Estudio multicéntrico sobre los comités multidisciplinarios en cáncer de próstata avanzado / Multicenter study on multidisciplinary committees in advanced prostate cancer

Introducción y objetivoAunque los comités multidisciplinares (CMD) están recomendados en el manejo del cáncer de próstata avanzado (CPA), su funcionamiento en práctica real se ha evaluado escasamente. Desarrollamos un estudio multicéntrico con el objetivo de evaluar el funcionamiento de los CMD urooncológicos en seis hospitales.Materiales y métodosRealizamos un estudio transversal descriptivo. El nivel de cumplimiento de los requisitos de calidad fundamentales (CRCF) de los CMD, se evaluó aplicando un cuestionario a los coordinadores de los CMD de cada hospital. La perspectiva de los miembros de los CMD se evaluó aplicando una encuesta anónima telemática.ResultadosEvidenciamos un alto nivel de CRCF en los CMD (75%), mostrando deficiencias en la actualización de protocolos, agendas, auditorías y producción científica. La encuesta fue respondida por un 62,32% de los 69 médicos encuestados (urólogos, oncólogos, radioterapéutas, radiólogos y anatomopatólogos). El 88,4% considera adecuado el tiempo de las reuniones. Existen opiniones dispares sobre la protección del tiempo de las reuniones y la actualización de protocolos. El 62,8% de los pacientes presentados requieren la intervención de dos especialidades. La mitad de los encuestados cree que se discuten todos los casos de CPRC y que existe una agenda previa. Las decisiones del CMD quedan reflejadas en la historia clínica en un 65,1% y son vinculantes en un 60,5%. La mitad de los encuestados niegan capacitación en CMD. La mayoría de los participantes (90,7%) avalan los beneficios de los CMD.ConclusionesLas evaluaciones de los CMD identifican deficiencias subsanables modificando la inercia hospitalaria y la planificación asistencial (AU)

Introduction and objectiveAlthough Multidisciplinary Teams (MDTs) are recommended in the management of Advanced Prostate Cancer (APC), their functioning in real practice has been poorly evaluated. We carried out a multicenter study with the objective of evaluating the functioning of uro-oncology MDTs in 6 hospitals.Materials and methodsA descriptive cross-sectional study was performed. The level of Compliance with the Fundamental Quality Requirements (CFQR) of the MDTs was evaluated by means of a questionnaire filled out by the coordinators of the MDTs in each hospital. The information on the perspective of the members of the MDTs was evaluated through an anonymous survey.ResultsA high level of CFQR in MDTs was evidenced (75%), showing deficiencies in terms of protocol update, agendas, audits, and scientific production. The survey was answered by 62.32% of the 69 physicians surveyed (urologists, oncologists, radiation therapists, radiologists, and pathologists). The 88.4% consider the duration of the meetings appropriate. There are disparate opinions concerning the protection of the MDT meeting time as well as protocol update. Of the patients with APC presented at the MDTs meeting, 62,8% require intervention from two specialties. Only 50% of respondents believe that all CRPC cases are discussed and that there is a prior agenda. The decisions made by the MDTs are reflected in the clinical history in 65.1% and are binding only in 60.5% of the cases. Half of the respondents have not been trained in MDTs. Most participants (90.7%) agree on the fact that MDTs. convey benefits.ConclusionsThe evaluations of the MDTs identify rectifiable deficiencies by modifying hospital inertia and care planning (AU)

Multicenter study on multidisciplinary committees in advanced prostate cancer.

INTRODUCTION AND OBJECTIVE: Although Multidisciplinary Teams (MDTs) are recommended in the management of Advanced Prostate Cancer (APC), their functioning in real practice has been poorly evaluated. We carried out a multicenter study with the objective of evaluating the functioning of uro-oncology MDTs in 6 hospitals. MATERIALS AND METHODS: A descriptive cross-sectional study was performed. The level of Compliance with the Fundamental Quality Requirements (CFQR) of the MDTs was evaluated by means of a questionnaire filled out by the coordinators of the MDTs in each hospital. The information on the perspective of the members of the MDTs was evaluated through an anonymous survey. RESULTS: A high level of CFQR in MDTs was evidenced (75%), showing deficiencies in terms of protocol update, agendas, audits, and scientific production. The survey was answered by 62.32% of the 69 physicians surveyed (urologists, oncologists, radiation therapists, radiologists, and pathologists). The 88.4% consider the duration of the meetings appropriate. There are disparate opinions concerning the protection of the MDT meeting time as well as protocol update. Of the patients with APC presented at the MDTs meeting, 62,8% require intervention from two specialties. Only 50% of respondents believe that all CRPC cases are discussed and that there is a prior agenda. The decisions made by the MDTs are reflected in the clinical history in 65.1% and are binding only in 60.5% of the cases. Half of the respondents have not been trained in MDTs. Most participants (90.7%) agree on the fact that MDTs. convey benefits. CONCLUSIONS: The evaluations of the MDTs identify rectifiable deficiencies by modifying hospital inertia and care planning.

Uso del antígeno prostático específico en atención primaria (PSA) / Use of prostatic specific antigen in primary care (PSA)

Introducción. En la literatura publicada queda demostrado que el uso del PSA es incorrecto en ocasiones, solicitando este marcador en varones muy jóvenes o muy ancianos, y repitiendo determinaciones en cortos periodos de tiempo. El objetivo principal de este trabajo ha sido describir la utilización del PSA en la práctica diaria por parte de los médicos de atención primaria de nuestra área, tratando aspectos como la importancia de la edad de los pacientes, el valor en el cribado del cáncer de próstata, o las creencias subjetivas sobre su utilidad. Como objetivo secundario se ha comparado el uso y las creencias entre los médicos que dicen conocer bien el PSA y los que no. Pacientes y métodos. Estudio descriptivo y comparativo llevado a cabo mediante cuestionarios que fueron administrados en mano a los médicos de atención primaria de todos los centros de salud de nuestra área. Se realizó un análisis descriptivo y se compararon los porcentajes de respuestas entre los médicos que creían tener suficiente información sobre el PSA y los que no mediante un test Chi-cuadrado. Resultados. Se recibieron cuestionarios de 103 profesionales. Un 83,5% afirmaba tener suficiente conocimiento sobre el PSA. Los profesionales de este último grupo solicitan PSA a edades más tempranas (p=0,029), con una mayor frecuencia (p=0,011) y dudan más sobre su utilidad (p=0,009) que aquellos con menor conocimiento. Un 49,5% decía solicitar al año menos de 50 determinaciones, y un 33% entre 50 y 100. Un 53,4% de los médicos no pediría el primer PSA hasta la década de los 50, y hasta un 49% lo solicita hasta los 80 años. Un 64,1% se ha planteado muchas veces la verdadera utilidad del PSA, y un 29,1% cree que es poco útil para diagnosticar cáncer. Conclusiones. En nuestro estudio, el 64% de los médicos de atención primaria se ha planteado bastantes veces la verdadera utilidad del PSA, y un 29% cree que es poco útil para el diagnóstico del cáncer de próstata. Además, algunos datos apuntan a un uso limitado del mismo, como el hecho de que el 50% realizan menos de 50 peticiones de PSA anuales, o que un 28% de los profesionales no lo solicitarían nunca en un varón sin sintomatología urinaria. En el presente trabajo se ha observado que aquellos profesionales que afirman no tener suficiente información sobre el PSA realizan más peticiones en pacientes con edades tardías y se plantean menos la utilidad o el rendimiento del marcador (AU)

Introduction. In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. Patients and methods. A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. Results. A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. Conclusions. In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary symptoms. In this study, it has been observed that those professionals who claim not to have enough information about the PSA make more requests in patients of an older age, and consider that it is of limited use as a marker (AU)

[Use of prostatic specific antigen in primary care (PSA)]. / Uso del antígeno prostático específico en atención primaria (PSA).

INTRODUCTION: In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. PATIENTS AND METHODS: A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. RESULTS: A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. CONCLUSIONS: In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary symptoms. In this study, it has been observed that those professionals who claim not to have enough information about the PSA make more requests in patients of an older age, and consider that it is of limited use as a marker.