You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2017MP77-18 WHAT FALSE NEGATIVE RATE OF NON-INVASIVE TESTING ARE ACTIVE SURVEILLANCE PATIENTS AND URO-ONCOLOGISTS WILLING TO ACCEPT IN ORDER TO AVOID PROSTATE BIOPSY? Rashid Sayyid, Dharmendra Dingar, Katherine Fleshner, Taylor Thorburn, Joshua Diamond, Erik Yao, Karen Hersey, Karen Chadwick, Nathan Perlis, Laurence Klotz, Antonio Finelli, Alexandre Zlotta, Robert Hamilton, Girish Kulkarni, and Neil Fleshner Rashid SayyidRashid Sayyid More articles by this author , Dharmendra DingarDharmendra Dingar More articles by this author , Katherine FleshnerKatherine Fleshner More articles by this author , Taylor ThorburnTaylor Thorburn More articles by this author , Joshua DiamondJoshua Diamond More articles by this author , Erik YaoErik Yao More articles by this author , Karen HerseyKaren Hersey More articles by this author , Karen ChadwickKaren Chadwick More articles by this author , Nathan PerlisNathan Perlis More articles by this author , Laurence KlotzLaurence Klotz More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , and Neil FleshnerNeil Fleshner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2126AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Repeat prostate biopsies in active surveillance patients are associated with significant complications. Novel imaging and blood/urine based non-invasive tests are being developed to better predict disease grade and volume progression. We conducted a theoretical study to determine what test performance characteristics and costs would a non-invasive test(s) require in order for patients and their physicians to comfortably avoid biopsy. METHODS Surveys were administered to two populations to determine an acceptable false-negative rate and cost for such test(s). AS patients were recruited at time of visit to the prostate cancer clinic at Princess Margaret Cancer Centre, beginning August 2015 for a period of four months. Responses from urologic oncologists worldwide were obtained in March 2016 by circulating an online survey via the Society of Urologic Oncology. Participants were questioned about their demographics and other characteristics that might influence chosen error rates and cost. Differences between patient and physician choices were tested using the Chi-square test. RESULTS 136 patients and 670 physicians were surveyed, with 130 (96%) and 104 (16%) responses obtained, respectively. 90.6% of patients were comfortable with a non-invasive test(s) in place of biopsy, with 64.8% accepting a false-negative rate of 5% or worse. 25.8% of patients requested a FN rate of 1% or lower. 93.3% of physicians were comfortable with a non-invasive test, with 77.9% accepting a rate of 5% or worse. 15.4% of physicians requested a FN rate of 1% or lower. 75% of patients and 77% of physicians felt that a cost of less than $1,000, per administration, would be reasonable. No significant differences existed between patient and physicians choices for FN rate or costs (p>0.05). CONCLUSIONS Most patients/physicians are comfortable with a non-invasive test(s). Although a 5% error rate seems acceptable to many, a substantial subset feels that 99% or higher negative predictive value is required. Thus, a personalized approach with shared-decision making between patients and physicians is essential to optimize patient care in such situations. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1028-e1029 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Rashid Sayyid More articles by this author Dharmendra Dingar More articles by this author Katherine Fleshner More articles by this author Taylor Thorburn More articles by this author Joshua Diamond More articles by this author Erik Yao More articles by this author Karen Hersey More articles by this author Karen Chadwick More articles by this author Nathan Perlis More articles by this author Laurence Klotz More articles by this author Antonio Finelli More articles by this author Alexandre Zlotta More articles by this author Robert Hamilton More articles by this author Girish Kulkarni More articles by this author Neil Fleshner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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