Using PCORI data to drive better decisions for men with localized - PowerPoint PPT Presentation

Using PCORI data to drive better decisions for men with localized prostate cancer Christopher Saigal MD, MPH Professor and Vice Chair, UCLA Department of Urology Twitter: csaigal 11/2/2018 #PCORI2018

Project team • David Penson , MD MPH, Chair, Dept. of Urology, Vanderbilt • Ralph Conwill , Patient Advisor • Jon Bergman MD, MPH, Assistant Professor of Urology UCLA, OVMC • Moira Inkeles MPH, PhD, Associate Professor UCLA School of Public Health • Merel Nissenberg , Thomas Kirk, California Prostate Cancer Coalition 2

Background and Introduction • Localized prostate cancer is emblematic of “preference sensitive” decision making • Issues with overtreatment and suboptimal decision quality • Innovations in preference measurement, low cost computing power, and patient familiarity with online apps present opportunities to improve 3

Intervention: novel software decision aid 4

5

6

7

Effectiveness of the approach • Adoption by MDs 93% • Fidelity of program 84% • Significant decreases in decisional conflict • Patients reported feeling more informed • Increased measures of shared decision making • Increase in Net Promoter Score 8

Comparative Effectiveness Analysis of Surgery and Radiation for localized prostate cancer (CEASAR) • PCORI- funded 3 year project to assess CE of prostate cancer treatments using population based data • Reflects modern treatment modalities • Racial variation in outcomes: African Americans with worse 1 year urinary continence outcomes • Potency rates after surgery: AMC, 86% CEASAR, 43% • How to get these data out there for patients? 9

Strategies for SDM implementation success • Start with patients • Find “wins” for physicians • Engage health system leadership in the value of SDM • Continuous improvement framework 10

Measuring success • Reach/penetration • Adoption • Fidelity • Maintenance • Decision Quality • Treatment choice in men with low risk disease 11

Patient leadership • Design and conception • Quarterly reviews of statistical process control charts from each site with rest of team; suggest new tactics • Disseminate findings, availability of the tool 12

Challenges/successes? • Identify and overcome system specific work flow barriers • Have made great progress on data modeling already • Engaged and excited implementation sites 13

Learn More • www.pcori.org • info@pcori.org • #PCORI2018 14

Questions? 15

Thank You! Christopher Saigal MD MPH Professor and Vice Chair Twitter: csaigal 11/2/18 16

Discussion Ralph Conwill 17

Roundtable Discussions PCORI funding opportunities in D&I 18