Using PCORI data to drive better decisions for men with localized - - PowerPoint PPT Presentation

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Using PCORI data to drive better decisions for men with localized - - PowerPoint PPT Presentation

Oct 19, 2023 168 likes •363 views

Using PCORI data to drive better decisions for men with localized prostate cancer Christopher Saigal MD, MPH Professor and Vice Chair, UCLA Department of Urology Twitter: csaigal 11/2/2018 #PCORI2018 Project team David Penson , MD MPH,

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Using PCORI data to drive better decisions for men with localized prostate cancer

Christopher Saigal MD, MPH

Professor and Vice Chair, UCLA Department of Urology Twitter: csaigal 11/2/2018

#PCORI2018

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Project team

  • David Penson, MD MPH, Chair, Dept. of Urology, Vanderbilt
  • Ralph Conwill, Patient Advisor
  • Jon Bergman MD, MPH, Assistant Professor of Urology UCLA,

OVMC

  • Moira Inkeles MPH, PhD, Associate Professor UCLA School of

Public Health

  • Merel Nissenberg, Thomas Kirk, California Prostate Cancer

Coalition

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Background and Introduction

  • Localized prostate cancer is emblematic of “preference sensitive”

decision making

  • Issues with overtreatment and suboptimal decision quality
  • Innovations in preference measurement, low cost computing

power, and patient familiarity with online apps present

  • pportunities to improve
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Intervention: novel software decision aid

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Effectiveness of the approach

  • Adoption by MDs 93%
  • Fidelity of program 84%
  • Significant decreases in decisional conflict
  • Patients reported feeling more informed
  • Increased measures of shared decision making
  • Increase in Net Promoter Score
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Comparative Effectiveness Analysis of Surgery and Radiation for localized prostate cancer (CEASAR)

  • PCORI- funded 3 year project to assess CE of prostate cancer

treatments using population based data

  • Reflects modern treatment modalities
  • Racial variation in outcomes: African Americans with worse 1

year urinary continence outcomes

  • Potency rates after surgery: AMC, 86% CEASAR, 43%
  • How to get these data out there for patients?
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Strategies for SDM implementation success

  • Start with patients
  • Find “wins” for physicians
  • Engage health system leadership in the value of SDM
  • Continuous improvement framework
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Measuring success

  • Reach/penetration
  • Adoption
  • Fidelity
  • Maintenance
  • Decision Quality
  • Treatment choice in men with low risk disease
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Patient leadership

  • Design and conception
  • Quarterly reviews of statistical process control charts from each

site with rest of team; suggest new tactics

  • Disseminate findings, availability of the tool
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Challenges/successes?

  • Identify and overcome system specific work flow barriers
  • Have made great progress on data modeling already
  • Engaged and excited implementation sites
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Learn More

  • www.pcori.org
  • info@pcori.org
  • #PCORI2018
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Questions?

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Thank You!

Christopher Saigal MD MPH

Professor and Vice Chair Twitter: csaigal 11/2/18

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Discussion Ralph Conwill

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Roundtable Discussions

PCORI funding opportunities in D&I