Patient Race and Outcome Preferences as Predictors of Urologists' Treatment Recommendations and Referral Patterns in Early-Stage Prostate Cancer
Abstract
This is a nationally-representative mailed survey of 2000 urologists to (1) collect information about physician sociodemographics and clinical practice characteristics and (2) relate this information to treatment recommendations in three clinical vignettes. The vignettes will allow for assessments of the independent effects of patient race, age, socioeconomic status, and tumor characteristics on urologist treatment recommendations. A major component of this work is disparities research, seeking to understand whether physician factors might influence previously well-described black-white differences in patterns of care for localized prostate cancer. To date, we have completed all survey mailings, collected responses, entered these into an Access database, and have initiated preliminary analyses. The response rate was 66.1%, which is excellent for a survey of this type and was made possible by closely following the Dillman method. Manuscripts in preparation will highlight the following findings (and others, to be determined): the percentage of minority urologists is extremely small (approximately 4%), grossly out of proportion to the patient population they treat. The vast majority of urologists perform fewer than 2.5 radical prostatectomies per month, raising significant concerns about surgical skill and outcomes. In a hypothetical vignette, patient socioeconomic status, not race, influenced treatment recommendations for localized prostate cancer. A majority of urologists rate their own surgical outcomes as better than the national average, and a significant proportion provide erroneous information about comparative outcomes for major treatment modalities (favoring prostatectomy in the process). Additional analyses are underway and we are planning a follow-up survey and telephone interviews of a selected group within the original sample.
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 01, 2005
- Accession Number
- ADA451338
Entities
People
- Thomas Denberg
Organizations
- University of Colorado Health