title: Clinical Use of Expanded Prostate Cancer Index Composite for Clinical Practice to Assess Patient Reported Prostate Cancer Quality of Life Following Robot-Assisted Radical Prostatectomy.
abstract: EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) is a short questionnaire that comprehensively measures patient reported health related quality of life at the point of care. We evaluated the feasibility of using EPIC-CP in the routine clinical care of patients with prostate cancer without research infrastructure. We compared longitudinal patient and practitioner reported prostate cancer outcomes.
  
  
  
  We reviewed health related quality of life outcomes in 482 patients who underwent radical prostatectomy at our institution from 2010 to 2014. EPIC-CP was administered and interpreted in routine clinical practice without research personnel. We compared practitioner documented rates of incontinence pad use and functional erections to patient reported rates using EPIC-CP.
  
  
  
  A total of 708 EPIC-CP questionnaires were completed. Mean urinary incontinence domain scores were significantly higher (worse) than baseline (mean ± SD 0.6 ± 0.2) 3 and 6 months after treatment (mean 3.1 ± 2.3 and 2.2 ± 2.1, respectively, each p <0.05) but they returned to baseline at 12 months (mean 1.6 ± 1.7, p >0.05). Mean sexual domain scores were significantly worse than baseline (mean 2.4 ± 2.8) at all posttreatment time points (each p <0.05). Practitioners significantly overestimated incontinence pad-free rates at 3 months (48% vs 39%) and functional erection rates at 3 months (18% vs 12%), 6 months (38% vs 23%) and 12 months (45% vs 23%, each p <0.05).
  
  
  
  EPIC-CP is feasible to use in the routine clinical care of patients with prostate cancer without requiring a research infrastructure. Using EPIC-CP in clinical practice may help practitioners objectively assess and appropriately manage posttreatment side effects in patients with prostate cancer.
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Wagner
authors.affiliation: Harvard Longwood Program in Urology, Boston, Massachusetts.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Cheng
authors.affiliation: Hospital Israelita Albert Einstein and ABC Medical School, São Paolo, Brazil.
authors.forename: Arie
authors.initials: A
authors.lastname: Carneiro
authors.affiliation: Virginia Beach, Virginia.
authors.forename: Ostap
authors.initials: O
authors.lastname: Dovirak
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Arjun
authors.initials: A
authors.lastname: Khosla
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Kimberly N
authors.initials: KN
authors.lastname: Taylor
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Catrina M
authors.initials: CM
authors.lastname: Crociani
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Kyle C
authors.initials: KC
authors.lastname: McAnally
authors.affiliation: Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Percy
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Dewey
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Sanda
authors.affiliation: Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: pchang@bidmc.harvard.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Chang
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D060787:Neoplasm Grading; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D014481:United States; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology
keywords: outcome assessment (health care); patient-centered care; prostatic neoplasms/therapy; quality of life; questionnaires