Abstract:
OBJECTIVE:To assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. DESIGN:Population based, prospective cohort study with follow-up over 15 years. SETTING:New South Wales, Australia. PARTICIPANTS:1642 men with localised prostate cancer, aged less than 70, and 786 controls randomly recruited from the New South Wales electoral roll into the New South Wales Prostate Cancer Care and Outcomes Study (PCOS). MAIN OUTCOME MEASURES:General health and disease specific quality of life were self-reported at seven time points over a 15 year period, using the 12-item Short Form Health Survey scale, University of California, Los Angeles prostate cancer index, and expanded prostate cancer index composite short form (EPIC-26). Adjusted mean differences were calculated with controls as the comparison group. Clinical significance of adjusted mean differences was assessed by the minimally important difference, defined as one third of the standard deviation (SD) from the baseline score. RESULTS:At 15 years, all treatment groups reported high levels of erectile dysfunction, depending on treatment (62.3% (active surveillance/watchful waiting, n=33/53) to 83.0% (non-nerve sparing radical prostatectomy, n=117/141)) compared with controls (42.7% (n=44/103)). Men who had external beam radiation therapy or high dose rate brachytherapy or androgen deprivation therapy as primary treatment reported more bowel problems. Self-reported urinary incontinence was particularly prevalent and persistent for men who underwent surgery, and an increase in urinary bother was reported in the group receiving androgen deprivation therapy from 10 to 15 years (year 10: adjusted mean difference -5.3, 95% confidence interval -10.8 to 0.2; year 15: -15.9; -25.1 to -6.7). CONCLUSIONS:Patients receiving initial active treatment for localised prostate cancer had generally worse long term self-reported quality of life than men without a diagnosis of prostate cancer. Men treated with radical prostatectomy faired especially badly, particularly in relation to long term sexual outcomes. Clinicians and patients should consider these long term quality of life outcomes when making treatment decisions.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Mazariego CG,Egger S,King MT,Juraskova I,Woo H,Berry M,Armstrong BK,Smith DPdoi
10.1136/bmj.m3503subject
Has Abstractpub_date
2020-10-07 00:00:00pages
m3503eissn
0959-8138issn
1756-1833journal_volume
371pub_type
杂志文章abstract:OBJECTIVE:To determine the prevalence of asthma in cohorts of Finnish young men in the period 1926-89. DESIGN:A retrospective analysis using reports and statistics of Finnish defence forces. SETTING:Call up examinations of candidates for military conscription and examination of conscripts discharged because of poor h...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6746.266
更新日期:1990-08-04 00:00:00
abstract::The results of the work of the Edinburgh Rehabilitation Medicine Service in one year were evaluated. Over 1400 new patients were seen, of whom 525 were in hospital at the time. Patients most often referred were those who had had cardiovascular accidents, back pain, lower limb amputations, and head injuries and those c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6648.601
更新日期:1988-09-03 00:00:00
abstract::The UN has reported that five multinational pharmaceutical companies would cut down HIV drug prices in the developing world. One of these drug companies is GlaxoWellcome, which has promised to reduce the price of zidovudine and lamivudine to US$2 in the poorest nations, a fifth of its price in the US. Although Peter ...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.320.7246.1357
更新日期:2000-05-20 00:00:00
abstract:OBJECTIVE:To identify modifiable factors that influence relatives' decision to allow organ donation. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, and CINAHL, without language restriction, searched to April 2008. Review methods Three authors independently assessed the eligibility of the identified studies. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.b991
更新日期:2009-04-21 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of interventions designed to improve outcomes in patients with multimorbidity in primary care and community settings. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, CINAHL, CAB Health, Cochrane central register of controlled trials, the database of abstracts of review...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.e5205
更新日期:2012-09-03 00:00:00
abstract:OBJECTIVE:To study prevalence of Turner's syndrome in Denmark and to assess validity of prenatal diagnosis. DESIGN:Study of data on prenatal and postnatal Turner's syndrome in Danish Cytogenetic Central Register. SUBJECTS:All registered Turner's syndrome karyotypes (100 prenatal cases and 215 postnatal cases) during ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7022.16
更新日期:1996-01-06 00:00:00
abstract:OBJECTIVE:To review and critically appraise published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at increased risk of becoming infected with...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m1328
更新日期:2020-04-07 00:00:00
abstract::The identification of the gene for cystic fibrosis has led to the possibility of population based screening for carriers of cystic fibrosis to identify couples at risk of having an affected child. Pilot studies have shown that screening is feasible and does not cause untoward anxiety, though the uptake of testing vari...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6908.849
更新日期:1993-10-02 00:00:00
abstract:OBJECTIVES:To determine the relation between the HIV/AIDS epidemic and support for dependent elderly people in Africa. DESIGN:Retrospective analysis using data from Demographic and Health Surveys. SETTING:22 African countries between 1991 and 2006. PARTICIPANTS:123,176 individuals over the age of 60. MAIN OUTCOME M...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c2841
更新日期:2010-06-16 00:00:00
abstract:OBJECTIVES:To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type. DESIGN:Prospective intervention study which was later costed. SETTING:Inner city acci...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7042.1340
更新日期:1996-05-25 00:00:00
abstract:OBJECTIVE:To discover if there is an association between respiratory tract infections and pericoronitis of erupting third molars in young adults. DESIGN:Data from male military conscripts' medical records were collected over five years and the incidence of respiratory tract infection before and after acute pericoronit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6983.834
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. DESIGN:Randomised controlled trial. SETTING:Care in a community hospital and district general hospital in Bra...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38498.387569.8F
更新日期:2005-08-06 00:00:00
abstract:OBJECTIVE:To assess the efficacy of a newly developed system for applying continuous or intermittent negative (subatmospheric) extrathoracic pressure in respiratory failure. DESIGN:Uncontrolled clinical trials in infants deteriorating or failing to improve despite standard medical treatment. SETTING:Paediatric and ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.299.6710.1253
更新日期:1989-11-18 00:00:00
abstract:OBJECTIVE:To investigate socioeconomic variation among young women in the risk of hospital admission for diseases (including neoplasms) of the female genital system and breast and for the common surgical procedures of dilatation and curettage and hysterectomy. DESIGN:Large nationally representative cohort study with i...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7009.840
更新日期:1995-09-30 00:00:00
abstract:OBJECTIVES:To examine the incidence of suicides due to co-proxamol compared with tricyclic antidepressants and paracetamol, and to compare fatality rates for self poisonings with these drugs. DESIGN:Analysis of routinely collected national and local data on suicides and self poisonings. SETTING:Records of suicides in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.326.7397.1006
更新日期:2003-05-10 00:00:00
abstract::The aim of the study was to determine the outcome in 181 diabetic patients with advanced, previously untreated renal impairment who had been identified in a survey conducted in six health regions in the United Kingdom in 1985. Late in 1987 questionnaires were sent to the consultant physicians, geriatricians, and nephr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6708.1135
更新日期:1989-11-04 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e3086
更新日期:2012-05-15 00:00:00
abstract:OBJECTIVES:To determine the association between ambulance response time and survival from out of hospital cardiopulmonary arrest and to estimate the effect of reducing response times. DESIGN:Cohort study. SETTING:Scottish Ambulance Service. SUBJECTS:All out of hospital cardiopulmonary arrests due to cardiac disease ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7299.1385
更新日期:2001-06-09 00:00:00
abstract:OBJECTIVE:To assess relative efficacy and toxicity of aminoglycosides given by single daily dose compared with multiple daily doses. DESIGN:Meta-analysis of 21 randomised trials identified through MEDLARS (1966 to January 1995). Data were overviewed with fixed effects and random effects models and with meta-regression...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.312.7027.338
更新日期:1996-02-10 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of two peritendinous autologous blood injections in addition to a standardised eccentric calf strengthening programme in improving pain and function in patients with mid-portion Achilles tendinopathy. DESIGN:Single centre, participant and single assessor blinded, parallel group, r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.f2310
更新日期:2013-04-18 00:00:00
abstract:OBJECTIVE:To determine whether women with atrial fibrillation have a higher risk of stroke than men. DESIGN:Nationwide retrospective cohort study. SETTING:Patients with a diagnosis of atrial fibrillation in the Swedish hospital discharge register between 1 July 2005 and 31 December 2008. Information about drug treatm...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e3522
更新日期:2012-05-30 00:00:00
abstract::There is currently much debate about how to improve undergraduate medical education, and in particular on how best to prepare students for clinical responsibility. For 20 years a period of trainee internship has formed part of New Zealand medical students' undergraduate training, and the model could have much to offer...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6925.398
更新日期:1994-02-05 00:00:00
abstract:OBJECTIVE:To determine the effects of perineal massage in the second stage of labour on perineal outcomes. DESIGN:Randomised controlled trial. PARTICIPANTS:At 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progres...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.322.7297.1277
更新日期:2001-05-26 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexually transmitted infections among gay men. DESIGN:Randomised controlled trial with 12 months' follow up. SETTING:Sexual health clinic in London. PARTICIPANTS:343 gay men with an acute sexually tran...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.322.7300.1451
更新日期:2001-06-16 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy. DESIGN:Randomised controlled trial. SETTING:Neurology outpatient clinics in three Dutch hospitals. PARTICIPANTS:205 patients with symptoms and signs of cervica...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b3883
更新日期:2009-10-07 00:00:00
abstract:AIM:To compare perinatal morbidity and mortality for babies delivered in water with rates for babies delivered conventionally (not in water). DESIGN:Surveillance study (of all consultant paediatricians) and postal survey (of all NHS maternity units). SETTING:British Isles (surveillance study); England and Wales (post...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7208.483
更新日期:1999-08-21 00:00:00
abstract:OBJECTIVE:To investigate whether breast feeding is related to subsequent risk of breast cancer. DESIGN:Population based case-control study designed primarily to investigate the relation between oral contraceptives and risk of breast cancer; data obtained from questionnaires administered by interviewers, general practi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6895.17
更新日期:1993-07-03 00:00:00
abstract::For an unprepared sexually active teenager the 1990s present a minefield of potential problems in addition to the most obvious problems of unplanned pregnancy and sexually transmitted disease. Promoting the importance of a healthy sexual and reproductive life to young people requires openness, better sex education, re...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6957.786
更新日期:1994-09-24 00:00:00
abstract:OBJECTIVES:To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm(3) at start of antiretroviral therapy. DESIGN:Cohort study. SETTING:Outpatient HIV c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d6016
更新日期:2011-10-11 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America. DESIGN:Matched case-control study. SETTING:Sev...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c2825
更新日期:2010-06-15 00:00:00