Responsiveness of the University of California-Los Angeles Prostate Cancer Index

Published In: Urology, v. 75, no. 6, June 2010, p. 1418-1423

Posted on RAND.org on June 01, 2010

by Jonathan Bergman, Christopher S. Saigal, Lorna Kwan, Mark Litwin

Read More

Access further information on this document at the publisher's website

This article was published outside of RAND. The full text of the article can be found at the link above.

OBJECTIVES: To determine the responsiveness of the University of California-Los Angeles Prostate Cancer Index (UCLA-PCI) by studying its sensitivity to clinically perceptible changes in health over time in men treated for localized prostate cancer. METHODS: All subjects underwent radical prostatectomy (n = 253), external beam radiotherapy (n = 66), or interstitial seed brachytherapy (n = 73). We assessed health-related quality of life (HRQOL) outcomes using the UCLA-PCI to capture disease-specific outcomes and the Medical Outcomes Study Short Form-36 to study general HRQOL. We assessed the UCLA-PCI's responsiveness to change by comparison with the health change item of the Medical Outcomes Study Short Form-36. We measured responsiveness by calculating effect sizes and Guyatt statistics when comparing UCLA-PCI scores between baseline and 1 year and between 1 and 2 years. RESULTS: Of the 475 men who completed all baseline questionnaires, 392 (83%) completed all surveys at 12-month follow-up. Although sexual function decreased from baseline to 12 months in all groups, the magnitude of the negative change was inversely proportional to general health. For those whose general health worsened, effect sizes were > 0.50 across all 6 domains. Effect sizes and Guyatt statistics were lowest (<0.25) for urinary bother, bowel function, and bowel bother in the groups demonstrating either no change or improvement in general health. Responsiveness of the UCLA-PCI in the short-term recovery period (12 months post-treatment) was better than in the chronic recovery phase (12-24 months) across almost all domains. CONCLUSIONS: The UCLA-PCI is responsive to change in assessing HRQOL in men treated for prostate cancer.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.