@Article{info:doi/10.2196/57414,
author="Lin, Shuangquan
and Duan, Lingxing
and Xu, Xiangda
and Cao, Haichao
and Lu, Xiongbing
and Wen, Xi
and Wei, Shanzun",
title="Analyzing Online Search Trends for Kidney, Prostate, and Bladder Cancers in China: Infodemiology Study Using Baidu Search Data (2011-2023)",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="14",
volume="11",
pages="e57414",
keywords="bladder cancer",
keywords="kidney cancer",
keywords="prostate cancer",
keywords="Baidu Index",
keywords="infodemiology",
keywords="public interest",
keywords="patients' concern",
abstract="Background: Cancers of the bladder, kidney, and prostate are the 3 major genitourinary cancers that significantly contribute to the global burden of disease (GBD) and continue to show increasing rates of morbidity and mortality worldwide. In mainland China, understanding the cancer burden on patients and their families is crucial; however, public awareness and concerns about these cancers, particularly from the patient's perspective, remain predominantly focused on financial costs. A more comprehensive exploration of their needs and concerns has yet to be fully addressed. Objective: This study aims to analyze trends in online searches and user information--seeking behaviors related to bladder, kidney, and prostate cancers---encompassing descriptive terms (eg, ``bladder cancer,'' ``kidney cancer,'' ``prostate cancer'') as well as related synonyms and variations---on both national and regional scales. This study leverages data from mainland China's leading search engine to explore the implications of these search patterns for addressing user needs and improving health management. Methods: The study analyzed Baidu Index search trends for bladder, kidney, and prostate cancers (from January 2011 to August 2023) at national and provincial levels. Search volume data were analyzed using the joinpoint regression model to calculate annual percentage changes (APCs) and average APCs (AAPCs), identifying shifts in public interest. User demand was assessed by categorizing the top 10 related terms weekly into 13 predefined topics, including diagnosis, treatment, and traditional Chinese medicine. Data visualization and statistical analyses were performed using Prism 9. Results revealed keyword trends, demographic distributions, and public information needs, offering insights into health communication and management strategies based on online information-seeking behavior. Results: Three cancer topics were analyzed using 39 search keywords, yielding a total Baidu Search Index (BSI) of 43,643,453. From 2011 to 2015, the overall APC was 15.2\% (P<.05), followed by --2.8\% from 2015 to 2021, and 8.9\% from 2021 to 2023, with an AAPC of 4.9\%. Bladder, kidney, and prostate cancers exhibited AAPCs of 2.8\%, 3.9\%, and 6.8\%, respectively (P<.05). The age distribution of individuals searching for these cancer topics varied across the topics. Geographically, searches for cancer were predominantly conducted by people from East China, who accounted for approximately 30\% of each cancer search query. Regarding user demand, the total BSI for relevant user demand terms from August 2022 to August 2023 was 676,526,998 out of 2,570,697,380 (15.74\%), representing only a limited total cancer-related search volume. Conclusions: Online searches and inquiries related to genitourinary cancers are on the rise. The depth of users' information demands appears to be influenced by regional economic levels. Cancer treatment decision-making may often involve a family-centered approach. Insights from internet search data can help medical professionals better understand public interests and concerns, enabling them to provide more targeted and reliable health care services. ",
doi="10.2196/57414",
url="https://cancer.jmir.org/2025/1/e57414"
}


@Article{info:doi/10.2196/69663,
author="Yanagisawa, Yuki
and Watabe, Satoshi
and Yokoyama, Sakura
and Sayama, Kyoko
and Kizaki, Hayato
and Tsuchiya, Masami
and Imai, Shungo
and Someya, Mitsuhiro
and Taniguchi, Ryoo
and Yada, Shuntaro
and Aramaki, Eiji
and Hori, Satoko",
title="Identifying Adverse Events in Outpatients With Prostate Cancer Using Pharmaceutical Care Records in Community Pharmacies: Application of Named Entity Recognition",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="11",
volume="11",
pages="e69663",
keywords="natural language processing",
keywords="pharmaceutical care records",
keywords="androgen receptor axis-targeting agents",
keywords="adverse events",
keywords="outpatient care",
abstract="Background: Androgen receptor axis-targeting reagents (ARATs) have become key drugs for patients with castration-resistant prostate cancer (CRPC). ARATs are taken long term in outpatient settings, and effective adverse event (AE) monitoring can help prolong treatment duration for patients with CRPC. Despite the importance of monitoring, few studies have identified which AEs can be captured and assessed in community pharmacies, where pharmacists in Japan dispense medications, provide counseling, and monitor potential AEs for outpatients prescribed ARATs. Therefore, we anticipated that a named entity recognition (NER) system might be used to extract AEs recorded in pharmaceutical care records generated by community pharmacists. Objective: This study aimed to evaluate whether an NER system can effectively and systematically identify AEs in outpatients undergoing ARAT therapy by reviewing pharmaceutical care records generated by community pharmacists, focusing on assessment notes, which often contain detailed records of AEs. Additionally, the study sought to determine whether outpatient pharmacotherapy monitoring can be enhanced by using NER to systematically collect AEs from pharmaceutical care records. Methods: We used an NER system based on the widely used Japanese medical term extraction system MedNER-CR-JA, which uses Bidirectional Encoder Representations from Transformers (BERT). To evaluate its performance for pharmaceutical care records by community pharmacists, the NER system was first applied to 1008 assessment notes in records related to anticancer drug prescriptions. Three pharmaceutically proficient researchers compared the results with the annotated notes assigned symptom tags according to annotation guidelines and evaluated the performance of the NER system on the assessment notes in the pharmaceutical care records. The system was then applied to 2193 assessment notes for patients prescribed ARATs. Results: The F1-score for exact matches of all symptom tags between the NER system and annotators was 0.72, confirming the NER system has sufficient performance for application to pharmaceutical care records. The NER system automatically assigned 1900 symptom tags for the 2193 assessment notes from patients prescribed ARATs; 623 tags (32.8\%) were positive symptom tags (symptoms present), while 1067 tags (56.2\%) were negative symptom tags (symptoms absent). Positive symptom tags included ARAT-related AEs such as ``pain,'' ``skin disorders,'' ``fatigue,'' and ``gastrointestinal symptoms.'' Many other symptoms were classified as serious AEs. Furthermore, differences in symptom tag profiles reflecting pharmacists' AE monitoring were observed between androgen synthesis inhibition and androgen receptor signaling inhibition. Conclusions: The NER system successfully extracted AEs from pharmaceutical care records of patients prescribed ARATs, demonstrating its potential to systematically track the presence and absence of AEs in outpatients. Based on the analysis of a large volume of pharmaceutical medical records using the NER system, community pharmacists not only detect potential AEs but also actively monitor the absence of severe AEs, offering valuable insights for the continuous improvement of patient safety management. ",
doi="10.2196/69663",
url="https://cancer.jmir.org/2025/1/e69663"
}


@Article{info:doi/10.2196/53539,
author="Crafoord, Marie-Ther{\'e}se
and Ekstrand, Joakim
and Sundberg, Kay
and Nilsson, I. Marie
and Fjell, Maria
and Langius-Ekl{\"o}f, Ann",
title="Mobile Electronic Patient-Reported Outcomes and Interactive Support During Breast and Prostate Cancer Treatment: Health Economic Evaluation From Two Randomized Controlled Trials",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="11",
volume="11",
pages="e53539",
keywords="cost-effectiveness",
keywords="ePRO",
keywords="mHealth",
keywords="disease monitoring",
keywords="cancer",
keywords="RCT",
keywords="randomized controlled trial",
keywords="controlled trials",
keywords="digital intervention",
keywords="patient-reported outcomes",
keywords="management",
keywords="payers' perspective",
keywords="health care costs",
keywords="apps",
keywords="prostate cancer",
keywords="breast cancer",
abstract="Background: Digital interventions for supportive care during cancer treatment incorporating electronic patient-reported outcomes (ePROs) can enhance early detection of symptoms and facilitate timely symptom management. However, economic evaluations are needed. Objective: This study aims to conduct a cost-utility analysis of an app for ePRO and interactive support from the perspective of the payer (Region Stockholm Health Care Organization) and to explore its impact on patient health care utilization and costs. Methods: Two open-label randomized controlled trials (RCTs) were conducted, including patients undergoing neoadjuvant chemotherapy for breast cancer (B-RCT; N=149) and radiotherapy for prostate cancer (P-RCT; N=150), recruited from oncology clinics at 2 university hospitals in Stockholm, Sweden. EORTC QLQ-C30 scores were mapped to EQ-5D-3L to calculate quality-adjusted life years (QALYs). Intervention and implementation costs and health care costs, obtained from an administrative database, were used to calculate incremental cost-effectiveness ratios (ICERs) in 3 ways: including all health care costs (ICERa), excluding nonacute health care costs (ICERb), and excluding health care costs altogether (ICERc). Nonparametric bootstrapping was used to explore ICER uncertainty. Health care costs were analyzed by classifying them as disease-related or acute. Results: In both RCT intervention groups, fewer QALYs were lost compared with the control group (P<.001). In the B-RCT, the mean intervention cost was {\texteuro}92 (SD {\texteuro}2; {\texteuro}1=US \$1.03). The mean cost for the intervention and all health care was {\texteuro}36,882 (SD {\texteuro}1032) in the intervention group and {\texteuro}35,427 (SD {\texteuro}959) in the control group (P<.001), with an ICERa of {\texteuro}202,368 (95\% CI {\texteuro}152,008-{\texteuro}252,728). The mean cost for the intervention and acute health care was {\texteuro}3585 (SD {\texteuro}480) in the intervention group and {\texteuro}3235 (SD {\texteuro}494) in the control group (P<.001). ICERb was {\texteuro}49,903 (95\% CI {\texteuro}37,049-{\texteuro}62,758) and ICERc was {\texteuro}13,213 (95\% CI {\texteuro}11,145-{\texteuro}15,281); 22 out of 74 (30\%) intervention group patients and 24 out of 75 (32\%) of the control group patients required acute inpatient care for fever. In the P-RCT, the mean intervention cost was {\texteuro}43 (SD {\texteuro}0.2). The mean cost for the intervention and all health care was {\texteuro}3419 (SD {\texteuro}739) in the intervention group and {\texteuro}3537 (SD {\texteuro}689) in the control group (P<.001), with an ICERa of --{\texteuro}1,092,136 (95\% CI --{\texteuro}3,274,774 to {\texteuro}1,090,502). The mean cost for the intervention and acute health care was {\texteuro}1219 (SD {\texteuro}593) in the intervention group and {\texteuro}802 (SD {\texteuro}281) in the control group (P<.001). ICERb was {\texteuro}745,987 (95\% CI --{\texteuro}247,317 to {\texteuro}1,739,292) and ICERc was {\texteuro}13,118 (95\% CI --68,468 to {\texteuro}94,704). As many as 10 out of the 75 (13\%) intervention group patients had acute inpatient care, with the most common symptom being dyspnea, while 9 out of the 75 (12\%) control group patients had acute inpatient care, with the most common symptom being urinary tract infection. Conclusions: ePRO and interactive support via an app generated a small improvement in QALYs at a low intervention cost and may be cost-effective, depending on the costs considered. Considerable variability in patient health care costs introduced uncertainty around the estimates, preventing a robust determination of cost-effectiveness. Larger studies examining cost-effectiveness from a societal perspective are needed. The study provides valuable insights into acute health care utilization during cancer treatment. Trial Registration: ClinicalTrials.gov NCT02479607; https://clinicaltrials.gov/ct2/show/NCT02479607, ClinicalTrials.gov NCT02477137; https://clinicaltrials.gov/ct2/show/NCT02477137 International Registered Report Identifier (IRRID): RR2-10.1186/s12885-017-3450-y ",
doi="10.2196/53539",
url="https://cancer.jmir.org/2025/1/e53539"
}


@Article{info:doi/10.2196/64747,
author="Kennedy, Fiona
and Smith, Susan
and Beeken, J. Rebecca
and Buck, Caroline
and Williams, Sarah
and Martin, Charlene
and Lally, Phillippa
and Fisher, Abi",
title="An App-Based Intervention With Behavioral Support to Promote Brisk Walking in People Diagnosed With Breast, Prostate, or Colorectal Cancer (APPROACH): Process Evaluation Study",
journal="JMIR Cancer",
year="2025",
month="Feb",
day="10",
volume="11",
pages="e64747",
keywords="cancer",
keywords="physical activity",
keywords="process evaluation",
keywords="randomized controlled trial",
keywords="intervention",
keywords="app",
keywords="habit",
abstract="Background: The APPROACH pilot study explored the feasibility and acceptability of an app (NHS Active 10) with brief, habit-based, behavioral support calls and print materials intended to increase brisk walking in people diagnosed with cancer. Objective: Following UK Medical Research Council guidelines, this study assessed the implementation of the intervention, examined the mechanisms of impact, and identified contextual factors influencing engagement. Methods: Adults (aged ?18 y) with breast, prostate, or colorectal cancer who reported not meeting the UK guidelines for moderate-to-vigorous physical activity (?150 min/wk) were recruited from a single hospital site in Yorkshire, United Kingdom. They were randomly assigned to the intervention or control (usual care) arm and assessed via quantitative surveys at baseline (time point 0 [T0]) and 3-month follow-up (time point 1 [T1]) and qualitative exit interviews (36/44, 82\%) at T1. The process evaluation included intervention participants only (n=44). Implementation was assessed using data from the T1 questionnaire exploring the use of the intervention components. The perceived usefulness of the app, leaflet, and behavioral support call was rated from 0 to 5. Behavioral support calls were recorded, and the fidelity of delivery of 25 planned behavior change techniques was rated from 0 to 5 using an adapted Dreyfus scale. Mechanisms of impact were identified by examining T0 and T1 scores on the Self-Reported Behavioural Automaticity Index and feedback on the leaflet, app, call, and planner in the T1 questionnaire and qualitative interviews. Contextual factors influencing engagement were identified through qualitative interviews. Results: The implementation of the intervention was successful: 98\% (43/44) of the participants received a behavioral support call, 78\% (32/41) reported reading the leaflet, 95\% (39/41) reported downloading the app, and 83\% (34/41) reported using the planners. The mean perceived usefulness of the app was 4.3 (SD 0.8) in participants still using the app at T1 (n=33). Participants rated the leaflet (mean 3.9, SD 0.6) and the behavioral support call (mean 4.1, SD 1) as useful. The intended behavior change techniques in the behavioral support calls were proficiently delivered (overall mean 4.2, SD 1.2). Mechanisms of impact included habit formation, behavioral monitoring, and support and reassurance from the intervention facilitator. Contextual factors impacting engagement included barriers, such as the impact of cancer and its treatment, and facilitators, such as social support. Conclusions: The APPROACH intervention was successfully implemented and shows promise for increasing brisk walking, potentially through promoting habit formation and enabling self-monitoring. Contextual factors will be important to consider when interpreting outcomes in the larger APPROACH randomized controlled trial. International Registered Report Identifier (IRRID): RR2-10.1186/s40814-022-01028-w ",
doi="10.2196/64747",
url="https://cancer.jmir.org/2025/1/e64747"
}


@Article{info:doi/10.2196/65148,
author="Scruton, Sarah
and Wong, Geoff
and Babinski, Stephanie
and Squires, R. Lauren
and Berlin, Alejandro
and Easley, Julie
and McGee, Sharon
and Noel, Ken
and Rodin, Danielle
and Sussman, Jonathan
and Urquhart, Robin
and Bender, L. Jacqueline",
title="Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="3",
volume="27",
pages="e65148",
keywords="cancer",
keywords="follow-up",
keywords="virtual",
keywords="outcomes",
keywords="realist evaluation",
keywords="survivorship",
abstract="Background: Virtual follow-up (VFU) has the potential to enhance cancer survivorship care. However, a greater understanding is needed of how VFU can be optimized. Objective: This study aims to examine how, for whom, and in what contexts VFU works for cancer survivorship care. Methods: We conducted a realist evaluation of VFU among patients with breast cancer and prostate cancer at an urban cancer center during the COVID-19 pandemic. Realist evaluations examine how underlying causal processes of an intervention (mechanisms) in specific circumstances (contexts) interact to produce results (outcomes). Semistructured interviews were conducted with a purposive sample of patients ?5 years after diagnosis. Interviews were audio-recorded and analyzed using a realist logic of analysis. Results: Participants (N=24; n=12, 50\% with breast cancer and n=12, 50\% with prostate cancer) had an average age of 59.6 (SD 10.7) years. Most participants (20/24, 83\%) were satisfied with VFU and wanted VFU options to continue after the COVID-19 pandemic. However, VFU impacted patient perceptions of the quality of their care, particularly in terms of its effectiveness and patient centeredness. Whether VFU worked well for patients depended on patient factors (eg, needs, psychosocial well-being, and technological competence), care provider factors (eg, socioemotional behaviors and technological competence), and virtual care system factors (eg, modality, functionality, usability, virtual process of care, and communication workflows). Key mechanisms that interacted with contexts to produce positive outcomes (eg, satisfaction) were visual cues, effective and empathetic communication, and a trusting relationship with their provider. Conclusions: Patients value VFU; however, VFU is not working as well as it could for patients. To optimize VFU, it is critical to consider contexts and mechanisms that impact patient perceptions of the patient centeredness and effectiveness of their care. Offering patients the choice of in-person, telephone, or video visits when possible, coupled with streamlined access to in-person care when required, is important. Prioritizing and addressing patient needs; enhancing physician virtual socioemotional behaviors and technology competency; and enhancing VFU functionality, usability, and processes of care and communication workflows will improve patient perceptions of the patient centeredness and effectiveness of virtual care. ",
doi="10.2196/65148",
url="https://www.jmir.org/2025/1/e65148"
}


@Article{info:doi/10.2196/48225,
author="Helissey, Carole
and Cavallero, Sophie
and Guitard, Nathalie
and Thery, H{\'e}l{\`e}ne
and Parnot, Charles
and Schernberg, Antoine
and Aissa, Imen
and Raffin, Florent
and Le Coz, Christine
and Mondot, Stanislas
and Christopoulos, Christos
and Malek, Karim
and Malaurie, Emmanuelle
and Blanchard, Pierre
and Chargari, Cyrus
and Francois, Sabine",
title="Correlation Between Electronic Patient-Reported Outcomes and Biological Markers of Key Parameters in Acute Radiation Cystitis Among Patients With Prostate Cancer (RABBIO): Prospective Observational Study",
journal="JMIR Cancer",
year="2024",
month="Dec",
day="12",
volume="10",
pages="e48225",
keywords="prostate cancer",
keywords="acute radiation cystitis",
keywords="e-PRO",
keywords="quality of life",
keywords="biomarkers",
keywords="electronic patient-reported outcome",
abstract="Background: Despite advances in radiation techniques, radiation cystitis (RC) remains a significant cause of morbidity from pelvic radiotherapy, which may affect patients' quality of life (QoL). The pathophysiology of RC is not well understood, which limits the development of effective treatments. Objective: The Radiotoxicity Bladder Biomarkers study aims to investigate the correlation between blood and urinary biomarkers and the intensity of acute RC symptoms and QoL in patients undergoing localized prostate cancer radiotherapy. Methods: This study included patients with low- or intermediate-risk localized prostate cancer who were eligible for localized radiotherapy. Blood and urinary biomarkers were analyzed before radiotherapy was initiated and at weeks 4 and 12 of radiation therapy. Patients completed questionnaires related to RC symptoms and QoL (International Prostate Symptom Score and Functional Assessment of Cancer Therapy-Prostate [FACT-P]) using a digital remote monitoring platform. The information was processed by means of an algorithm, which classified patients according to the severity of symptoms and adverse events reported. Levels of blood and urinary biomarkers were tested with the severity of acute RC symptoms and patient-reported QoL. Results: A total of 401 adverse events questionnaires were collected over the duration of this study from 20 patients. The most frequently reported adverse events at week 4 were pollakiuria, constipation, and diarrhea. In comparison with baseline, the mean FACT-P score decreased at week 4. A significant increase in the proportion of M2 phenotype cells (CD206+, CD163+, CD204+) at W12 compared to W0 was observed. An increase in serum and urine levels of macrophage colony-stimulating factor (M-CSF), hepatocyte growth factor, and macrophagic inflammatory protein was observed at week 12 compared to baseline levels. Baseline serum and urine M-CSF concentrations showed a significant negative correlation with FACT-P scores at weeks 4 and 12 (r=?0.65, P=.04, and r=?0.76, P=.02, respectively). Conclusions: The Radiotoxicity Bladder Biomarkers study is the first to explore the overexpression of inflammatory proteins in blood and urine of patients with symptoms of acute RC. These preliminary findings suggest that serum and urine levels of hepatocyte growth factor, M-CSF, and macrophagic inflammatory protein, as well as macrophage polarization, are mobilized after prostate radiotherapy. The elevated M-CSF levels in serum and urine at baseline were associated with the deterioration of QoL during radiotherapy. The results of this study may help to develop mitigation strategies to limit radiation damage to the bladder. Trial Registration: ClinicalTrials.gov NCT05246774; https://clinicaltrials.gov/study/NCT05246774 ",
doi="10.2196/48225",
url="https://cancer.jmir.org/2024/1/e48225"
}


@Article{info:doi/10.2196/51877,
author="Ma, Chunxuan
and Adler, H. Rachel
and Neidre, B. Daria
and Chen, C. Ronald
and Northouse, L. Laurel
and Rini, Christine
and Tan, Xianming
and Song, Lixin",
title="Challenges and Approaches to Recruitment for and Retention in a Dyad-Focused eHealth Intervention During COVID-19: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="3",
volume="26",
pages="e51877",
keywords="randomized controlled trials",
keywords="RCT",
keywords="prostate cancer",
keywords="accrual",
keywords="retention",
keywords="COVID-19 pandemic",
keywords="family-based research",
abstract="Background: Family-based randomized controlled trials (RCTs) encounter recruitment and retention challenges. Cancer-focused RCTs typically recruit convenience samples from local cancer centers and hospitals. Objective: This study aimed to examine the recruitment and retention of a population-based, patient-partner dyad cohort in an RCT testing a dyadic eHealth intervention to improve the quality of life in patients with prostate cancer and their partners. Methods: In this 2-arm, parallel-group RCT, men who recently completed treatment for localized prostate cancer statewide were recruited through North Carolina Central Cancer Registry rapid case ascertainment between April 2018 and April 2021, coinciding with the COVID-19 pandemic. Patient-partner dyads underwent baseline assessments and were randomly assigned to either the intervention or control groups. Follow-up surveys were conducted at 4, 8, and 12 months after baseline. Descriptive and logistic regression analyses were used to achieve the study's aims. Results: Of the 3078 patients referred from rapid case ascertainment, 2899 were screened. A total of 357 partners were approached after obtaining the eligible patients' permission, 280 dyads completed baseline assessments and were randomized (dyad enrollment rate: 85.11\%, 95\% CI 81.3\%-88.9\%), and 221 dyads completed the 12-month follow-up (retention rate: 78.93\%, 95\% CI 74.2\%-83.7\%). Regarding the factors associated with retention, compared with White participants, people self-reporting as ``other races'' (including American Indian, Asian, and multiracial) were more likely to drop out of the study (odds ratio 2.78, 95\% CI 1.10-7.04), and older participants were less likely to withdraw (odds ratio 0.96, 95\% CI 0.92-0.99). Conclusions: Despite the negative impact of the pandemic, we successfully recruited enough patient-partner dyads to test our RCT hypotheses. Our recruitment and retention rates were equivalent to or higher than those in most dyadic intervention studies. A well-functioning research team and specific strategies (eg, eHealth intervention, internet phone, and online surveys) facilitated the recruitment and retention of patients with prostate cancer and their partners during the unprecedented pandemic. Trial Registration: ClinicalTrials.gov NCT03489057; https://clinicaltrials.gov/study/NCT03489057 International Registered Report Identifier (IRRID): RR2-https://doi.org/10.1186/s13063-021-05948-5 ",
doi="10.2196/51877",
url="https://www.jmir.org/2024/1/e51877",
url="http://www.ncbi.nlm.nih.gov/pubmed/39625741"
}


@Article{info:doi/10.2196/57415,
author="Malandrone, Francesca
and Urru, Sara
and Berchialla, Paola
and Rossini, Gilbert Pierre
and Oliva, Francesco
and Bianchi, Silvia
and Ottaviano, Manuel
and Gonzalez-Martinez, Sergio
and Carli, Vladimir
and Valenza, Gaetano
and Scilingo, Pasquale Enzo
and Carletto, Sara
and Ostacoli, Luca",
title="Exploring the Effects of Variety and Amount of Mindfulness Practices on Depression, Anxiety, and Stress Symptoms: Longitudinal Study on a Mental Health--Focused eHealth System for Patients With Breast or Prostate Cancer",
journal="JMIR Ment Health",
year="2024",
month="Nov",
day="21",
volume="11",
pages="e57415",
keywords="depression",
keywords="anxiety",
keywords="stress",
keywords="internet-based",
keywords="mental health",
keywords="mindfulness",
keywords="breast cancer",
keywords="prostate cancer",
keywords="cancer-related mental distress",
keywords="emotional distress",
keywords="psychological distress",
keywords="mindfulness-based interventions",
keywords="MBI",
keywords="e-MBI",
keywords="dispositional mindfulness",
keywords="self-compassion",
keywords="mental wellbeing",
keywords="mobile phone",
abstract="Background: Patients with cancer often face depression and anxiety, and mindfulness-based interventions, including internet-based versions, can effectively reduce these symptoms and improve their quality of life. This study aims to investigate the impact of internet-based mindfulness-based interventions (e-MBIs) on anxiety, depression, and stress symptoms in patients with prostate or breast cancer. Objective: The primary aims are to assess the association between the amount and variety of e-MBI practices and symptom reduction. Second, this study aims to examine how baseline information such as sociodemographic characteristics, dispositional mindfulness (DM), and dispositional self-compassion (DSC) correlate with both app usage and symptom reduction. Methods: Participants included 107 patients with cancer (68 women with breast cancer and 38 men with prostate cancer) enrolled in a hospital setting. They were assigned to the intervention group of the NEVERMIND project, using the e-BMI module via the NEVERMIND app. A longitudinal design involved Pearson correlation analysis to determine the relationship between the amount and duration of e-MBI practices. Linear regression analysis was conducted to gauge the dose-response effect, evaluating the impact of DM and DSC on depression, anxiety, and stress. Negative binomial regression was conudcted to study sociodemographic factors' influence on the amount of practice in e-MBIs. Results: The participants with more diverse and sustained mindfulness practices experienced significant reductions in depression, anxiety, and stress. A high correlation (0.94) between e-MBI practices and symptom reduction was also highlighted. Male, married, and highly educated patients were more likely to engage in mindfulness. Even if DM and DSC did not impact the amount or variety of practices correlated, they were correlated with symptom reduction, showing that higher levels were associated with significant reductions in depression, anxiety, and stress. Conclusions: While more e-MBI practice is linked to reduced anxiety, depression, and stress, this study emphasizes the crucial role of variety of practice over amount. DM and DSC are key in shaping intervention effectiveness and may act as protectors against psychological distress. Using app log data, our research provides a unique perspective on e-MBI impact, contributing to cancer care understanding and guiding future studies. ",
doi="10.2196/57415",
url="https://mental.jmir.org/2024/1/e57415"
}


@Article{info:doi/10.2196/59480,
author="Gopukumar, Deepika
and Menon, Nirup
and Schoen, W. Martin",
title="Medication Prescription Policy for US Veterans With Metastatic Castration-Resistant Prostate Cancer: Causal Machine Learning Approach",
journal="JMIR Med Inform",
year="2024",
month="Nov",
day="19",
volume="12",
pages="e59480",
keywords="prostate cancer",
keywords="metastatic castration resistant prostate cancer",
keywords="causal survival forest",
keywords="machine learning",
keywords="heterogeneity",
keywords="prescription policy tree",
keywords="oncology",
keywords="pharmacology",
abstract="Background: Prostate cancer is the second leading cause of death among American men. If detected and treated at an early stage, prostate cancer is often curable. However, an advanced stage such as metastatic castration-resistant prostate cancer (mCRPC) has a high risk of mortality. Multiple treatment options exist, the most common included docetaxel, abiraterone, and enzalutamide. Docetaxel is a cytotoxic chemotherapy, whereas abiraterone and enzalutamide are androgen receptor pathway inhibitors (ARPI). ARPIs are preferred over docetaxel due to lower toxicity. No study has used machine learning with patients' demographics, test results, and comorbidities to identify heterogeneous treatment rules that might improve the survival duration of patients with mCRPC. Objective: This study aimed to measure patient-level heterogeneity in the association of medication prescribed with overall survival duration (in the form of follow-up days) and arrive at a set of medication prescription rules using patient demographics, test results, and comorbidities. Methods: We excluded patients with mCRPC who were on docetaxel, cabaxitaxel, mitoxantrone, and sipuleucel-T either before or after the prescription of an ARPI. We included only the African American and white populations. In total, 2886 identified veterans treated for mCRPC who were prescribed either abiraterone or enzalutamide as the first line of treatment from 2014 to 2017, with follow-up until 2020, were analyzed. We used causal survival forests for analysis. The unit level of analysis was the patient. The primary outcome of this study was follow-up days indicating survival duration while on the first-line medication. After estimating the treatment effect, a prescription policy tree was constructed. Results: For 2886 veterans, enzalutamide is associated with an average of 59.94 (95\% CI 35.60-84.28) more days of survival than abiraterone. The increase in overall survival duration for the 2 drugs varied across patient demographics, test results, and comorbidities. Two data-driven subgroups of patients were identified by ranking them on their augmented inverse-propensity weighted (AIPW) scores. The average AIPW scores for the 2 subgroups were 19.36 (95\% CI --16.93 to 55.65) and 100.68 (95\% CI 62.46-138.89). Based on visualization and t test, the AIPW score for low and high subgroups was significant (P=.003), thereby supporting heterogeneity. The analysis resulted in a set of prescription rules for the 2 ARPIs based on a few covariates available to the physicians at the time of prescription. Conclusions: This study of 2886 veterans showed evidence of heterogeneity and that survival days may be improved for certain patients with mCRPC based on the medication prescribed. Findings suggest that prescription rules based on the patient characteristics, laboratory test results, and comorbidities available to the physician at the time of prescription could improve survival by providing personalized treatment decisions. ",
doi="10.2196/59480",
url="https://medinform.jmir.org/2024/1/e59480"
}


@Article{info:doi/10.2196/63551,
author="Li, Guorong
and Tholance, Yannick
and Mallouk, Nora
and Waeckel, Louis
and Flandrin, Pascale
and Bali, Bruno
and Badet, Lionel
and Cornillon, Pierre",
title="Quantification of Urinary Exosomal Prostate-Specific Antigen for the Diagnosis of Prostate Cancer Using Clinical Laboratory--Based Techniques: Protocol for a Case-Control Study",
journal="JMIR Res Protoc",
year="2024",
month="Sep",
day="11",
volume="13",
pages="e63551",
keywords="liquid biopsy",
keywords="urinary exosome",
keywords="diagnosis",
keywords="PSA",
keywords="prostate-specific antigen",
keywords="prostate cancer",
abstract="Background: Prostate cancer is the most common cancer in men and represents a major public health problem. The current method for the diagnosis or screening of prostate cancer is invasive and costly. There have been renewed and innovative studies searching for urinary biomarkers to aid in the diagnosis of prostate cancer, especially with technologies based on urinary exosomes. However, technologies based on urine exosomes usually need expensive machines such as an ultracentrifuge and they are difficult to standardize, which hinder their application in clinical laboratories. We have optimized and standardized the isolation of urinary exosomes with the precipitation method. We have found that urinary exosomal prostate-specific antigen (PSA) can be quantified by automatic Elecsys total PSA technique. Objective: In this study, our objective is to utilize urinary exosomes from prostate cancer for the development of a test to aid in its diagnosis. Methods: Exosomes from the prostate cancer cell line LNCaP was used to set up the technique. To analyze urine samples from patients, the methods include the collection of first-void urine using the Colli-Pee device, the isolation of urine exosomes using the optimized precipitation method, and the quantification of exosomal PSA by Elecsys total PSA. Results: This will be a 2-year study. We will start including patients and controls in the last quarter of 2024. We expect the results to be published in the second quarter of 2027. Conclusions: This is the first study to quantify urinary exosomal PSA using the Elecsys total PSA technique for the diagnosis of prostate cancer. This study emphasizes techniques that are suitable for implementation in clinical laboratories, which will facilitate the application of urinary exosomes to simplify and improve the diagnosis and screening of prostate cancer. International Registered Report Identifier (IRRID): PRR1-10.2196/63551 ",
doi="10.2196/63551",
url="https://www.researchprotocols.org/2024/1/e63551",
url="http://www.ncbi.nlm.nih.gov/pubmed/39024018"
}


@Article{info:doi/10.2196/51061,
author="Jin, William
and Montoya, Christopher
and Rich, James Benjamin
and Taswell, Seldon Crystal
and Noy, Miguel
and Kwon, Deukwoo
and Spieler, Benjamin
and Mahal, Brandon
and Abramowitz, Matthew
and Yechieli, Raphael
and Pollack, Alan
and Dal Pra, Alan",
title="A Smart Water Bottle and Companion App (HidrateSpark 3) to Improve Bladder-Filling Compliance in Patients With Prostate Cancer Receiving Radiotherapy: Nonrandomized Trial of Feasibility and Acceptability",
journal="JMIR Cancer",
year="2024",
month="Sep",
day="10",
volume="10",
pages="e51061",
keywords="digital therapeutics",
keywords="behavioral intervention",
keywords="digital health",
keywords="prostate cancer",
keywords="radiation",
keywords="smart water bottle",
keywords="companion app",
keywords="oncology",
keywords="prostate",
keywords="privacy",
keywords="radiation therapy",
keywords="bladder",
keywords="compliance",
keywords="smartphone-based behavioral intervention",
keywords="mobile phone",
abstract="Background: Patients with prostate cancer undergoing radiation therapy (RT) need comfortably full bladders to reduce toxicities during treatment. Poor compliance is common with standard of care written or verbal instructions, leading to wasted patient value (PV) and clinic resources via poor throughput efficiency (TE). Objective: Herein, we assessed the feasibility and acceptability of a smartphone-based behavioral intervention (SBI) to improve bladder-filling compliance and methods for quantifying PV and TE. Methods: In total, 36 patients with prostate cancer were enrolled in a single-institution, closed-access, nonrandomized feasibility trial. The SBI consists of a fully automated smart water bottle and smartphone app. Both pieces alert the patient to empty his bladder and drink a personalized volume goal, based on simulation bladder volume, 1.25 hours before his scheduled RT. Patients were trained to adjust their volume goal and notification times to achieve comfortably full bladders. The primary end point was met if qualitative (QLC) and quantitative compliance (QNC) were >80\%. For QLC, patients were asked if they prepared their bladders before daily RT. QNC was met if bladder volumes on daily cone-beam tomography were >75\% of the simulation's volume. The Service User Technology Acceptability Questionnaire (SUTAQ) was given in person pre- and post-SBI. Additional acceptability and engagement end points were met if >3 out of 5 across 4 domains on the SUTAQ and >80\% (15/18) of patients used the device >50\% of the time, respectively. Finally, the impact of SBI on PV and TE was measured by time spent in a clinic and on the linear accelerator (linac), respectively, and contrasted with matched controls. Results: QLC was 100\% in 375 out of 398 (94.2\%) total treatments, while QNC was 88.9\% in 341 out of 398 (85.7\%) total treatments. Of a total score of 5, patients scored 4.33 on privacy concerns, 4 on belief in benefits, 4.56 on satisfaction, and 4.24 on usability via SUTAQ. Further, 83\% (15/18) of patients used the SBI on >50\% of treatments. Patients in the intervention arm spent less time in a clinic (53.24, SEM 1.71 minutes) compared to the control (75.01, SEM 2.26 minutes) group (P<.001). Similarly, the intervention arm spent less time on the linac (10.67, SEM 0.40 minutes) compared to the control (14.19, SEM 0.32 minutes) group (P<.001). Conclusions: This digital intervention trial showed high rates of bladder-filling compliance and engagement. High patient value and TE were feasibly quantified by shortened clinic times and linac usage, respectively. Future studies are needed to evaluate clinical outcomes, patient experience, and cost-benefit. Trial Registration: ClinicalTrials.gov NCT04946214; https://www.clinicaltrials.gov/study/NCT04946214 ",
doi="10.2196/51061",
url="https://cancer.jmir.org/2024/1/e51061"
}


@Article{info:doi/10.2196/55939,
author="Gibson, Damien
and Jackson, Stuart
and Shanmugasundaram, Ramesh
and Seth, Ishith
and Siu, Adrian
and Ahmadi, Nariman
and Kam, Jonathan
and Mehan, Nicholas
and Thanigasalam, Ruban
and Jeffery, Nicola
and Patel, I. Manish
and Leslie, Scott",
title="Evaluating the Efficacy of ChatGPT as a Patient Education Tool in Prostate Cancer: Multimetric Assessment",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="14",
volume="26",
pages="e55939",
keywords="prostate cancer",
keywords="patient education",
keywords="large language model",
keywords="ChatGPT",
keywords="AI language model",
keywords="multimetric assessment",
keywords="artificial intelligence",
keywords="AI",
keywords="AI chatbots",
keywords="health care professional",
keywords="health care professionals",
keywords="men",
keywords="man",
keywords="prostate",
keywords="cancer",
keywords="decision-making",
keywords="prostate specific",
keywords="antigen screening",
keywords="medical information",
keywords="natural language processing",
keywords="NLP",
abstract="Background: Artificial intelligence (AI) chatbots, such as ChatGPT, have made significant progress. These chatbots, particularly popular among health care professionals and patients, are transforming patient education and disease experience with personalized information. Accurate, timely patient education is crucial for informed decision-making, especially regarding prostate-specific antigen screening and treatment options. However, the accuracy and reliability of AI chatbots' medical information must be rigorously evaluated. Studies testing ChatGPT's knowledge of prostate cancer are emerging, but there is a need for ongoing evaluation to ensure the quality and safety of information provided to patients. Objective: This study aims to evaluate the quality, accuracy, and readability of ChatGPT-4's responses to common prostate cancer questions posed by patients. Methods: Overall, 8 questions were formulated with an inductive approach based on information topics in peer-reviewed literature and Google Trends data. Adapted versions of the Patient Education Materials Assessment Tool for AI (PEMAT-AI), Global Quality Score, and DISCERN-AI tools were used by 4 independent reviewers to assess the quality of the AI responses. The 8 AI outputs were judged by 7 expert urologists, using an assessment framework developed to assess accuracy, safety, appropriateness, actionability, and effectiveness. The AI responses' readability was assessed using established algorithms (Flesch Reading Ease score, Gunning Fog Index, Flesch-Kincaid Grade Level, The Coleman-Liau Index, and Simple Measure of Gobbledygook [SMOG] Index). A brief tool (Reference Assessment AI [REF-AI]) was developed to analyze the references provided by AI outputs, assessing for reference hallucination, relevance, and quality of references. Results: The PEMAT-AI understandability score was very good (mean 79.44\%, SD 10.44\%), the DISCERN-AI rating was scored as ``good'' quality (mean 13.88, SD 0.93), and the Global Quality Score was high (mean 4.46/5, SD 0.50). Natural Language Assessment Tool for AI had pooled mean accuracy of 3.96 (SD 0.91), safety of 4.32 (SD 0.86), appropriateness of 4.45 (SD 0.81), actionability of 4.05 (SD 1.15), and effectiveness of 4.09 (SD 0.98). The readability algorithm consensus was ``difficult to read'' (Flesch Reading Ease score mean 45.97, SD 8.69; Gunning Fog Index mean 14.55, SD 4.79), averaging an 11th-grade reading level, equivalent to 15- to 17-year-olds (Flesch-Kincaid Grade Level mean 12.12, SD 4.34; The Coleman-Liau Index mean 12.75, SD 1.98; SMOG Index mean 11.06, SD 3.20). REF-AI identified 2 reference hallucinations, while the majority (28/30, 93\%) of references appropriately supplemented the text. Most references (26/30, 86\%) were from reputable government organizations, while a handful were direct citations from scientific literature. Conclusions: Our analysis found that ChatGPT-4 provides generally good responses to common prostate cancer queries, making it a potentially valuable tool for patient education in prostate cancer care. Objective quality assessment tools indicated that the natural language processing outputs were generally reliable and appropriate, but there is room for improvement. ",
doi="10.2196/55939",
url="https://www.jmir.org/2024/1/e55939"
}


@Article{info:doi/10.2196/47102,
author="Lee, Kyoungjin
and Park, Jeongok
and Oh, Geum Eui
and Lee, JuHee
and Park, Chang
and Choi, Deuk Young",
title="Effectiveness of a Nurse-Led Mobile-Based Health Coaching Program for Patients With Prostate Cancer at High Risk of Metabolic Syndrome: Randomized Waitlist Controlled Trial",
journal="JMIR Mhealth Uhealth",
year="2024",
month="Feb",
day="1",
volume="12",
pages="e47102",
keywords="nurses",
keywords="prostate neoplasms",
keywords="healthy lifestyle",
keywords="metabolic syndrome",
keywords="exercise",
keywords="diet",
keywords="mobile phone",
abstract="Background: Androgen deprivation therapy (ADT), a standard treatment for prostate cancer (PC), causes many physical side effects. In particular, it causes metabolic changes such as fasting glucose abnormalities or accumulation of body fat, and its continuation can lead to metabolic syndrome (MetS), which is closely related to diabetes and cardiovascular disease. Therefore, it is important to maintain and practice a healthy lifestyle in patients with PC. Objective: This study aims to evaluate the effectiveness of a nurse-led mobile-based program that aims to promote a healthy lifestyle in patients with PC undergoing ADT with MetS risk factors. Methods: This was a single-blind, randomized, waitlist control interventional study. A total of 48 patients were randomly assigned to the experimental and waitlist control groups at the urology cancer clinic of a tertiary general hospital in South Korea. The inclusion criteria were patients who had undergone ADT for >6 months, had at least 1 of the 5 MetS components in the abnormal range, and could access a mobile-based education program. The experimental group attended a 4-week mobile-based program on exercise and diet that included counseling and encouragement to maintain a healthy lifestyle, whereas the control group was placed on a waitlist and received usual care during the follow-up period, followed by the intervention. The primary outcome was a change in the lifestyle score. The secondary outcomes were changes in 5 MetS components, body composition, and health-related quality of life. The outcomes were measured at 6 weeks and 12 weeks after the initiation of the intervention. Each participant was assigned to each group in a sequential order of enrollment in a 4{\texttimes}4 permuted block design randomization table generated in the SAS (SAS Institute) statistical program. A linear mixed model was used for statistical analysis. Results: A total of 24 participants were randomly assigned to each group; however, 2 participants in the experimental group dropped out for personal reasons before starting the intervention. Finally, 46 participants were included in the intention-to-treat analysis. The experimental group showed more positive changes in the healthy lifestyle score ($\beta$=29.23; P?.001), level of each MetS component (fasting blood sugar: $\beta$=?12.0; P=.05 and abdominal circumference: $\beta$=?2.49; P=.049), body composition (body weight: $\beta$=?1.52; P<.001 and BMI: $\beta$=?0.55; P<.001), and the urinary irritative and obstructive domain of health-related quality of life ($\beta$=14.63; P<.001) over time than the waitlist control group. Conclusions: Lifestyle changes through nurse-led education can improve level of each MetS components, body composition, and ADT side effects. Nurses can induce positive changes in patients' lifestyles and improve the self-management of patients starting ADT through this program. Trial Registration: Clinical Research Information Service KCT0006560; http://tinyurl.com/yhvj4vwh ",
doi="10.2196/47102",
url="https://mhealth.jmir.org/2024/1/e47102",
url="http://www.ncbi.nlm.nih.gov/pubmed/38300697"
}


@Article{info:doi/10.2196/47161,
author="Ruan, Xiaohao
and Zhang, Ning
and Wang, Dawei
and Huang, Jingyi
and Huang, Jinlun
and Huang, Da
and Chun, Stacia Tsun Tsun
and Ho, Ho Brian Sze
and Ng, Tsui-Lin Ada
and Tsu, Hok-Leung James
and Zhan, Yongle
and Na, Rong",
title="The Impact of Prostate-Specific Antigen Screening on Prostate Cancer Incidence and Mortality in China: 13-Year Prospective Population-Based Cohort Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Jan",
day="18",
volume="10",
pages="e47161",
keywords="prostate-specific antigen",
keywords="PSA",
keywords="prostate cancer",
keywords="prostate screening",
keywords="screening interval",
keywords="incidence",
keywords="mortality",
keywords="cohort study",
keywords="electronic health record",
keywords="China",
abstract="Background: The status of prostate-specific antigen (PSA) screening is unclear in China. Evidence regarding the optimal frequency and interval of serial screening for prostate cancer (PCa) is disputable. Objective: This study aimed to depict the status of PSA screening and to explore the optimal screening frequency for PCa in China. Methods: A 13-year prospective cohort study was conducted using the Chinese Electronic Health Records Research in Yinzhou study's data set. A total of 420,941 male participants aged ?45 years were included between January 2009 and June 2022. Diagnosis of PCa, cancer-specific death, and all-cause death were obtained from the electronic health records and vital statistic system. Hazard ratios (HRs) with 95\% CIs were estimated using Cox regression analysis. Results: The cumulative rate of ever PSA testing was 17.9\% with an average annual percent change (AAPC) of 8.7\% (95\% CI 3.6\%-14.0\%) in the past decade in China. People with an older age, a higher BMI, higher waist circumference, tobacco smoking and alcohol drinking behaviors, higher level of physical activity, medication use, and comorbidities were more likely to receive PSA screening, whereas those with a lower education level and a widowed status were less likely to receive the test. People receiving serial screening ?3 times were at a 67\% higher risk of PCa detection (HR 1.67; 95\% CI 1.48-1.88) but a 64\% lower risk of PCa-specific mortality (HR 0.36; 95\% CI 0.18-0.70) and a 28\% lower risk of overall mortality (HR 0.72; 95\% CI 0.67-0.77). People following a serial screening strategy at least once every 4 years were at a 25\% higher risk of PCa detection (HR 1.25; 95\% CI 1.13-1.36) but 70\% (HR 0.30; 95\% CI 0.16-0.57) and 23\% (HR 0.77; 95\% CI 0.73-0.82) lower risks of PCa-specific and all-cause mortality, respectively. Conclusions: This study reveals a low coverage of PSA screening in China and provides the first evidence of its benefits in the general Chinese population. The findings of this study indicate that receiving serial screening at least once every 4 years is beneficial for overall and PCa-specific survival. Further studies based on a nationwide population and with long-term follow-up are warranted to identify the optimal screening interval in China. ",
doi="10.2196/47161",
url="https://publichealth.jmir.org/2024/1/e47161",
url="http://www.ncbi.nlm.nih.gov/pubmed/38236627"
}


@Article{info:doi/10.2196/49353,
author="Young, Karen
and Xiong, Ting
and Lee, Rachel
and Banerjee, Tina Ananya
and Leslie, Myles
and Ko, Yu Wellam
and Pham, Quynh",
title="User-Centered Design and Usability of a Culturally Adapted Virtual Survivorship Care App for Chinese Canadian Prostate Cancer Survivors: Qualitative Descriptive Study",
journal="JMIR Hum Factors",
year="2024",
month="Jan",
day="1",
volume="11",
pages="e49353",
keywords="digital health",
keywords="virtual care",
keywords="digital therapeutics",
keywords="prostate cancer",
keywords="cancer survivorship",
keywords="user-centred design",
keywords="usability",
keywords="supportive care",
keywords="cultural adaptation",
keywords="Chinese Canadians",
abstract="Background: Cultural adaptations of digital health innovations are a growing field. However, digital health innovations can increase health inequities. While completing exploratory work for the cultural adaptation of the Ned Clinic virtual survivorship app, we identified structural considerations that provided a space to design digitally connected and collective care. Objective: This study used a community-based participatory research and user-centered design process to develop a cultural adaptation of the Ned Clinic app while designing to intervene in structural inequities. Methods: The design process included primary data collection and qualitative analysis to explore and distill design principles, an iterative design phase with a multidisciplinary team, and a final evaluation phase with participants throughout the design process as a form of member checking and validation. Results: Participants indicated that they found the final adapted prototype to be acceptable, appropriate, and feasible for their use. The changes made to adapt the prototype were not specifically culturally Chinese. Instead, we identified ways to strengthen connections between the survivor and their providers; improve accessibility to resources; and honor participants' desires for relationality, accountability, and care. Conclusions: We grounded the use of user-centered design to develop a prototype design that supports the acts of caring through digital technology by identifying and designing to resist structures that create health inequities in the lives of this community of survivors. By designing for collective justice, we can provide accessible, feasible, and relational care with digital health through the application of Indigenous and Black feminist ways of being and knowing. ",
doi="10.2196/49353",
url="https://humanfactors.jmir.org/2024/1/e49353",
url="http://www.ncbi.nlm.nih.gov/pubmed/38163295"
}


@Article{info:doi/10.2196/46552,
author="Diefenbach, A. Michael
and Marziliano, Allison
and Tagai, K. Erin
and Pfister, Halie
and Lapitan, Emmanuel
and Hall, J. Simon
and Vira, Manish
and Ibrahim, Said
and Aibel, Kelli
and Kutikov, Alexander
and Horwitz, M. Eric
and Miyamoto, Curtis
and Reese, C. Adam
and Miller, M. Suzanne",
title="Preference Elicitation and Treatment Decision-Making Among Men Diagnosed With Prostate Cancer: Randomized Controlled Trial Results of Healium",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="20",
volume="25",
pages="e46552",
keywords="prostate cancer",
keywords="decision-making",
keywords="decision support",
keywords="decision tool",
keywords="web-based intervention",
keywords="patient preferences",
keywords="preference elicitation software",
keywords="preference",
keywords="RCT",
keywords="randomized controlled trial",
keywords="oncology",
keywords="prostate",
keywords="men's health",
keywords="emotional",
abstract="Background: Elicitation of patients' preferences is an integral part of shared decision-making, the recommended approach for prostate cancer decision-making. Existing decision aids for this population often do not specifically focus on patients' preferences. Healium is a brief interactive web-based decision aid that aims to elicit patients' treatment preferences and is designed for a low health literate population. Objective: This study used a randomized controlled trial to evaluate whether Healium, designed to target preference elicitation, is as efficacious as Healing Choices, a comprehensive education and decision tool, in improving outcomes for decision-making and emotional quality of life. Methods: Patients diagnosed with localized prostate cancer who had not yet made a treatment decision were randomly assigned to the brief Healium intervention or Healing Choices, a decision aid previously developed by our group that serves as a virtual information center on prostate cancer diagnosis and treatment. Assessments were completed at baseline, 6 weeks, and 3 months post baseline, and included decisional outcomes (decisional conflict, satisfaction with decision, and preparation for decision-making), and emotional quality of life (anxiety/tension and depression), along with demographics, comorbidities, and health literacy. Results: A total of 327 individuals consented to participate in the study (171 were randomized to the Healium intervention arm and 156 were randomized to Healing Choices). The majority of the sample was non-Hispanic (272/282, 96\%), White (239/314, 76\%), married (251/320, 78.4\%), and was on average 62.4 (SD 6.9) years old. Within both arms, there was a significant decrease in decisional conflict from baseline to 6 weeks postbaseline (Healium, P?.001; Healing Choices, P?.001), and a significant increase in satisfaction with one's decision from 6 weeks to 3 months (Healium, P=.04; Healing Choices, P=.01). Within both arms, anxiety/tension (Healium, P=.23; Healing Choices, P=.27) and depression (Healium, P=.001; Healing Choices, P?.001) decreased from baseline to 6 weeks, but only in the case of depression was the decrease statistically significant. Conclusions: Healium, our brief decision aid focusing on treatment preference elicitation, is as successful in reducing decisional conflict as our previously tested comprehensive decision aid, Healing Choices, and has the added benefit of brevity, making it the ideal tool for integration into the physician consultation and electronic medical record. Trial Registration: ClinicalTrials.gov NCT05800483; https://clinicaltrials.gov/study/NCT05800483 ",
doi="10.2196/46552",
url="https://www.jmir.org/2023/1/e46552",
url="http://www.ncbi.nlm.nih.gov/pubmed/37862103"
}


@Article{info:doi/10.2196/49775,
author="Petros, Gebrewold Nuhamin
and Alvarsson-Hjort, Jesper
and Hadlaczky, Gerg{\"o}
and Wasserman, Danuta
and Ottaviano, Manuel
and Gonzalez-Martinez, Sergio
and Carletto, Sara
and Scilingo, Pasquale Enzo
and Valenza, Gaetano
and Carli, Vladimir",
title="Predictors of the Use of a Mental Health--Focused eHealth System in Patients With Breast and Prostate Cancer: Bayesian Structural Equation Modeling Analysis of a Prospective Study",
journal="JMIR Cancer",
year="2023",
month="Sep",
day="12",
volume="9",
pages="e49775",
keywords="mental health",
keywords="eHealth system",
keywords="perceived usefulness",
keywords="structural equation modeling",
keywords="cancer",
keywords="NEVERMIND system",
keywords="usability",
keywords="digital health",
keywords="Technology Acceptance Model",
abstract="Background: eHealth systems have been increasingly used to manage depressive symptoms in patients with somatic illnesses. However, understanding the factors that drive their use, particularly among patients with breast and prostate cancer, remains a critical area of research. Objective: This study aimed to determine the factors influencing use of the NEVERMIND eHealth system among patients with breast and prostate cancer over 12 weeks, with a focus on the Technology Acceptance Model. Methods: Data from the NEVERMIND trial, which included 129 patients with breast and prostate cancer, were retrieved. At baseline, participants completed questionnaires detailing demographic data and measuring depressive and stress symptoms using the Beck Depression Inventory--II and the Depression, Anxiety, and Stress Scale--21, respectively. Over a 12-week period, patients engaged with the NEVERMIND system, with follow-up questionnaires administered at 4 weeks and after 12 weeks assessing the system's perceived ease of use and usefulness. Use log data were collected at the 2- and 12-week marks. The relationships among sex, education, baseline depressive and stress symptoms, perceived ease of use, perceived usefulness (PU), and system use at various stages were examined using Bayesian structural equation modeling in a path analysis, a technique that differs from traditional frequentist methods. Results: The path analysis was conducted among 100 patients with breast and prostate cancer, with 66\% (n=66) being female and 81\% (n=81) having a college education. Patients reported good mental health scores, with low levels of depression and stress at baseline. System use was approximately 6 days in the initial 2 weeks and 45 days over the 12-week study period. The results revealed that PU was the strongest predictor of system use at 12 weeks ($\beta$use at 12 weeks is predicted by PU at 12 weeks=.384), whereas system use at 2 weeks moderately predicted system use at 12 weeks ($\beta$use at 12 weeks is predicted by use at 2 weeks=.239). Notably, there were uncertain associations between baseline variables (education, sex, and mental health symptoms) and system use at 2 weeks, indicating a need for better predictors for early system use. Conclusions: This study underscores the importance of PU and early engagement in patient engagement with eHealth systems such as NEVERMIND. This suggests that, in general eHealth implementations, caregivers should educate patients about the benefits and functionalities of such systems, thus enhancing their understanding of potential health impacts. Concentrating resources on promoting early engagement is also essential given its influence on sustained use. Further research is necessary to clarify the remaining uncertainties, enabling us to refine our strategies and maximize the benefits of eHealth systems in health care settings. ",
doi="10.2196/49775",
url="https://cancer.jmir.org/2023/1/e49775",
url="http://www.ncbi.nlm.nih.gov/pubmed/37698900"
}


@Article{info:doi/10.2196/45432,
author="Wang, Y. Elizabeth
and Borno, T. Hala
and Washington III, L. Samuel
and Friedlander, Terence
and Zhang, Sylvia
and Trejo, Evelin
and Van Blarigan, L. Erin
and Chan, M. June
and Shariff-Marco, Salma
and Beatty, L. Alexis
and Kenfield, A. Stacey",
title="Engaging Men of Diverse Racial and Ethnic Groups With Advanced Prostate Cancer in the Design of an mHealth Diet and Exercise Intervention: Focus Group Study",
journal="JMIR Cancer",
year="2023",
month="Jun",
day="1",
volume="9",
pages="e45432",
keywords="cancer survivorship",
keywords="digital health",
keywords="technology-based intervention",
keywords="modifiable behaviors",
keywords="metastatic",
keywords="androgen deprivation therapy",
keywords="race and ethnicity",
keywords="social determinants of health",
keywords="mobile phone",
abstract="Background: Healthy diet and exercise can improve quality of life and prognosis among men with prostate cancer. Understanding the perceived barriers to lifestyle change and patient preferences in a diverse cohort of men with prostate cancer is necessary to inform mobile health (mHealth) lifestyle interventions and increase health equity. Objective: We conducted a multisite study to understand the preferences, attitudes, and health behaviors related to diet and lifestyle in this patient population. This report focuses on the qualitative findings from 4 web-based focus groups comprising a racially and ethnically diverse group of patients with advanced prostate cancer who are on androgen deprivation therapy. Methods: We used grounded theory analyses including open, axial, and selective coding to generate codes. Qualitative data were analyzed as a whole rather than by focus group to optimize data saturation and the transferability of results. We present codes and themes that emerged for lifestyle intervention design and provide recommendations and considerations for future mHealth intervention studies. Results: Overall, 14 men participated in 4 racially and ethnically concordant focus groups (African American or Black: 3/14, 21\%; Asian American: 3/14, 21\%; Hispanic or Latino: 3/14, 21\%; and White: 5/14, 36\%). Analyses converged on 7 interwoven categories: context (home environment, access, competing priorities, and lifestyle programs), motivation (accountability, discordance, feeling supported, fear, and temptation), preparedness (health literacy, technological literacy, technological preferences, trust, readiness to change, identity, adaptability, and clinical characteristics), data-driven design (education, psychosocial factors, and quality of life), program mechanics (communication, materials, customization, and being holistic), habits (eg, dietary habits), and intervention impressions. These results suggest actionable pathways to increase program intuitiveness. Recommendations for future mHealth intervention design and implementation include but are not limited to assessment at the individual, household, and neighborhood levels to support a tailored intervention; prioritization of information to disseminate based on individuals' major concerns and the delivery of information based on health and technological literacy and communication preferences; prescribing a personalized intervention based on individuals' baseline responses, home and neighborhood environment, and support network; and incorporating strategies to foster engagement (eg, responsive and relevant feedback systems) to aid participant decision-making and behavior change. Conclusions: Assessing a patient's social context, motivation, and preparedness is necessary when tailoring a program to each patient's needs in all racial and ethnic groups. Addressing the patients' contexts and motivation and preparedness related to diet and exercise including the household, access (to food and exercise), competing priorities, health and technological literacy, readiness to change, and clinical characteristics will help to customize the intervention to the participant. These data support a tailored approach leveraging the identified components and their interrelationships to ensure that mHealth lifestyle interventions will engage and be effective in racially and ethnically diverse patients with cancer. Trial Registration: ClinicalTrials.gov NCT05324098; https://clinicaltrials.gov/ct2/show/NCT05324098 ",
doi="10.2196/45432",
url="https://cancer.jmir.org/2023/1/e45432",
url="http://www.ncbi.nlm.nih.gov/pubmed/37261885"
}


@Article{info:doi/10.2196/38362,
author="Helissey, Carole
and Cavallero, Sophie
and Mondot, Stanislas
and Parnot, Charles
and Yssaad, Halima
and Becherirat, Selma
and Guitard, Nathalie
and Thery, H{\'e}l{\`e}ne
and Schernberg, Antoine
and Breitwiller, Hugo
and Chargari, Cyrus
and Francois, Sabine",
title="Correlation Between Serum and Urine Biomarkers and the Intensity of Acute Radiation Cystitis in Patients Treated With Radiation Therapy for Localized Prostate Cancer: Protocol for the Radiotoxicity Bladder Biomarkers (RABBIO) Study",
journal="JMIR Res Protoc",
year="2023",
month="Jan",
day="10",
volume="12",
pages="e38362",
keywords="radiation cystitis",
keywords="radiotoxicity",
keywords="urine",
keywords="bladder",
keywords="serum",
keywords="quality of life",
keywords="remote monitoring",
keywords="biomarker",
keywords="prostate",
keywords="cancer",
keywords="immunosorbent",
keywords="urology",
keywords="cytometry",
keywords="protocol",
keywords="telehealth",
keywords="telemedicine",
keywords="health platform",
keywords="online platform",
keywords="monitor",
keywords="digital health",
keywords="radiotherapy",
keywords="radiation",
keywords="risk",
keywords="inflammation",
keywords="inflammatory",
keywords="sequencing",
keywords="biopsy",
keywords="biopsies",
keywords="gene expression",
keywords="protein",
keywords="microbiology",
keywords="cystitis",
keywords="microbe",
keywords="microbiota",
keywords="RNA",
keywords="proteomics",
keywords="assay",
keywords="algorithm",
keywords="oncology",
keywords="radiology",
keywords="radiation therapy",
keywords="prostate cancer",
keywords="diagnostic",
abstract="Background: Despite improvements in radiation techniques, pelvic radiotherapy is responsible for acute and delayed bladder adverse events, defined as radiation cystitis. The initial symptoms of bladder injury secondary to pelvic irradiation are likely to occur during treatment or within 3 months of radiotherapy in approximately 50\% of irradiated patients, and have a significant impact on their quality of life. The pathophysiology of radiation cystitis is not well understood, particularly because of the risk of complications associated with access to bladder tissue after irradiation, which limits our ability to study this process and develop treatments. Objective: It is an original study combining digital data collection to monitor patients' symptoms and biological markers during irradiation. The main objective of our study is to evaluate the correlation of biological biomarkers with the intensity of acute radiation cystitis and the quality of life of patients, assessed with the digital telemonitoring platform Cureety. Methods: Patients with intermediate-risk localized prostate cancer who are eligible for localized radiotherapy will be included. Inflammatory biomarkers will be analyzed in urine and blood samples before the start of radiotherapy and at weeks 4, 12, and 48 of irradiation, through quantitative methods such as a multiplex Luminex assay, flow cytometry, and enzyme-linked immunosorbent assay. We will also characterize the patients' gut and urine microbiota composition using 16S ribosomal RNA sequencing technology. Between sample collection visits, patients will complete various questionnaires related to radiation cystitis symptoms (using the International Prostate Symptom Score), adverse events, and quality of life (using the Functional Assessment of Cancer Therapy--Prostate questionnaire), using the Cureety digital remote monitoring platform. Upon receipt of the questionnaires, an algorithm will process the information and classify patients in accordance with the severity of symptoms and adverse events reported on the basis of Common Terminology Criteria for Adverse Events and International Prostate Symptom Score standards. This will allow us to correlate levels of urinary, blood, and fecal biomarkers with the severity of acute radiation cystitis symptoms and patient-reported quality of life. Results: The study started in March 2022. We estimate a recruitment period of approximately 18 months, and the final results are expected in 2024. Conclusions: This prospective study is the first to explore the overexpression of inflammatory proteins in fluid biopsies from patients with symptoms of acute radiation cystitis. In addition, the 1-year follow-up after treatment will allow us to predict which patients are at risk of late radiation cystitis and to refer them for radioprotective treatment. The results of this study will allow us to develop strategies to limit radiation damage to the bladder and improve the quality of life of patients. Trial Registration: ClinicalTrials.gov NCT05246774; https://clinicaltrials.gov/ct2/show/NCT05246774?term=NCT05246774 International Registered Report Identifier (IRRID): DERR1-10.2196/38362 ",
doi="10.2196/38362",
url="https://www.researchprotocols.org/2023/1/e38362",
url="http://www.ncbi.nlm.nih.gov/pubmed/36626198"
}


@Article{info:doi/10.2196/27890,
author="Marziliano, Allison
and Diefenbach, A. Michael
and Hudson, V. Shawna
and Tagai, K. Erin
and Handorf, A. Elizabeth
and Bator, Alicja
and Miller, M. Suzanne",
title="Demographic and Psychosocial Characteristics Associated With Use of a Prostate Cancer Survivorship Website: Implications From a Multisite Randomized Controlled Trial",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="21",
volume="24",
number="3",
pages="e27890",
keywords="prostate cancer",
keywords="cancer survivorship",
keywords="web-based resource",
keywords="monitoring style of coping",
keywords="cancer",
keywords="survivorship",
keywords="eHealth",
keywords="emotions",
keywords="interpersonal",
abstract="Background: Many prostate cancer (PC) survivors experience disease and treatment-related symptomatology in both the physical and psychosocial domains. Although the benefits and barriers to using web-based resources for cancer patients are well-documented, less research has focused on the personal characteristics important for efficient tailoring and targeting of information that are associated with usage. Objective: We used the Cognitive-Social Health Information Processing (C-SHIP) framework to guide our exploration of personal characteristics associated with use of PROGRESS, an informational PC survivorship website that addresses physical, emotional, interpersonal, and practical concerns relevant for PC survivors. Methods: PC survivors (N=217) were randomized to the intervention arm (PROGRESS) of a randomized controlled trial. Of those randomized to the intervention arm, 84 used PROGRESS, and 133 did not use PROGRESS. Multivariable analyses evaluated demographic and psychosocial characteristics (eg, style of coping, health literacy, self-efficacy, affective states of depression, anxiety, and fatigue) associated with website use. Results: A larger proportion of non-Hispanic White (68/160, 42.5\%), compared with non-Hispanic Black (9/40, 23\%), participants used PROGRESS (P<.001). Further, PROGRESS users were older in age (P<.001), had a monitoring style of coping (P=.01), and were less depressed (P=.004), anxious (P=.02), and fatigued (P<.001) than nonusers. Education, income, health literacy, blunting style of coping, self-efficacy, and treatment type (radiation therapy or surgery) were not significantly related to use. On multivariable analyses, race (OR 0.28, P<.001), age (OR 1.05, P<.001), monitoring style of coping (OR 1.27, P=.02), and overall mood (OR 0.98, P<.001) remained significant. Conclusions: A combination of monitoring and low levels of negative affect were associated with website use. Additionally, users were older, non-Hispanic White survivors. To ensure that important survivorship-relevant information reaches users, future efforts need to focus on enhancing patient engagement. Trial Registration: ClinicalTrials.gov NCT02224482; https://clinicaltrials.gov/ct2/show/NCT02224482 ",
doi="10.2196/27890",
url="https://www.jmir.org/2022/3/e27890",
url="http://www.ncbi.nlm.nih.gov/pubmed/35311678"
}


@Article{info:doi/10.2196/25659,
author="Vromans, D. Ruben
and van Eenbergen, C. Mies
and Geleijnse, Gijs
and Pauws, Steffen
and van de Poll-Franse, V. Lonneke
and Krahmer, J. Emiel",
title="Exploring Cancer Survivor Needs and Preferences for Communicating Personalized Cancer Statistics From Registry Data: Qualitative Multimethod Study",
journal="JMIR Cancer",
year="2021",
month="Oct",
day="25",
volume="7",
number="4",
pages="e25659",
keywords="breast cancer",
keywords="cancer statistics",
keywords="personalization",
keywords="prostate cancer",
keywords="risk communication",
keywords="cancer registry",
keywords="cancer",
keywords="patient needs and preferences",
abstract="Background: Disclosure of cancer statistics (eg, survival or incidence rates) based on a representative group of patients can help increase cancer survivors' understanding of their own diagnostic and prognostic situation, and care planning. More recently, there has been an increasing interest in the use of cancer registry data for disclosing and communicating personalized cancer statistics (tailored toward personal and clinical characteristics) to cancer survivors and relatives. Objective: The aim of this study was to explore breast cancer (BCa) and prostate cancer (PCa) survivor needs and preferences for disclosing (what) and presenting (how) personalized statistics from a large Dutch population-based data set, the Netherlands Cancer Registry (NCR). Methods: To elicit survivor needs and preferences for communicating personalized NCR statistics, we created different (non)interactive tools visualizing hypothetical scenarios and adopted a qualitative multimethod study design. We first conducted 2 focus groups (study 1; n=13) for collecting group data on BCa and PCa survivor needs and preferences, using noninteractive sketches of what a tool for communicating personalized statistics might look like. Based on these insights, we designed a revised interactive tool, which was used to further explore the needs and preferences of another group of cancer survivors during individual think-aloud observations and semistructured interviews (study 2; n=11). All sessions were audio-recorded, transcribed verbatim, analyzed using thematic (focus groups) and content analysis (think-aloud observations), and reported in compliance with qualitative research reporting criteria. Results: In both studies, cancer survivors expressed the need to receive personalized statistics from a representative source, with especially a need for survival and conditional survival rates (ie, survival rate for those who have already survived for a certain period). Personalized statistics adjusted toward personal and clinical factors were deemed more relevant and useful to know than generic or average-based statistics. Participants also needed support for correctly interpreting the personalized statistics and putting them into perspective, for instance by adding contextual or comparative information. Furthermore, while thinking aloud, participants experienced a mix of positive (sense of hope) and negative emotions (feelings of distress) while viewing the personalized survival data. Overall, participants preferred simplicity and conciseness, and the ability to tailor the type of visualization and amount of (detailed) statistical information. Conclusions: The majority of our sample of cancer survivors wanted to receive personalized statistics from the NCR. Given the variation in patient needs and preferences for presenting personalized statistics, designers of similar information tools may consider potential tailoring strategies on multiple levels, as well as effective ways for providing supporting information to make sure that the personalized statistics are properly understood. This is encouraging for cancer registries to address this unmet need, but also for those who are developing or implementing personalized data-driven information tools for patients and relatives. ",
doi="10.2196/25659",
url="https://cancer.jmir.org/2021/4/e25659",
url="http://www.ncbi.nlm.nih.gov/pubmed/34694237"
}


@Article{info:doi/10.2196/25464,
author="vd Wiel, J. Hester
and Stuiver, M. Martijn
and May, M. Anne
and van Grinsven, Susan
and Benink, A. Marlou F.
and Aaronson, K. Neil
and Oldenburg, A. Hester S.
and van der Poel, G. Henk
and van Harten, H. Wim
and Groen, G. Wim",
title="Characteristics of Participants and Nonparticipants in a Blended Internet-Based Physical Activity Trial for Breast and Prostate Cancer Survivors: Cross-sectional Study",
journal="JMIR Cancer",
year="2021",
month="Oct",
day="5",
volume="7",
number="4",
pages="e25464",
keywords="internet-based intervention",
keywords="physical activity",
keywords="nonparticipants",
keywords="breast cancer survivors",
keywords="prostate cancer survivors",
keywords="RCT",
abstract="Background: As the number of cancer survivors is increasing, it is important to be able to offer exercise and physical activity (PA)--promoting interventions that are both effective and reasonably accessible. Internet-based interventions are typically less expensive and more accessible alternatives to on-site supervised interventions. Currently, little is known about the characteristics of nonparticipants in PA promotion trials in the cancer survivorship setting, both in general and specifically in trials using internet-supported interventions. Objective: This study aims to gain insight into the characteristics associated with nonparticipation in a blended internet-based supported intervention trial to promote PA. Methods: Breast and prostate cancer survivors, 3-36 months after primary curative treatment, were invited to participate in the PABLO trial; this trial compared an internet-based intervention to enhance PA levels, with or without additional support from a physical therapist, to usual care. Participants and nonparticipants were asked to complete a comprehensive questionnaire assessing sociodemographics, fatigue, and health-related quality of life. Baseline data for participants and nonparticipants were compared using the independent Student t test and chi-square test. Results: The inclusion rate in the trial was 11.03\% (137/1242). Of the nonparticipants, 13.95\% (154/1104) completed the questionnaire. Participants were more highly educated (P=.04), had a paid job less often (P=.03), and were on sick leave more often (P=.03). They reported less PA per week, both moderate (P=.03) and vigorous (P<.01), before diagnosis and during leisure time (P<.01, effect size [ES]=0.44). They reported a significantly lower stage of change (P?.01), lower self-efficacy (P<.01, ES=0.61), perceived barriers to PA (P<.01, ES=0.54), and more general fatigue (P<.01, ES=0.60). Participants reported lower health-related quality of life for most domains (ES ranging from 0.34 for mental health to 0.48 for social functioning). No significant differences were found for other sociodemographics, mood state, or attitudes toward or perceived social support for PA. Conclusions: The participants who self-selected for trial participation reported lower PA levels before diagnosis and a stronger need for support compared with nonparticipants. The trial thus included those patients who might benefit the most from internet-based supportive PA interventions. Trial Registration: Netherlands trial register NTR6911; https://www.trialregister.nl/trial/6733 ",
doi="10.2196/25464",
url="https://cancer.jmir.org/2021/4/e25464",
url="http://www.ncbi.nlm.nih.gov/pubmed/34609311"
}


@Article{info:doi/10.2196/27063,
author="Loeb, Stacy
and Massey, Philip
and Leader, E. Amy
and Thakker, Sameer
and Falge, Emily
and Taneja, Sabina
and Byrne, Nataliya
and Rose, Meredith
and Joy, Matthew
and Walter, Dawn
and Katz, S. Matthew
and Wong, L. Risa
and Selvan, Preethi
and Keith, W. Scott
and Giri, N. Veda",
title="Gaps in Public Awareness About BRCA and Genetic Testing in Prostate Cancer: Social Media Landscape Analysis",
journal="JMIR Cancer",
year="2021",
month="Sep",
day="20",
volume="7",
number="3",
pages="e27063",
keywords="genetic testing",
keywords="BRCA",
keywords="prostate cancer",
keywords="breast cancer",
keywords="social media",
keywords="infodemiology",
abstract="Background: Genetic testing, particularly for BRCA1/2, is increasingly important in prostate cancer (PCa) care, with impact on PCa management and hereditary cancer risk. However, the extent of public awareness and online discourse on social media is unknown, and presents opportunities to identify gaps and enhance population awareness and uptake of advances in PCa precision medicine. Objective: The objective of this study was to characterize activity and engagement across multiple social media platforms (Twitter, Facebook, and YouTube) regarding BRCA and genetic testing for PCa compared with breast cancer, which has a long history of public awareness, advocacy, and prominent social media presence. Methods: The Symplur Signals online analytics platform was used to obtain metrics for tweets about (1) \#BRCA and \#breastcancer, (2) \#BRCA and \#prostatecancer, (3) \#genetictesting and \#breastcancer, and (4) \#genetictesting and \#prostatecancer from 2016 to 2020. We examined the total number of tweets, users, and reach for each hashtag, and performed content analysis for a subset of tweets. Facebook and YouTube were queried using analogous search terms, and engagement metrics were calculated. Results: During a 5-year period, there were 10,005 tweets for \#BRCA and \#breastcancer, versus 1008 tweets about \#BRCA and \#prostatecancer. There were also more tweets about \#genetictesting and \#breastcancer (n=1748), compared with \#genetic testing and \#prostatecancer (n=328). Tweets about genetic testing (12,921,954) and BRCA (75,724,795) in breast cancer also had substantially greater reach than those about PCa (1,463,777 and 4,849,905, respectively). Facebook groups and pages regarding PCa and BRCA/genetic testing had fewer average members, new members, and new posts, as well as fewer likes and followers, compared with breast cancer. Facebook videos had more engagement than YouTube videos across both PCa and breast cancer content. Conclusions: There is substantially less social media engagement about BRCA and genetic testing in PCa compared with breast cancer. This landscape analysis provides insights into strategies for leveraging social media platforms to increase public awareness about PCa germline testing, including use of Facebook to share video content and Twitter for discussions with health professionals. ",
doi="10.2196/27063",
url="https://cancer.jmir.org/2021/3/e27063",
url="http://www.ncbi.nlm.nih.gov/pubmed/34542414"
}


@Article{info:doi/10.2196/30430,
author="Bandala-Jacques, Antonio
and Castellanos Esquivel, Daniel Kevin
and P{\'e}rez-Hurtado, Fernanda
and Hern{\'a}ndez-Silva, Cristobal
and Reynoso-Nover{\'o}n, Nancy",
title="Prostate Cancer Risk Calculators for Healthy Populations: Systematic Review",
journal="JMIR Cancer",
year="2021",
month="Sep",
day="3",
volume="7",
number="3",
pages="e30430",
keywords="prostate cancer",
keywords="risk calculator",
keywords="risk reduction",
abstract="Background: Screening for prostate cancer has long been a debated, complex topic. The use of risk calculators for prostate cancer is recommended for determining patients' individual risk of cancer and the subsequent need for a prostate biopsy. These tools could lead to better discrimination of patients in need of invasive diagnostic procedures and optimized allocation of health care resources Objective: The goal of the research was to systematically review available literature on the performance of current prostate cancer risk calculators in healthy populations by comparing the relative impact of individual items on different cohorts and on the models' overall performance. Methods: We performed a systematic review of available prostate cancer risk calculators targeted at healthy populations. We included studies published from January 2000 to March 2021 in English, Spanish, French, Portuguese, or German. Two reviewers independently decided for or against inclusion based on abstracts. A third reviewer intervened in case of disagreements. From the selected titles, we extracted information regarding the purpose of the manuscript, analyzed calculators, population for which it was calibrated, included risk factors, and the model's overall accuracy. Results: We included a total of 18 calculators from 53 different manuscripts. The most commonly analyzed ones were the Prostate Cancer Prevention Trial (PCPT) and European Randomized Study on Prostate Cancer (ERSPC) risk calculators developed from North American and European cohorts, respectively. Both calculators provided high diagnostic ability of aggressive prostate cancer (AUC as high as 0.798 for PCPT and 0.91 for ERSPC). We found 9 calculators developed from scratch for specific populations that reached a diagnostic ability as high as 0.938. The most commonly included risk factors in the calculators were age, prostate specific antigen levels, and digital rectal examination findings. Additional calculators included race and detailed personal and family history. Conclusions: Both the PCPR and ERSPC risk calculators have been successfully adapted for cohorts other than the ones they were originally created for with no loss of diagnostic ability. Furthermore, designing calculators from scratch considering each population's sociocultural differences has resulted in risk tools that can be well adapted to be valid in more patients. The best risk calculator for prostate cancer will be that which has been calibrated for its intended population and can be easily reproduced and implemented. Trial Registration: PROSPERO CRD42021242110; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=242110 ",
doi="10.2196/30430",
url="https://cancer.jmir.org/2021/3/e30430",
url="http://www.ncbi.nlm.nih.gov/pubmed/34477564"
}


@Article{info:doi/10.2196/28370,
author="Evans, EL Holly
and Forbes, C. Cynthia
and Galv{\~a}o, A. Daniel
and Vandelanotte, Corneel
and Newton, U. Robert
and Wittert, Gary
and Chambers, Suzanne
and Vincent, D. Andrew
and Kichenadasse, Ganessan
and Girard, Danielle
and Brook, Nicholas
and Short, E. Camille",
title="Usability, Acceptability, and Safety Analysis of a Computer-Tailored Web-Based Exercise Intervention (ExerciseGuide) for Individuals With Metastatic Prostate Cancer: Multi-Methods Laboratory-Based Study",
journal="JMIR Cancer",
year="2021",
month="Jul",
day="28",
volume="7",
number="3",
pages="e28370",
keywords="exercise",
keywords="metastatic prostate cancer",
keywords="behavioral change",
keywords="eHealth",
keywords="computer-tailoring",
keywords="usability",
keywords="acceptability",
abstract="Background: Digital health interventions such as tailored websites are emerging as valuable tools to provide individualized exercise and behavioral change information for individuals diagnosed with cancer. Objective: The aim of this study is to investigate and iteratively refine the acceptability and usability of a web-based exercise intervention (ExerciseGuide) for men with metastatic prostate cancer and determine how well individuals can replicate the video-based exercise prescription. Methods: A laboratory-based multi-methods design was used, incorporating questionnaires, think-aloud tests, interviews, and movement screening among 11 men aged 63 to 82 years with metastatic prostate cancer. Overall, 9 participants were undergoing androgen deprivation therapy, and 2 were completing chemotherapy. Data were collected in two waves, with changes made for quality improvement after participant 5. Results: The intervention's usability score was deemed moderate overall but improved after modifications (from 60, SD 2.9 to 69.6, SD 2.2 out of 100). Overall, the participants found the intervention acceptable, with scores improving from wave 1 (24.2, SD 1.1 out of 30) to wave 2 (26.3, SD 2.1 out of 30). The personalized multimodal exercise prescription and computer-tailored education were seen as valuable. After wave 1, website navigation videos were added, medical terminology was simplified, and a telehealth component was included after expert real-time telehealth support was requested. Wave 2 changes included the added variety for aerobic exercise modes, reduced computer-tailoring question loads, and improved consistency of style and grammar. Finally, the participants could replicate the resistance exercise videos to a satisfactory level as judged by the movement screen; however, additional technique cueing within the videos is recommended to address safety concerns. Conclusions: The acceptability and usability of ExerciseGuide were deemed satisfactory. Various problems were identified and resolved. Notably, the participants requested the inclusion of personalized expert support through telehealth. The resistance training algorithms were shown to provide appropriate content safely, and the users could replicate the exercise technique unaided to a satisfactory level. This study has optimized the ExerciseGuide intervention for further investigation in this population. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001978257; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001978257 ",
doi="10.2196/28370",
url="https://cancer.jmir.org/2021/3/e28370",
url="http://www.ncbi.nlm.nih.gov/pubmed/34318759"
}


@Article{info:doi/10.2196/21502,
author="O'Connor, R. Sean
and Flannagan, Carrie
and Parahoo, Kader
and Steele, Mary
and Thompson, Samantha
and Jain, Suneil
and Kirby, Michael
and Brady, Nuala
and Maguire, Roma
and Connaghan, John
and McCaughan, M. Eilis",
title="Efficacy, Use, and Acceptability of a Web-Based Self-management Intervention Designed to Maximize Sexual Well-being in Men Living With Prostate Cancer: Single-Arm Experimental Study",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="26",
volume="23",
number="7",
pages="e21502",
keywords="prostate cancer",
keywords="sexual well-being",
keywords="digital interventions",
keywords="self-management",
abstract="Background: Sexual dysfunction is a frequent side effect associated with different prostate cancer treatment approaches. It can have a substantial impact on men and their partners and is associated with increased psychological morbidity. Despite this, sexual concerns are often not adequately addressed in routine practice. Evidence-based web-based interventions have the potential to provide ongoing information and sexual well-being support throughout all stages of care. Objective: The aim of this study is to examine the efficacy of a web-based self-management intervention designed to maximize sexual well-being in men living with prostate cancer and explore user perspectives on usability and acceptability. Methods: We used a single-arm study design, and participants were provided with access to the 5-step intervention for a period of 3 months. The intervention content was tailored based on responses to brief screening questions on treatment type, relationship status, and sexual orientation. Efficacy was assessed by using two-tailed, paired sample t tests for comparing the mean differences between pre- and postintervention measurements for exploring the participants' self-reported knowledge and understanding, sexual satisfaction, and comfort in discussing sexual issues. Usability and acceptability were determined based on the program use data and a postintervention survey for exploring perceived usefulness. Results: A total of 109 participants were recruited for this study. Significant postintervention improvements at follow-up were observed in the total scores (out of 20) from the survey (mean 12.23/20 points, SD 2.46 vs mean 13.62/20, SD 2.31; t88=9.570; P=.001) as well as in individual item scores on the extent to which the participants agreed that they had sufficient information to manage the impact that prostate cancer had on their sex life (mean 2.31/4 points, SD 0.86 vs mean 2.57/4, SD 0.85; t88=3.660; P=.001) and had the potential to have a satisfying sex life following treatment (mean 2.38/4 points, SD 0.79 vs mean 3.17/4, SD 0.78; t88=7.643; P=.001). The median number of intervention sessions was 3 (range 1-11), and intervention sessions had a median duration of 22 minutes (range 8-77). Acceptable usability scores were reported, with the highest result observed for the question on the extent to which the intervention provided relevant information. Conclusions: This study provides evidence on the efficacy of a tailored web-based intervention for maximizing sexual well-being in men living with prostate cancer. The results indicate that the intervention may improve one's self-perceived knowledge and understanding of how to manage sexual issues and increase self-efficacy or the belief that a satisfactory sex life could be achieved following treatment. The findings will be used to refine the intervention content before testing as part of a larger longitudinal study for examining its effectiveness. ",
doi="10.2196/21502",
url="https://www.jmir.org/2021/7/e21502",
url="http://www.ncbi.nlm.nih.gov/pubmed/34309580"
}


@Article{info:doi/10.2196/27970,
author="Yu, Shun
and Le, Anh
and Feld, Emily
and Schriver, Emily
and Gabriel, Peter
and Doucette, Abigail
and Narayan, Vivek
and Feldman, Michael
and Schwartz, Lauren
and Maxwell, Kara
and Mowery, Danielle",
title="A Natural Language Processing--Assisted Extraction System for Gleason Scores: Development and Usability Study",
journal="JMIR Cancer",
year="2021",
month="Jul",
day="2",
volume="7",
number="3",
pages="e27970",
keywords="NLP",
keywords="Gleason score",
keywords="prostate cancer",
keywords="natural language processing",
abstract="Background: Natural language processing (NLP) offers significantly faster variable extraction compared to traditional human extraction but cannot interpret complicated notes as well as humans can. Thus, we hypothesized that an ``NLP-assisted'' extraction system, which uses humans for complicated notes and NLP for uncomplicated notes, could produce faster extraction without compromising accuracy. Objective: The aim of this study was to develop and pilot an NLP-assisted extraction system to leverage the strengths of both human and NLP extraction of prostate cancer Gleason scores. Methods: We collected all available clinical and pathology notes for prostate cancer patients in an unselected academic biobank cohort. We developed an NLP system to extract prostate cancer Gleason scores from both clinical and pathology notes. Next, we designed and implemented the NLP-assisted extraction system algorithm to categorize notes into ``uncomplicated'' and ``complicated'' notes. Uncomplicated notes were assigned to NLP extraction and complicated notes were assigned to human extraction. We randomly reviewed 200 patients to assess the accuracy and speed of our NLP-assisted extraction system and compared it to NLP extraction alone and human extraction alone. Results: Of the 2051 patients in our cohort, the NLP system extracted a prostate surgery Gleason score from 1147 (55.92\%) patients and a prostate biopsy Gleason score from 1624 (79.18\%) patients. Our NLP-assisted extraction system had an overall accuracy rate of 98.7\%, which was similar to the accuracy of human extraction alone (97.5\%; P=.17) and significantly higher than the accuracy of NLP extraction alone (95.3\%; P<.001). Moreover, our NLP-assisted extraction system reduced the workload of human extractors by approximately 95\%, resulting in an average extraction time of 12.7 seconds per patient (vs 256.1 seconds per patient for human extraction alone). Conclusions: We demonstrated that an NLP-assisted extraction system was able to achieve much faster Gleason score extraction compared to traditional human extraction without sacrificing accuracy. ",
doi="10.2196/27970",
url="https://cancer.jmir.org/2021/3/e27970",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255641"
}


@Article{info:doi/10.2196/22394,
author="Castaldo, Rossana
and Cavaliere, Carlo
and Soricelli, Andrea
and Salvatore, Marco
and Pecchia, Leandro
and Franzese, Monica",
title="Radiomic and Genomic Machine Learning Method Performance for Prostate Cancer Diagnosis: Systematic Literature Review",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="1",
volume="23",
number="4",
pages="e22394",
keywords="prostate cancer",
keywords="machine learning",
keywords="systematic review",
keywords="meta-analysis",
keywords="diagnosis",
keywords="imaging",
keywords="radiomics",
keywords="genomics",
keywords="clinical",
keywords="biomarkers",
abstract="Background: Machine learning algorithms have been drawing attention at the joining of pathology and radiology in prostate cancer research. However, due to their algorithmic learning complexity and the variability of their architecture, there is an ongoing need to analyze their performance. Objective: This study assesses the source of heterogeneity and the performance of machine learning applied to radiomic, genomic, and clinical biomarkers for the diagnosis of prostate cancer. One research focus of this study was on clearly identifying problems and issues related to the implementation of machine learning in clinical studies. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, 816 titles were identified from the PubMed, Scopus, and OvidSP databases. Studies that used machine learning to detect prostate cancer and provided performance measures were included in our analysis. The quality of the eligible studies was assessed using the QUADAS-2 (quality assessment of diagnostic accuracy studies--version 2) tool. The hierarchical multivariate model was applied to the pooled data in a meta-analysis. To investigate the heterogeneity among studies, I2 statistics were performed along with visual evaluation of coupled forest plots. Due to the internal heterogeneity among machine learning algorithms, subgroup analysis was carried out to investigate the diagnostic capability of machine learning systems in clinical practice. Results: In the final analysis, 37 studies were included, of which 29 entered the meta-analysis pooling. The analysis of machine learning methods to detect prostate cancer reveals the limited usage of the methods and the lack of standards that hinder the implementation of machine learning in clinical applications. Conclusions: The performance of machine learning for diagnosis of prostate cancer was considered satisfactory for several studies investigating the multiparametric magnetic resonance imaging and urine biomarkers; however, given the limitations indicated in our study, further studies are warranted to extend the potential use of machine learning to clinical settings. Recommendations on the use of machine learning techniques were also provided to help researchers to design robust studies to facilitate evidence generation from the use of radiomic and genomic biomarkers. ",
doi="10.2196/22394",
url="https://www.jmir.org/2021/4/e22394",
url="http://www.ncbi.nlm.nih.gov/pubmed/33792552"
}


@Article{info:doi/10.2196/19238,
author="Chan, M. June
and Van Blarigan, L. Erin
and Langlais, S. Crystal
and Zhao, Shoujun
and Ramsdill, W. Justin
and Daniel, Kimi
and Macaire, Greta
and Wang, Elizabeth
and Paich, Kellie
and Kessler, R. Elizabeth
and Beer, M. Tomasz
and Lyons, S. Karen
and Broering, M. Jeanette
and Carroll, R. Peter
and Kenfield, A. Stacey
and Winters-Stone, M. Kerri",
title="Feasibility and Acceptability of a Remotely Delivered, Web-Based Behavioral Intervention for Men With Prostate Cancer: Four-Arm Randomized Controlled Pilot Trial",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="31",
volume="22",
number="12",
pages="e19238",
keywords="diet",
keywords="physical activity",
keywords="exercise",
keywords="lifestyle",
keywords="cancer",
keywords="survivorship",
keywords="text messages",
keywords="internet",
abstract="Background: Diet and exercise may be associated with quality of life and survival in men with prostate cancer. Objective: This study aimed to determine the feasibility and acceptability of a remotely delivered web-based behavioral intervention among men with prostate cancer. Methods: We conducted a multi-site 4-arm pilot randomized controlled trial of a 3-month intervention (TrueNTH Community of Wellness). Eligibility included self-reported prostate cancer diagnosis, having a personal device that connected to the internet, age ?18 years, and ability to read English and receive text messages and emails. Men receiving chemotherapy or radiation, or those who reported contraindications to exercise, could participate with physician clearance. Participants were randomized (1:1:1:1) to additive intervention levels: website; website and personalized diet and exercise prescription; website, personalized prescription, Fitbit, and text messages; and website, personalized prescription, Fitbit, text messages, and 2 30-minute phone calls---one with an exercise trainer and one with a registered dietician. Primary outcomes were feasibility (accrual and attrition) and acceptability (survey data and website use). We described self-reported diet and exercise behavior at the time of enrollment, 3 months, and 6 months as secondary outcomes. Results: In total, 202 men consented and were randomized between August 2017 and September 2018 (level 1: 49, level 2: 51, level 3: 50, level 4: 52). A total of 160 men completed the onboarding process and were exposed to their randomly assigned intervention (38, 38, 42, and 42 in levels 1, 2, 3, and 4, respectively). The follow-up rate was 82.7\% (167/202) at 3 months and 77.2\% (156/202) at 6 months. Participants had a median age of 70 years and were primarily White and college educated. Website visit frequency over the 3-month intervention period increased across levels (median: 2, 9, 11, and 16 visits for levels 1, 2, 3, and 4, respectively). Most were satisfied or very satisfied with the intervention (20/39, 51\%; 27/42, 64\%; 23/44, 52\%; and 27/42, 64\% for levels 1, 2, 3, and 4, respectively). The percentage of men who reported being very satisfied was highest among level 4 participants (10/42, 24\% vs 4/39, 10\%; 5/42, 12\%; and 5/44, 11\% for levels 1, 2, and 3, respectively). Dissatisfaction was highest in level 1 (5/39, 13\% vs 1/42, 2\%; 3/44, 7\%; and 2/42, 5\% for levels 2, 3, and 4, respectively). We observed small improvements in diet and physical activity at 3 months among men in level 4 versus those in level 1. Conclusions: A web-based, remotely delivered, tailored behavioral intervention for men with prostate cancer is feasible. Future studies are warranted to increase the effect of the intervention on patient behavior while maintaining sustainability and scalability as well as to design and implement interventions for more diverse populations. Trial Registration: ClinicalTrials.gov NCT03406013; http://clinicaltrials.gov/ct2/show/NCT03406013 ",
doi="10.2196/19238",
url="http://www.jmir.org/2020/12/e19238/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33382378"
}


@Article{info:doi/10.2196/16322,
author="Chen, Alan I-Hsuan
and Chu, Chi-Hsiang
and Lin, Jen-Tai
and Tsai, Jeng-Yu
and Yu, Chia-Cheng
and Sridhar, Narasimha Ashwin
and Sooriakumaran, Prasanna
and Loureiro, V. Rui C.
and Chand, Manish",
title="Prostate Cancer Risk Calculator Apps in a Taiwanese Population Cohort: Validation Study",
journal="J Med Internet Res",
year="2020",
month="Dec",
day="18",
volume="22",
number="12",
pages="e16322",
keywords="diagnosis",
keywords="mHealth",
keywords="mobile apps",
keywords="prostate cancer",
keywords="prostate-specific antigen",
keywords="risk calculator",
abstract="Background: Mobile health apps have emerged as useful tools for patients and clinicians alike, sharing health information or assisting in clinical decision-making. Prostate cancer (PCa) risk calculator mobile apps have been introduced to assess risks of PCa and high-grade PCa (Gleason score ?7). The Rotterdam Prostate Cancer Risk Calculator and Coral--Prostate Cancer Nomogram Calculator apps were developed from the 2 most-studied PCa risk calculators, the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the North American Prostate Cancer Prevention Trial (PCPT) risk calculators, respectively. A systematic review has indicated that the Rotterdam and Coral apps perform best during the prebiopsy stage. However, the epidemiology of PCa varies among different populations, and therefore, the applicability of these apps in a Taiwanese population needs to be evaluated. This study is the first to validate the PCa risk calculator apps with both biopsy and prostatectomy cohorts in Taiwan. Objective: The study's objective is to validate the PCa risk calculator apps using a Taiwanese cohort of patients. Additionally, we aim to utilize postprostatectomy pathology outcomes to assess the accuracy of both apps with regard to high-grade PCa. Methods: All male patients who had undergone transrectal ultrasound prostate biopsies in a single Taiwanese tertiary medical center from 2012 to 2018 were identified retrospectively. The probabilities of PCa and high-grade PCa were calculated utilizing the Rotterdam and Coral apps, and compared with biopsy and prostatectomy results. Calibration was graphically evaluated with the Hosmer-Lemeshow goodness-of-fit test. Discrimination was analyzed utilizing the area under the receiver operating characteristic curve (AUC). Decision curve analysis was performed for clinical utility. Results: Of 1134 patients, 246 (21.7\%) were diagnosed with PCa; of these 246 patients, 155 (63\%) had high-grade PCa, according to the biopsy results. After confirmation with prostatectomy pathological outcomes, 47.2\% (25/53) of patients were upgraded to high-grade PCa, and 1.2\% (1/84) of patients were downgraded to low-grade PCa. Only the Rotterdam app demonstrated good calibration for detecting high-grade PCa in the biopsy cohort. The discriminative ability for both PCa (AUC: 0.779 vs 0.687; DeLong's method: P<.001) and high-grade PCa (AUC: 0.862 vs 0.758; P<.001) was significantly better for the Rotterdam app. In the prostatectomy cohort, there was no significant difference between both apps (AUC: 0.857 vs 0.777; P=.128). Conclusions: The Rotterdam and Coral apps can be applied to the Taiwanese cohort with accuracy. The Rotterdam app outperformed the Coral app in the prediction of PCa and high-grade PCa. Despite the small size of the prostatectomy cohort, both apps, to some extent, demonstrated the predictive capacity for true high-grade PCa, confirmed by the whole prostate specimen. Following our external validation, the Rotterdam app might be a good alternative to help detect PCa and high-grade PCa for Taiwanese men. ",
doi="10.2196/16322",
url="http://www.jmir.org/2020/12/e16322/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33337340"
}


@Article{info:doi/10.2196/14241,
author="Bender, L. Jacqueline
and Feldman-Stewart, Deb
and Tong, Christine
and Lee, Karen
and Brundage, Michael
and Pai, Howard
and Robinson, John
and Panzarella, Tony",
title="Health-Related Internet Use Among Men With Prostate Cancer in Canada: Cancer Registry Survey Study",
journal="J Med Internet Res",
year="2019",
month="Nov",
day="19",
volume="21",
number="11",
pages="e14241",
keywords="prostate cancer",
keywords="internet",
keywords="health decision making",
keywords="digital divide",
abstract="Background: After a prostate cancer diagnosis, men want information about their disease and treatment options. The internet offers a convenient means to deliver health information to patients with prostate cancer. However, there are concerns about the use of the internet among this largely senior population. Objective: This study aimed to determine the patterns and factors associated with the use of the internet as a source of health information among Canadian men with prostate cancer and the features and information required in a website. Methods: Population surveys were conducted in four Canadian provinces (British Columbia, Alberta, Saskatchewan, and Ontario) in 2014-2015. Data analyses included descriptive, bivariable, and multivariable analyses. The Pearson Chi-square and univariable regression were used to examine associations between independent variables and health-related internet use. Correlates of health-related internet use were analyzed using multivariable logistic regression. Results: A total of 1362 patients responded across the four provinces. The mean age of respondents was 69 years (SD 8.2). In addition, 82\% (n=1071) were internet users and 71\% (n=910) used the internet daily. Further, 65\% (n=784) used the internet as a source of prostate cancer information, and 40\% (n=521) were confident about using information obtained from the internet to make health decisions. Men who used the internet to obtain prostate cancer information were more likely to be active information seekers (odds ratio [OR]: 4.5, 95\% CI 2.6-7.8), be confident using information from the internet to make health decisions (OR: 3.6, 95\% CI 2.3-5.7), have broadband internet access (OR: 1.8, 95\% CI 1.2-2.7), and have more unmet supportive care needs (OR: 1.05, 95\% CI 1.0-1.1). Top features wanted in a website, reported by more than 50\% of respondents, were a library of resources (n=893, 65.6\%), tools to support treatment decision making (n=815, 59.8\%), and tools to help navigate the prostate cancer journey (n=698, 51.2\%). Top three topics of information wanted in such a website were treatment options (n=916, 67.3\%), disease progression (n=904, 66.4\%), and management of side effects (n=858, 63\%). Conclusions: Over two-thirds of Canadian patients with prostate cancer surveyed use the internet as a source of health information about prostate cancer, but over half did not feel confident using information from the internet to make health decisions. Being an active information seeker, having confidence in using information from the internet to make health decisions, having broadband internet, and having more unmet supportive care needs were significantly associated with health-related internet use. Future work should examine electronic health literacy interventions as a means to boost men's confidence in using information from the internet and design websites that include information and features that help men navigate the prostate cancer journey and support treatment decision making and management of side effects. ",
doi="10.2196/14241",
url="http://www.jmir.org/2019/11/e14241/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31742561"
}


@Article{info:doi/10.2196/14094,
author="Balakrishnan, S. Ashwin
and Nguyen, G. Hao
and Shinohara, Katsuto
and Au Yeung, Reuben
and Carroll, R. Peter
and Odisho, Y. Anobel",
title="A Mobile Health Intervention for Prostate Biopsy Patients Reduces Appointment Cancellations: Cohort Study",
journal="J Med Internet Res",
year="2019",
month="Jun",
day="2",
volume="21",
number="6",
pages="e14094",
keywords="text messaging",
keywords="appointments and schedules",
keywords="mHealth",
keywords="quality improvement",
keywords="urology",
keywords="prostate neoplasm",
abstract="Background: Inadequate patient education and preparation for office-based procedures often leads to delayed care, poor patient satisfaction, and increased costs to the health care system. We developed and deployed a mobile health (mHealth) reminder and education program for patients scheduled for transrectal prostate biopsy. Objective: We aimed to evaluate the impact of an mHealth reminder and education program on appointment cancellation rates, communication frequency, and patient satisfaction. Methods: We developed a text message (SMS, short message service)--based program with seven reminders containing links to Web-based content and surveys sent over an 18-day period (14 days before through 3 days after prostate biopsy). Messages contained educational content, reminders, and readiness questionnaires. Demographic information, appointment cancellations or change data, and patient/provider communication events were collected for 6 months before and after launching the intervention. Patient satisfaction was evaluated in the postintervention cohort. Results: The preintervention (n=473) and postintervention (n=359) cohorts were composed of men of similar median age and racial/ethnic distribution living a similar distance from clinic. The postintervention cohort had significantly fewer canceled or rescheduled appointments (33.8\% vs 21.2\%, P<.001) and fewer same-day cancellations (3.8\% vs 0.5\%, P<.001). There was a significant increase in preprocedural telephone calls (0.6 vs 0.8 calls per patient, P=.02) in the postintervention cohort, but not a detectable change in postprocedural calls. The mean satisfaction with the program was 4.5 out of 5 (SD 0.9). Conclusions: An mHealth periprocedural outreach program significantly lowered appointment cancellation and rescheduling and was associated with high patient satisfaction scores with a slight increase in preprocedural telephone calls. This led to fewer underused procedure appointments and high patient satisfaction. ",
doi="10.2196/14094",
url="https://www.jmir.org/2019/6/e14094/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31199294"
}


@Article{info:doi/10.2196/11625,
author="Ekstedt, Mirjam
and Schildmeijer, Kristina
and Wennerberg, Camilla
and Nilsson, Lina
and Wannheden, Carolina
and Hellstr{\"o}m, Amanda",
title="Enhanced Patient Activation in Cancer Care Transitions: Protocol for a Randomized Controlled Trial of a Tailored Electronic Health Intervention for Men With Prostate Cancer",
journal="JMIR Res Protoc",
year="2019",
month="Mar",
day="22",
volume="8",
number="3",
pages="e11625",
keywords="medical informatics",
keywords="eHealth",
keywords="mHealth",
keywords="motivation",
keywords="patient activation",
keywords="prostate cancer",
keywords="self-management",
abstract="Background: Prostate cancer has increased in incidence worldwide and is the leading cause of cancer death in 24 countries. The most common treatment is radical prostatectomy. However, surgery is associated with postoperative complications such as urinary incontinence and sexual dysfunction, causing decreased quality of life. If survivors are encouraged to be more active in self-care management, the symptom burden may decrease and quality of life may improve. An electronic health (eHealth) intervention based on motivational behavioral theory has been developed for this purpose. Objective: This study aimed to compare the effectiveness of standard care in combination with a tailored eHealth and mobile health self-management support system, electronic Patient Activation in Treatment at Home (ePATH), with standard care of adverse effects of prostate cancer treatment (urinary incontinence and sexual functioning) in men undergoing radical prostatectomy. The secondary aim was to test the effect on patient activation, motivation, overall well-being, and health literacy over time in and between groups. Methods: A pragmatic multicenter, block-randomized controlled trial with 2 study arms, standard care (control) and eHealth-assisted standard care (intervention), for patients undergoing radical prostatectomy. For 80\% power, a sample of 242 men will need to be recruited. Results: Recruitment started in January 2018 and is expected to be completed by August 2019. Data collection will be completed in August 2020. The first cross-sectional results from this trial are anticipated to be published in January 2020. Conclusions: With the increasing number of prostate cancer survivors, attention should be paid to rehabilitation, psychosocial care, and support for endurance of self-care to reduce suffering from adverse treatment effects, poor quality of life, and depression because of postoperative complications. This project may increase knowledge of how patients can be supported to feel involved in their care and returning to as normal a life as possible. The anticipated effects of ePATH could improve health outcomes for individuals and facilitate follow-up for health care professionals. Trial Registration: International Standard Randomised Controlled Trial Number: 18055968; http://www.isrctn.com/ISRCTN18055968 (Archived by WebCite at http://www.isrctn.com/ISRCTN18055968). International Registered Report Identifier (IRRID): DERR1-10.2196/11625 ",
doi="10.2196/11625",
url="http://www.researchprotocols.org/2019/3/e11625/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30900999"
}


@Article{info:doi/10.2196/10352,
author="Rat, C{\'e}dric
and Schmeltz, Heloise
and Rocher, Sylvain
and Nanin, France
and Gaultier, Aur{\'e}lie
and Nguyen, Jean-Michel",
title="Factors Related to Prostate-Specific Antigen--Based Prostate Cancer Screening in Primary Care: Retrospective Cohort Study of 120,587 French Men Over the Age of 50 Years",
journal="JMIR Public Health Surveill",
year="2018",
month="Oct",
day="23",
volume="4",
number="4",
pages="e10352",
keywords="prostate cancer",
keywords="screening",
keywords="prostate-specific antigen testing",
keywords="general practice",
keywords="primary care",
abstract="Background: International guidelines recommend avoiding prostate-specific antigen (PSA)-based prostate cancer screening in the elderly when life expectancy is less than 10 years. For younger men, most recommendations encourage a shared decision-making process taking into account patient comorbidities. Objective: The objective was to assess the performance of PSA-based prostate cancer screening in men older than 74 years and assess whether the presence (vs absence) of comorbidities was related to the performance of PSA testing in younger men aged 50 to 74 years who were eligible for screening. Methods: We analyzed data from the French national health care database (Loire-Atlantique geographic area). We reported the follow-up of two cohorts of men from April 1, 2014, to March 31, 2016: 22,480 men aged over 74 years and 98,107 men aged 50 to 74 years. We analyzed whether these patients underwent PSA testing after 2 years of follow-up and whether PSA testing performance was related to the following patient-related variables: age, low income, proxy measures indicative of major comorbidities (repeated ambulance transportation, having one of 30 chronic diseases, taking 5 or more drugs per day), or proxy measures indicative of specific comorbidities (cancer diseases, cardiovascular diseases, or psychiatric disorders). Statistical analysis was based on a multivariate mixed-effects logistic regression. Results: The proportion of patients who underwent a PSA-based screening test was 41.35\% (9296/22,480) among men older than 74 years versus 41.05\% (40,275/98,107) among men aged 50 to 74 years. The following factors were associated with less frequent PSA testing in men older than 74 years---age (odds ratio [OR] 0.89, 95\% CI 0.88-0.89), low income (OR 0.18, 95\% CI 0.05-0.69), suffering from a chronic disease (OR 0.82, 95\% CI 0.76-0.88), repeated ambulance transportation (OR 0.37, 95\% CI 0.31-0.44), diabetes requiring insulin (OR 0.51, 95\% CI 0.43-0.60), dementia (OR 0.68, 95\% CI 0.55-0.84), and antipsychotic treatment (OR 0.62, 95\% CI 0.51-0.75)---whereas cardiovascular drug treatment was associated with more frequent PSA testing (OR 1.6, 95\% CI 1.53-1.84). The following factors were associated with less frequent PSA testing in men aged 50 to 74 years---low income (OR 0.61, 95\% CI 0.55-0.68); nonspecific conditions related to frailty: suffering from a chronic disease (OR 0.80, 95\% CI 0.76-0.83), repeated ambulance transportation (OR 0.29, 95\% CI 0.23-0.38), or chronic treatment with 5 or more drugs (OR 0.89, 95\% CI 0.83-0.96); and various specific comorbidities: anticancer drug treatment (OR 0.67, 95\% CI 0.55-0.83), diabetes requiring insulin (OR 0.55, 95\% CI 0.49-0.61), and antiaggregant treatment (OR 0.91, 95\% CI 0.86-0.96)---whereas older age (OR 1.07, 95\% CI 1.07-1.08) and treatment with other cardiovascular drugs (OR 2.23, 95\% CI 2.15-2.32) were associated with more frequent PSA testing. Conclusions: In this study, 41.35\% (9296/22,480) of French men older than 74 years had a PSA-based screening test. Although it depends on patient comorbidities, PSA testing remains inappropriate in certain populations. ",
doi="10.2196/10352",
url="http://publichealth.jmir.org/2018/4/e10352/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30355559"
}