Symptom Severity and Patients' Values in the Decision to Perform a Transurethral Resection of the Prostate
To develop and validate a method to assess patients' subjective values for outcomes of surgical and nonsurgical management of benign prostatic hypertrophy (BPH), the authors studied 20 patients who had symptoms of BPH. Eight were scheduled for prostatic surgery and 12 were not. They conducted a...
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| Veröffentlicht in: | Medical decision making 1988, Vol.8 (1), p.1-8 |
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| container_title | Medical decision making |
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| creator | Krumins, Peter E. Fihn, Stephan D. Kent, Daniel L. |
| description | To develop and validate a method to assess patients' subjective values for outcomes of surgical and nonsurgical management of benign prostatic hypertrophy (BPH), the authors studied 20 patients who had symptoms of BPH. Eight were scheduled for prostatic surgery and 12 were not. They conducted an interview, including a time-trade-off (TTO) exercise to elicit values for single and combined outcomes and questions about symptoms used to complete a symptom severity score. Expected gain and symptom severity were independent and significant (p |
| doi_str_mv | 10.1177/0272989X8800800101 |
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Eight were scheduled for prostatic surgery and 12 were not. They conducted an interview, including a time-trade-off (TTO) exercise to elicit values for single and combined outcomes and questions about symptoms used to complete a symptom severity score. Expected gain and symptom severity were independent and significant (p <0.001 for both comparisons) determinants of whether surgery was sched uled, while the correlation between these two factors was limited (Spearman = 0.058, p = 0.004). Based on a decision analytic model incorporating TTO values, a high expected gain in quality from surgery was strongly related to whether surgery was scheduled (p = 0.002), and had a higher positive predictive value (0.86) than symptom severity score (0.73). This small study demonstrates the feasibility and validity of using value assessment in this setting and suggests that this approach can be useful to clinicians when counseling patients. Key Words: transurethral resection of the prostate (TURP); benign prostatic hypertrophy (BPH); decision analysis; patient values. 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Eight were scheduled for prostatic surgery and 12 were not. They conducted an interview, including a time-trade-off (TTO) exercise to elicit values for single and combined outcomes and questions about symptoms used to complete a symptom severity score. Expected gain and symptom severity were independent and significant (p <0.001 for both comparisons) determinants of whether surgery was sched uled, while the correlation between these two factors was limited (Spearman = 0.058, p = 0.004). Based on a decision analytic model incorporating TTO values, a high expected gain in quality from surgery was strongly related to whether surgery was scheduled (p = 0.002), and had a higher positive predictive value (0.86) than symptom severity score (0.73). This small study demonstrates the feasibility and validity of using value assessment in this setting and suggests that this approach can be useful to clinicians when counseling patients. Key Words: transurethral resection of the prostate (TURP); benign prostatic hypertrophy (BPH); decision analysis; patient values. (Med Decis Making 8:1-8, 1988)</description><subject>Aged</subject><subject>Decision Trees</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Psychological</subject><subject>Predictive Value of Tests</subject><subject>Prostatectomy - psychology</subject><subject>Prostatic Hyperplasia - psychology</subject><subject>Prostatic Hyperplasia - surgery</subject><subject>Quality of Life</subject><subject>Risk Factors</subject><issn>0272-989X</issn><issn>1552-681X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kF1LwzAUhoMoOqd_QBBypVd1SZss6aX4DQOHX3hX0uTUdbTNTFJh_97UDW8EIXBIzvO-OedF6ISSC0qFmJBUpLnM36UkJB5K6A4aUc7TZCrp-y4aDUAyEAfo0PtlRFgu2T7aTxmTXIgRWj6v21WwLX6GL3B1WGPVGTxXoYYu-HP8ppoePK47HBaAr0HXvrbxYvEcXGVdixV-carzvYOwcKrBT-BBhwGy1Y9o7qwPKsAR2qtU4-F4W8fo9fbm5eo-mT3ePVxdzhKd8iwkpTRcccXKjMvMgNFaG2Yy0ILTsmRTGd9LxVJqYKpyTipJcjYVOSnLXBslsjE62_iunP2Mw4eirb2GplEd2N4XYhCI-NcYpRtQxwm9g6pYubpVbl1QUgwBF38DjqLTrXtftmB-JdtEY3-y6Xv1AcXS9q6Ly_7n-A1wt4VA</recordid><startdate>1988</startdate><enddate>1988</enddate><creator>Krumins, Peter E.</creator><creator>Fihn, Stephan D.</creator><creator>Kent, Daniel L.</creator><general>Sage Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1988</creationdate><title>Symptom Severity and Patients' Values in the Decision to Perform a Transurethral Resection of the Prostate</title><author>Krumins, Peter E. ; Fihn, Stephan D. ; Kent, Daniel L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c253t-b8d5a5a4b3583dedcccd4d3ec751bb468358ba421de6a950f80946790bb9cda73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1988</creationdate><topic>Aged</topic><topic>Decision Trees</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Psychological</topic><topic>Predictive Value of Tests</topic><topic>Prostatectomy - psychology</topic><topic>Prostatic Hyperplasia - psychology</topic><topic>Prostatic Hyperplasia - surgery</topic><topic>Quality of Life</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krumins, Peter E.</creatorcontrib><creatorcontrib>Fihn, Stephan D.</creatorcontrib><creatorcontrib>Kent, Daniel L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical decision making</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krumins, Peter E.</au><au>Fihn, Stephan D.</au><au>Kent, Daniel L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Symptom Severity and Patients' Values in the Decision to Perform a Transurethral Resection of the Prostate</atitle><jtitle>Medical decision making</jtitle><addtitle>Med Decis Making</addtitle><date>1988</date><risdate>1988</risdate><volume>8</volume><issue>1</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>0272-989X</issn><eissn>1552-681X</eissn><abstract>To develop and validate a method to assess patients' subjective values for outcomes of surgical and nonsurgical management of benign prostatic hypertrophy (BPH), the authors studied 20 patients who had symptoms of BPH. Eight were scheduled for prostatic surgery and 12 were not. They conducted an interview, including a time-trade-off (TTO) exercise to elicit values for single and combined outcomes and questions about symptoms used to complete a symptom severity score. Expected gain and symptom severity were independent and significant (p <0.001 for both comparisons) determinants of whether surgery was sched uled, while the correlation between these two factors was limited (Spearman = 0.058, p = 0.004). Based on a decision analytic model incorporating TTO values, a high expected gain in quality from surgery was strongly related to whether surgery was scheduled (p = 0.002), and had a higher positive predictive value (0.86) than symptom severity score (0.73). This small study demonstrates the feasibility and validity of using value assessment in this setting and suggests that this approach can be useful to clinicians when counseling patients. 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| ispartof | Medical decision making, 1988, Vol.8 (1), p.1-8 |
| issn | 0272-989X 1552-681X |
| language | eng |
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| source | Access via SAGE; MEDLINE |
| subjects | Aged Decision Trees Humans Male Middle Aged Models, Psychological Predictive Value of Tests Prostatectomy - psychology Prostatic Hyperplasia - psychology Prostatic Hyperplasia - surgery Quality of Life Risk Factors |
| title | Symptom Severity and Patients' Values in the Decision to Perform a Transurethral Resection of the Prostate |
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