{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:23:33Z","timestamp":1790731413385,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,5,22]],"date-time":"2014-05-22T00:00:00Z","timestamp":1400716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"US Army Medical Research and Material Command","award":["DAMD17-02-1-0090"],"award-info":[{"award-number":["DAMD17-02-1-0090"]}]},{"name":"US Army Medical Research and Material Command","award":["W81XWH-05-1-0093"],"award-info":[{"award-number":["W81XWH-05-1-0093"]}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2014,10]]},"abstract":"\n Objective<\/jats:title>\n \n \n \n \n To describe a successful quality improvement process that arose from unexpected differences in control groups' short\u2010term patient\u2010reported outcomes (\n PROs<\/jats:styled-content>\n ) within a comparative effectiveness study of a prostate brachytherapy technique intended to reduce urinary morbidity.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n \n \n Patients planning prostate brachytherapy at one of three institutions were enrolled in a prospective cohort study.<\/jats:p>\n <\/jats:list-item>\n \n Patients were surveyed using a validated instrument to assess treatment\u2010related toxicity before treatment and at pre\u2010specified intervals.<\/jats:p>\n <\/jats:list-item>\n \n \n Unexpectedly, urinary\n PROs<\/jats:styled-content>\n were worse in one of two standard brachytherapy technique control populations (\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 1<\/jats:sub>\n and\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 2<\/jats:sub>\n ). Therefore, we collaboratively reviewed treatment procedures, identified a discrepancy in technique, made a corrective modification, and evaluated the change.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n The patient groups were demographically and clinically similar.<\/jats:p>\n <\/jats:list-item>\n \n \n In the first preliminary analysis,\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 2<\/jats:sub>\n patients reported significantly more short\u2010term post\u2010treatment urinary symptoms than\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 1<\/jats:sub>\n patients.\n <\/jats:p>\n <\/jats:list-item>\n \n \n The study's treating physicians reviewed the\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 1<\/jats:sub>\n and\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 2<\/jats:sub>\n treatment protocols and found that they differed in whether they used an indwelling urinary catheter.\n <\/jats:p>\n <\/jats:list-item>\n \n \n After adopting the\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 1<\/jats:sub>\n approach, short\u2010term urinary morbidity in\n US<\/jats:styled-content>\n \u2010\n BT<\/jats:styled-content>\n 2<\/jats:sub>\n patients decreased significantly. Brachytherapy procedures were otherwise unchanged.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n \n \n Many procedures in cancer treatments are not evaluated, resulting in practice variation and suboptimal outcomes. Patients, the primary medical consumers, provide little direct input in evaluations of their care.<\/jats:p>\n <\/jats:list-item>\n \n \n We used\n PROs<\/jats:styled-content>\n , a sensitive and valid measure of treatment\u2010related toxicity, for quality assessment and quality improvement (\n QA<\/jats:styled-content>\n \/\n QI<\/jats:styled-content>\n ) of prostate brachytherapy. This serendipitous patient\u2010centred\n QA<\/jats:styled-content>\n \/\n QI<\/jats:styled-content>\n process may be a useful model for empirically evaluating complex cancer treatment procedures and for screening for substandard care.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12464","type":"journal-article","created":{"date-parts":[[2013,10,11]],"date-time":"2013-10-11T18:08:18Z","timestamp":1381514898000},"page":"511-516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Using patient\u2010reported outcomes to assess and improve prostate cancer brachytherapy"],"prefix":"10.1111","volume":"114","author":[{"given":"James A.","family":"Talcott","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Cancer Center Boston MA USA"},{"name":"Continuum Cancer Centers of New York New York NY USA"},{"name":"Albert Einstein School of Medicine New York 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