rezūm and TUMT (−0.61 points in favour of TUMT, 95% CI: −3.46 to 2.23) or between TUNA and Rezūm (0.50 points in favour of TUNA, 95% CI: −2.45 to 3.47). TURP, on the other hand, significantly outperformed Rezūm by 3.14 points (95% CI: 0.26 to 6.03); this difference was statistically and clinically significant (IPSS change >MCID of 3 points) 47 . The GRADE ratings for these findings can be seen in Table 2.…”

Section: Resultsmentioning

confidence: 89%

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A systematic review and network meta‐analysis comparing Rezūm with transurethral needle ablation and microwave thermotherapy for the management of enlarged prostate

Bhatia,

Porto,

Titus

et al. 2024

BJUI Compass

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ObjectivesWe aim to compare efficacy and safety of water vapour therapy (Rezūm), transurethral needle ablation (TUNA) and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms.MaterialsPubMed/MEDLINE, EMBASE and Cochrane Library were searched from inception to 30 July 2023, followed by reference searching and dual‐independent study selection. We analysed only randomized clinical trials. RoB‐2, NIH‐quality assessment tool and GRADE guidelines were used for quality‐of‐evidence (QoE) assessment. Relevant prospective studies without a critical risk‐of‐bias were included.ResultsAt 12 months, Rezūm showed similar efficacy to TUNA and TUMT for improvement in International Prostate Symptoms Score – Rezūm versus TUMT: 1.33 points (95% CI: −1.66 to 4.35) favouring TUMT (QoE: Moderate) and Rezūm versus TUNA: 0.07 points (95% CI: −3.64 to 3.88) favouring TUNA (QoE: Low). Rezum had similar outcomes to TUNA and TUMT for Maximum Peak‐Flow Rate (Qmax): Rezūm versus TUMT: 1.05 mL/s (95% CI: −4.88 to 2.82) favouring Rezūm (QoE: Low) and Rezūm versus TUNA: 0.37 mL/s (95% CI: −4.61 to 4.21) favouring TUNA (QoE: Low). Furthermore, post‐void residual volume (PVR) comparisons demonstrated that Rezūm was similar, or inferior to other techniques at 12 months – Rezūm versus TUMT: 11.20 mL (95% CI: −32.40 to 10.30) favouring TUMT (QoE: Low) and Rezūm versus TUNA: 24.10 mL (95% CI: 2.81 to 45.10) favouring TUNA (QoE: Low). Rezūm also had a similar surgical retreatment rate with TUMT and TUNA up to 3‐years – TUMT versus Rezūm RR: 1.21 (95% CI: 0.20 to 15.90) (QoE: Low) and TUNA versus Rezūm showed RR: 1.81 (95% CI: 0.2 to 24.60) (QoE: Low). In the first 12 months after treatment, Rezūm had a higher rate of serious adverse events (Clavien‐Dindo ≥ Grade 3) than TUMT and TUNA. TUMT versus Rezūm with RR = 0.53 (95% CI: 0.13 to 3.14) (QoE: Low) and TUNA versus Rezūm with RR = 0.38 (95% CI: 0.04 to 3.49) (QoE: Low).ConclusionsModerate to weak evidence suggests that Rezūm is not superior to TUNA and TUMT in all domains studied.

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Section: Resultsmentioning

confidence: 89%

“…TURP, on the other hand, significantly outperformed Rezūm by 3.14 points (95% CI: 0.26 to 6.03); this difference was statistically and clinically significant (IPSS change >MCID of 3 points). 47 The GRADE ratings for these findings can be seen in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

A systematic review and network meta‐analysis comparing Rezūm with transurethral needle ablation and microwave thermotherapy for the management of enlarged prostate

Bhatia,

Porto,

Titus

et al. 2024

BJUI Compass

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“…Data mining has been used to identify predictive factors associated with various urologic conditions, such as urinary tract injury during surgery, reproductive outcomes following varicocele embolization, and treatment response for benign prostatic hyperplasia. 13 , 14 Our data suggest that data mining is an efficient and accurate way of identifying clinical factors related to conditions of sexual dysfunction in large cohorts of men. While basing clinical practice on statistical methodology can be problematic, it is reassuring that our model showed reasonable accuracy in predicting eventual DE as well as confirmed several known factors (eg, depression).…”

Section: Discussionmentioning

confidence: 87%

Diagnoses and medications associated with delayed ejaculation

Mulloy,

Zhang,

Balladelli

et al. 2023

Sexual Medicine

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Background Delayed ejaculation (DE) is a disorder that can cause significant distress for sexually active men. The etiology of DE is largely idiopathic, with even less being known about clinical factors associated with the condition. Aim We sought to use data mining techniques to examine a broad group of health conditions and pharmaceutical treatments to identify factors associated with DE. Methods Using an insurance claims database, we evaluated all men with a diagnosis of DE and matched them to a cohort (1:1) of men with other male sexual disorders of urologic origin (ie, erectile dysfunction [ED] and Peyronie’s disease [PD]). Given the low prevalence of DE, we incorporated the random forest approach for classification of DE vs controls, with a plethora of predictors and cross-validation with the least absolute shrinkage and selection operator (LASSO). We used both a high-performance generalized linear model and a multivariate logistic model. The area under the curve was reported to demonstrate classifier performance, and odds ratios were used to indicate risks of each predictor. We also evaluated for differences in the prevalence of conditions in DE by race/ethnicity. Outcomes Clinical factors (ie, diagnoses and medications) associated with DE were identified. Results In total, 11 602 men with DE were matched to a cohort of men with PD and ED. We focused on the 20 factors with the strongest association with DE across all models. The factors demonstrating positive associations with DE compared to other disorders of male sexual dysfunction (ie, ED and PD) included male infertility, testicular dysfunction, anxiety, disorders of lipid metabolism, alpha adrenergic blocker use, anemia, antidepressant use, and psychoses such as schizophrenia or schizoaffective disorder. In addition, the prevalence of several conditions varied by race/ethnicity. For example, male infertility was present in 5% of Asian men compared to <2% of men of other races. Clinical Implications Several medical conditions and pharmacologic treatments are associated with DE, findings that may provide insight into the etiology of DE and offer treatment options. Strengths and Limitations This study is to our knowledge the first to use using data mining techniques to investigate the association between medical conditions/pharmacologic agents and the development of subsequent DE. The generalizability of our findings is limited given that all men were commercially insured. Conclusion DE is associated with multiple medical conditions, a finding that may help identify the etiology for this disorder.

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“…A summary of the included studies is reported in Table 1. 3,[15][16][17] Fu et al 3 used the cubic hesitant fuzzy sets (CHFS) and the dice measure of CHFSs for the initial diagnosis and evaluation of BPH and compared them with the existing evaluation methods.…”

Section: Applications Of Ai In Benign Prostatic Hyperplasiamentioning

confidence: 99%

“…Fusco et al 17 designed an integrated clinical data mining analysis system to identify factors associated with a clinically meaningful response to placebo or tadalafil 5 mg once daily in patients with LUTS-BPH. The dataset of 1500 patients was randomly split into training and test subsets.…”

Section: Applications Of Ai In Benign Prostatic Hyperplasiamentioning

confidence: 99%

Current Applications of Artificial Intelligence in Benign Prostatic Hyperplasia

Shah¹,

Naik²,

Hameed³

et al. 2022

Turkish Journal of Urology

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Artificial intelligence is used in predicting the clinical outcomes before minimally invasive treatments for benign prostatic hyperplasia, to address the insufficient reliability despite multiple assessment parameters, such as flow rates and symptom scores. Various models of artificial intelligence and its contemporary applications in benign prostatic hyperplasia are reviewed and discussed. A search strategy adapted to identify and review the literature on the application of artificial intelligence with a dedicated search string with the following keywords: "Machine Learning," "Artificial Intelligence," AND "Benign Prostate Enlargement" OR "BPH" OR "Benign Prostatic Hyperplasia" was included and categorized. Review articles, editorial comments, and non-urologic studies were excluded. In the present review, 1600 patients were included from 4 studies that used different classifiers such as fuzzy systems, computer-based vision systems, and clinical data mining to study the applications of artificial intelligence in diagnoses and severity prediction and determine clinical factors responsible for treatment response in benign prostatic hyperplasia. The accuracy to correctly diagnose benign prostatic hyperplasia by Fuzzy systems was 90%, while that of computer-based vision system was 96.3%. Data mining achieved sensitivity and specificity of 70% and 50%, respectively, in correctly predicting the clinical response to medical treatment in benign prostatic hyperplasia. Artificial intelligence is gaining attraction in urology, with the potential to improve diagnostics and patient care. The results of artificial intelligence-based applications in benign prostatic hyperplasia are promising but lack generalizability of results. However, in the future, we will see a shift in the clinical paradigm as artificial intelligence applications will find their place in the guidelines and revolutionize the decision-making process.

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Predictors of Individual Response to Placebo or Tadalafil 5mg among Men with Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: An Integrated Clinical Data Mining Analysis

Cited by 7 publications

References 37 publications

A systematic review and network meta‐analysis comparing Rezūm with transurethral needle ablation and microwave thermotherapy for the management of enlarged prostate

A systematic review and network meta‐analysis comparing Rezūm with transurethral needle ablation and microwave thermotherapy for the management of enlarged prostate

Diagnoses and medications associated with delayed ejaculation

Current Applications of Artificial Intelligence in Benign Prostatic Hyperplasia

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