PCa therapies among top priorities for effectiveness research

Treatments for prostate cancer are among 100 health topics that should receive priority attention and funding from a new national research effort to identify which health care services are most effective, according to a recently released report.

The report, from the National Academy of Sciences’ Institute of Medicine, also spells out actions and resources needed to ensure that this comparative effectiveness research initiative will be a sustained effort with a continuous process for updating priorities as needed and that the results are put into clinical practice.

Comparative effectiveness research weighs the benefits and harms of various ways to prevent, diagnose, treat, or monitor clinical conditions to determine which work best for particular types of patients and in different settings and circumstances. Among the recommended comparative effectiveness research initiatives pertinent to the practice of urology are:

to compare the effectiveness of management strategies for localized prostate cancer (eg, active surveillance, radical prostatectomy [conventional, robotic, and laparoscopic], and radiotherapy [conformal, brachytherapy, proton-beam, and intensity-modulated radiotherapy]) on survival, recurrence, side effects, quality of life, and costs

to compare the effectiveness of robotic assistance surgery and conventional surgery for common operations, such as prostatectomies

to compare the effectiveness of genetic and biomarker testing and usual care in preventing and treating prostate, breast, colorectal, lung, and ovarian cancers

to compare the effectiveness of minimally invasive abdominal surgery and open surgical procedures on postoperative infections, pain management, and recuperative requirements

to compare the effectiveness of diagnostic imaging performed by non-radiologists and radiologists.

"This report lays the foundation for an ongoing enterprise to provide the evidence that health care providers need to make better decisions and achieve better results," said committee co-chair Sheldon Greenfield, MD, of the University of California, Irvine.

The study was sponsored by the U.S. Department of Health and Human Services.