title: Knowledge, attitudes and beliefs towards management of men with locally advanced prostate cancer following radical prostatectomy: an Australian survey of urologists.
abstract: OBJECTIVE
  To investigate Australian urologists' knowledge, attitudes and beliefs, and the association of these with treatment preferences relating to guideline-recommended adjuvant radiotherapy for men with adverse pathologic features following radical prostatectomy.
  
  
  METHODS
  A nationwide mailed and web-based survey of Australian urologist members of the Urological Society of Australia and New Zealand (USANZ).
  
  
  RESULTS
  157 surveys were included in the analysis (45% response rate). Just over half of respondents (54%) were aware of national clinical practice guidelines for the management of prostate cancer. Urologists' attitudes and beliefs towards the specific recommendation for post-operative adjuvant radiotherapy for men with locally advanced prostate cancer were mixed. Just over half agreed the recommendation is based on a valid interpretation of the underpinning evidence (54.1%, 95% CI [46%, 62.2%]) but less than one third agreed adjuvant radiotherapy will lead to improved patient outcomes (30.2%, 95% CI [22.8%, 37.6%]). Treatment preferences were varied, demonstrating clinical equipoise. A positive attitude towards the clinical practice recommendation was significantly associated with treatment preference for adjuvant radiotherapy (rho = 0.520, P < 0.0001). There was stronger preference for adjuvant radiotherapy in more recently trained urologists (registrars) while preference for watchful waiting was greater in more experienced urologists (consultants) (b = 0.156, P = 0.034; 95% CI [0.048, 1.24]). Urologists' attitudes towards clinical practice guidelines in general were positive.
  
  
  CONCLUSIONS
  There remains clinical equipoise among Australian urologists in relation to adjuvant radiotherapy for men with adverse pathologic features following radical prostatectomy.
authors.affiliation: Sax Institute, Haymarket, New South Wales, Australia.|School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Brown
authors.affiliation: School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Young
authors.affiliation: Northern Sydney Cancer Centre, Sydney, New South Wales, Australia.|Northern Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Kneebone
authors.affiliation: Westmead Private Hospital, Westmead, New South Wales, Australia.|Westmead Clinical School, University of Sydney, Camperdown, New South Wales, Australia.|NSW Agency for Clinical Innovation, Sydney, New South Wales, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Brooks
authors.affiliation: Sax Institute, Haymarket, New South Wales, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Dominello
authors.affiliation: Sax Institute, Haymarket, New South Wales, Australia.|School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Haines
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D057212:Therapeutic Equipoise; D014572:Urology; D055815:Young Adult
keywords: adjuvant radiation therapy; clinical practice guidelines; prostate cancer; radical prostatectomy; urologist