Prostate Cancer Clinical Trial
Official title:
Effects of a New Diagnostic Test on the Care of Prostate Cancer Patients: The ProMark™ Clinical Utility Study
The objectives of this study are to assess clinical practice variation in prostate cancer
diagnosis and treatment among urologists and how ProMark™ affects clinical practice
decision-making. The study uses a randomized controlled study design of urologists.
Urologists will be randomly assigned to a control and intervention arm.
- Pre-intervention/baseline assessment: will be done using prostate cancer CPV® vignettes
and a physician questionnaire to both control and intervention arms.
- Intervention: 2-4 weeks after baseline introduce ProMark™ to the intervention group of
urologists using a protocol to be determined by Metamark and QURE.
- Post-intervention: 6 weeks post-intervention, a second round of prostate cancer CPV®
vignettes will be administered to both control and intervention arms. The ProMark™ test
will be available to "order" for all physicians taking the vignettes.
The Clinical Performance and Value Vignettes (CPV®) used in this study simulate a clinical
encounter for a man presenting with prostate cancer. Each urologist will provide responses to
open-ended questions regarding clinical care they would provide for that patient. These
responses are scored in five domains (taking a medical history, performing a physical
examination, ordering appropriate tests, making a diagnosis and prescribing treatment against
explicit evidence and criteria as determined by the literature and medical associations.
Results are presented as percentage correct. Each case will take approximately 15-20 minutes
to complete. All case responses will be completed online and kept confidential.
The study hypotheses are:
1. Clinical practice, specifically decisions around prostate cancer treatment
post-diagnosis, will vary widely among urologists. This variation in practice will
demonstrate the need a new diagnostic, such as ProMark™, would fulfill.
2. ProMark™ will improve clinical decision making of urologists for prostate cancer
patients with a Gleason Score of 3+3=6 and 3+4=7 by improving the diagnosis and/or
treatment CPV® domain score post-intervention versus baseline comparing intervention and
control groups
The investigators will estimate the effect of ProMark™ on the primary outcomes comparing
treatment and control groups using a difference-in-difference analysis comparing differences
between groups before and after intervention. The investigators will control for potential
confounders, such as age, gender, and other physician and practice characteristics.
Secondary outcome measure include:
1. Difference in overall Clinical Performance and Value Vignettes (CPV®) scores
post-intervention versus baseline comparing intervention and control groups
2. Difference between intervention and control for use of active surveillance.
3. Change in utilization of resources in terms of surgery, radiation (in any form),
chemotherapy (in any of its forms) between intervention and control groups.
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