Biomedical subjects

David Skarsgard

Publications and source records attributed to David Skarsgard.

4 recordsLinked to original sources

PubMed2006

A randomized controlled trial comparing two educational booklets on prostate cancer.

PURPOSE: To compare the helpfulness of two educational aids or booklets on early-stage prostate cancer. METHOD: Participating consecutive patients and a family member, in three centres, received one of two booklets, one produced by AstraZeneca (AZ), the other produced by us (CCE); the patient and family shared a booklet but were separate study participants. The primary outcome was the Purpose-based Information Assessment completed after participants read their booklet; they rated the importance (4-point Likert scale) of six potential purposes for the information: to help organize their thoughts, understand their situations, decide on treatment, plan, provide emotional support to others, and discuss issues. Each participant then rated how helpful their booklet was (4-point Likert scale) in addressing each purpose they had rated above the lowest importance category. Participants mailed in their responses. RESULTS: Complete data were received from 308 (81%) of those who consented to the study: 152 in the CCE group and 156 in the AZ group. The CCE booklet was read for a longer time [chi(2) = 28.61, p = 0.00] but was easier to find information in chi(2) = 7.6, p = 0.05]. Although for each purpose, most readers rated each booklet in one of the top two (of four) helpfulness categories, the CCE booklet was rated more helpful for: organizing [chi(2) = 30.49, p = 0.00], understanding [chi(2) = 12.07, p = .007], deciding [chi(2) = 9.96, p = 0.02] and planning [chi(2) = 18.67, p = 0.00]. CONCLUSIONS: High helpfulness ratings of both booklets suggest that patients benefit from education aids while differences in the booklet ratings suggest that aids are not equally helpful. The CCE booklet, the more helpful booklet of this study, is a systematically developed education aid available to urologists in Canada.

Humans↗

PubMed2003

Twenty-year follow-up study of long-term survival of limited-stage small-cell lung cancer and overview of prognostic and treatment factors.

PURPOSE: To predict the long-term survival results of clinical trials earlier than using actuarial methods and to assess the factors predictive of long-term cure in patients with limited-stage small-cell lung cancer. METHODS AND MATERIALS: Between 1981 and 1998, 1417 new cases of small-cell lung cancer were diagnosed in Saskatchewan, Canada, of which 244 were limited stage and treated with curative intent. They were followed to the end of February 2002. A parametric lognormal statistical model was retrospectively validated to determine whether long-term survival rates could be estimated several years earlier than is possible using the standard life-table actuarial method. RESULTS: The survival time of the uncured group followed a lognormal distribution. Four 2-year periods of diagnosis were combined, and patients were followed as a cohort for an additional 2 years. The estimated 10-year cause-specific survival rate was 13% by the lognormal model. The Kaplan-Meier calculation for 10-year cause-specific survival rate was 15% +/- 3%. The data also showed that the absence of mediastinal lymphadenopathy and higher chest radiotherapy dose were significant prognostic factors on multivariate analysis (p < 0.05). Among the 163 patients given prophylactic cranial irradiation, a higher biologically effective dose to the brain did not improve survival or decrease the incidence of brain metastases. CONCLUSION: The lognormal model has been validated for the estimation of survival in patients with limited-stage small-cell lung cancer. A higher biologically effective dose to the brain did not improve survival or decrease the incidence of brain metastases.

Algorithms↗

PubMed2003

Evaluation of a question-and-answer booklet on early-stage prostate-cancer.

A question-and-answer booklet about early-stage prostate-cancer was created for patients and their family members. Two sequential studies were conducted to determine if the single source of information would be useful to both patients and their families. The first study used 1:1 interviews with 11 readers (6 patients and 5 family members) to identify features of the booklet that may be problematic. In all, six features were identified as either irrelevant or problematic in their design. The second study was a survey of 54 patients (79% response rate) and 33 family members (49% response rate); the study was designed to obtain an overall evaluation of the booklet, to clarify the proportion of readers for whom the features identified in the first study were problematic, to provide insight into how and why readers were reading the booklet, and to determine if patients and family differed on any of the outcomes. Results showed that 85% of readers liked the booklet; most (81.6%) read it from beginning to end. Most readers in both groups wanted the information to help them understand (85.2% patients; 87.9% family); more patients than family wanted it for treatment decision making (44.4% patients; 27.3% family) and for planning (35.2% patients; 9.1% family); more family (42.4%) than patients (20.4%) wanted the information to help them provide support. We conclude that even though patients and family differ in why they want information, the booklet appears to be considered useful by both groups.

Humans↗

PubMed2002

Prophylactic cranial irradiation revisited: cost-effectiveness and quality of life in small-cell lung cancer.

PURPOSE: To investigate the therapeutic usefulness and cost-effectiveness of prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer (SCLC) who had achieved a complete remission. METHODS: A retrospective chart review was undertaken of all patients diagnosed in Saskatchewan with SCLC between 1987 and 1998 inclusive. Patients who achieved a complete remission were divided into two groups, depending on whether they underwent PCI (PCI+ and PCI-, respectively). The quality-of-life-adjusted survival was estimated by the Q-TWiST method (quality time without symptoms and toxicity). The mean incremental costs per month of incremental OS were calculated in a cost-effectiveness analysis. RESULTS: Among the 98 complete remission patients, the median OS for PCI+ and PCI- patients was 20.0 and 19.0 months, respectively (p > 0.05, nonsignificant). The median disease-free survival was 14.7 and 10.0 months, respectively (p < 0.05). The difference in the mean Q-TWiST survival was significant (p < 0.01). The mean marginal cost was $18,834/PCI+ patient and $17,885/PCI- patient (p > 0.05, nonsignificant). The cost-effectiveness ratio was $70/mo of incremental OS if u(tox) and u(rel) (the utility coefficients to reflect the value of time in health states of toxicity and relapse) were assumed to be 1.0. CONCLUSION: PCI is a cost-effective treatment that improves the quality-of-life-adjusted survival for patients with a complete remission of SCLC.

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