MP54-02 VARIATION IN CONTENT DISCUSSED BY SPECIALTY IN CONSULTATIONS FOR CLINICALLY LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP54-02 VARIATION IN CONTENT DISCUSSED BY SPECIALTY IN CONSULTATIONS FOR CLINICALLY LOCALIZED PROSTATE CANCER Nadine A. Friedrich, Michael Luu, Rebecca Gale, Dong Shin, Reva Polineni, Alex Shiang, Stephen J. Freedland, Brennan Spiegel, and Timothy J. Daskivich Nadine A. FriedrichNadine A. Friedrich More articles by this author , Michael LuuMichael Luu More articles by this author , Rebecca GaleRebecca Gale More articles by this author , Dong ShinDong Shin More articles by this author , Reva PolineniReva Polineni More articles by this author , Alex ShiangAlex Shiang More articles by this author , Stephen J. FreedlandStephen J. Freedland More articles by this author , Brennan SpiegelBrennan Spiegel More articles by this author , and Timothy J. DaskivichTimothy J. Daskivich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003307.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients often consult with Urology, Radiation Oncology, and Medical Oncology when considering treatment options for prostate cancer. However, it is unknown what content each specialty discusses during consultations. METHODS: We transcribed consultations of men with localized prostate cancer across 3 urologists, 3 radiation oncologists, and 3 medical oncologists. Coders independently coded consultations for narrative content. Reviewers identified 11 content areas: Overview of prostate cancer; medical history; assessment of baseline risk; cancer prognosis; life expectancy/competing risks; discussion of active surveillance, radical prostatectomy, focal therapy, and radiation therapy; physician recommendations; and shared decision making (SDM). We then calculated the number of words devoted to each content area per consult as a proxy for time spent. We then compared incidence rate ratio (IRR) for content-specific word count across specialties using a multivariable Poisson regression. RESULTS: Our analytic sample included 5,569 segments of conversation across 28 Urology, 11 Radiation Oncology, 11 Medical Oncology consultations. In addition to spending more time discussing surgical treatments, Urologists also spent 1.8-fold more time discussing cancer prognosis than both Medical Oncologists and Radiation Oncologists (p<0.03 for both). Urologists also spent 11-fold more time discussing competing risks than Radiation Oncologists (p<0.0001). Medical Oncologists devoted 2.6-fold more time on SDM than Urologists (p<0.0001). Medical Oncologists spent 10-fold more time discussing life expectancy/competing risks than Radiation Oncologists (p<0.0001). In additional to spending more time discussing radiation therapy, Radiation Oncologists spent 1.7-fold more time on SDM than Urologists (p<0.04). CONCLUSIONS: Multidisciplinary specialists focus effort on different areas of content in consultations, beyond the specific treatments they offer. Urologists appear to more thoroughly discuss prognosis than other specialists but spend the least amount of time on SDM. Source of Funding: Dr. Daskivich is supported by career development award CA230155 from the NIH/NCI. Dr. Friedrich was funded by NIH grant T32CA240172-03 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e753 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nadine A. Friedrich More articles by this author Michael Luu More articles by this author Rebecca Gale More articles by this author Dong Shin More articles by this author Reva Polineni More articles by this author Alex Shiang More articles by this author Stephen J. Freedland More articles by this author Brennan Spiegel More articles by this author Timothy J. Daskivich More articles by this author Expand All Advertisement PDF downloadLoading ...