Dear Sir, Madam,
My name is Saskia Peters, I am a student at the University of Nijmegen
in the Netherlands. I am a trainee at the catalan agency for Health
Technology Assessment. I am performing a survey as part of the my last
year at the University of Nijmegen in which I hope to get my degree in
Biomedical Health Science.
Please find in this message a questionnaire regarding prostate cancer
screening, to which I cordially invite you to respond. This
questionnaire is part of an international study on the evaluation and
implementation of local, regional and national prostate cancer
screening policies.
There is a controversy on the appropriateness of prostate cancer
screening worldwide. Little is really known about the programmes that
have been implemented all over the world. The objective of this
international comparison is to assess the current standard of clinical
practice with regard to prostate cancer screening in Western Europe,
Canada, Australia and the United States.
The study aims at an international comparison with respect to items
such as the screening recommendation, decision making, the
characteristics of the implemented screening, the screening
population, further therapy and financial coverage.
Please forward this message to agencies for Health Technology
Assessment, doctors active in other organisations or institutes
occupied with implementation, financing, evaluating and decisionmaking
related to prostate cancer screening in different countries.
Please, be so kind to return this questionnaire as soon as possible,
preferably by fax.
The information you supply will not be exchanged with others in any
way that makes your identity recognisable to them and it will be
treated with confidentiality. Please don't hesitate to contact Dr.
Albert J. Jovell or me, should you have any questions or remarks. I
am very grateful for the time you could dedicate to this research.
Yours sincerely,
Saskia Peters
S.M.A.B. Peters
Catalan Agency for Health Technology Assessment
Trav. de les Corts 131-159
Pavelló Ave Maria
08028 Barcelona
Espagna
Telephone: +34-93-2272900
Facsimile: +34-93-227 2998
e-mail: [log in to unmask]
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QUESTIONNAIRE
Evaluation and Implementation of local, regional and national prostate
cancer screening programmes and management policies. A cross-national
comparison of the current standards of clinical practice in Western
Europe, Canada, Australia and the United States.
Instructions:
Please mark the circle of the most appropriate answer to the following
questions. Only in the questions that contain the sentence: ´´ More
than one answer is possible `` is it permitted to mark more than one
option corresponding to the situation in your country. In the
questions with a yes/no choice, please mark the appropriate answer
with a circle.
A General Issues
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1. What is the name of the organisation you are in or you work for,
and in which country is it established?
2. What is it's main area of action? (more than one answer is
possible)
" Technology Assessment
" Clinical Research
" Financing
" Policy making at government level
" Provider of health care and medical services
" University
" Other: please specify
" Don't know / do not answer
B Prostate cancer screening recommendation and performance
3. Is prostate cancer screening RECOMMENDED (recommended means that
it is advised as an effective or appropriate medical technology) in
your country?
IF YES, by which organisations or institutes is the screening
recommended? (more than one answer is possible)
" Government
" Consumers associations
" Research institutes
" Medical society, if appropriate please specify the type of medical
society:
" Other, please specify:
" Don't know, do not answer
4. On what grounds is/was the decision to RECOMMEND or NOT RECOMMEND
prostate cancer screening made? (more than one answer is possible)
" Consensus of specialists on the area of prostate cancer screening
" Research evidence (Information from controlled clinical trials and
systematic reviews)
" The principle of offering patients every available technology that
might be helpful or beneficial to them
" Other, please specify:
" Don't know, do not answer
5. Is prostate cancer screening PERFORMED in your country?
yes/ no
IF YES, please answer the following questions.
IF NO, please go to the final questions #25 and #26 on page 9.
6. In what context is prostate cancer (PC) screening performed in
your country? (more than one answer is possible)
" Performance of PC screening within a formal structural
programme
" Performance of PC screening within a formal study (Randomised Clinical Trial)
" Performance within a pilot study (non-experimental)
" Discretionary, in clinical practice. If this options is appropriate,
please specify who requested the screening:
" request by the GP
" request by the specialist
" request by patient
" Other, please specify:
" Don't know / do not answer
Characteristics of the performed prostate cancer screening
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7. Who is responsible for the performance of the screening? (more
than one answer is possible)
" General Practitioner, primary care
" Urologist
" Oncologist
" Doctors in regional or national organisation concerned with public
health and prevention
" Other, please specify:
" Don't know / do not answer
8. Which tests are used in screening for prostate cancer and in what
order?
" a PSA
Can you please specify the kind of PSA: PSA total,
PSA free, PSA % free, PSA density, PSA velocity:
" b Digital Rectal Examination (DRE)
" c Trans Rectal Ultra Sonography (TRUS)
" d Abdominal Ultrasonography
" e Biopsy
" f Other: please specify:
" g Don't know / do not answer
9. Is there a protocol ( a protocol is a set of explicit recommendations on what to execute in the different steps of the screening procedure and how to
perform it) for the performance of the screening?
yes / no
10. Is there a tumour staging system and/or a grading system used in
the further diagnosis and management of men with positive screening results?
yes / no
IF YES, what staging system is used? (more than one answer is possible)
" Clinical staging system: TNM-classification system
" Clinical staging system: Whitmore and Jewett classification
" Histologic grading system: Gleason score
" Other: please specify
" Don't know / do not answer.
11. Which of the following treatments are used in your country for
the therapy of men with a LOCALISED PROSTATE CANCER? (localised means: screen
detected prostate cancer confined to the prostate gland; more than one answer is possible)
" Radical Prostatectomy
" Nerve-sparing Prostatectomy
" External Radiotherapy
" Brachytherapy
" Watchful observation
" Hormone therapy only
" Coadjuvant hormone therapy
" Thermotherapy
" Other, please specify:
" Don't know / do not answer
In the case of more therapy options, for LOCALISED prostate cancer, which
are the criteria that determine the choice of the therapy?(more than one answer is possible)
" Age of the patient
" Co- morbidities
" Clinical stage of the cancer
" Histological grade
" Patients preferences
" Other, please specify:
" Don't know / do not answer
12 . Which of the following treatments are used in your country
for the therapy of men with ADVANCED PROSTATE CANCER? (advanced means:
prostate cancer extended beyond the prostate gland extracapsular
extension and possible metastases; more than one answer is possible)
" Radical Prostatectomy
" Nerve-sparing Prostatectomy
" External Radiotherapy
" Brachytherapy
" Watchful observation
" Hormone therapy only
" Coadjuvante hormone therapy
" Thermotherapy
" Other, please specify:
" Don't know / do not answer
In the case of more therapy options, for ADVANCED prostate cancer, which
are the criteria that determine the choice of the therapy? (more than one answer is possible)
" Age of the patient
" Co- morbidities
" Clinical stage of the cancer
" Histological grade
" Patients preferences
" Other, please specify:
" Don't know / do not answer
Population screened
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13. What is, in your opinion, the most important factor that lead to actually
undergoing screening for the majority of the screened men? (more than one
answer is possible)
" A mass media request for men to participate in prostate cancer
screening (i.e. Prostate awareness week)
" The fact that they were requested for screening from population
register or census
" The fact that they were requested from hospital
records
" Information they received about prostate cancer screening from General practitioner or Urologist
" The attention paid to prostate cancer screening in the media (i.e. males journals)
" Information they received about prostate cancer at a Work check-up or
exam
" Other, please specify:
" Don't know / do not answer.
14. What is the age cut-off point for participants in prostate cancer screening?
" 40 years old or older
" 45 years old or older
" 50 years old or older
" Other: please specify
" Don't know / do not answer
15. What other selection criteria are used, for men undergoing PC screening?
(more than one answer is possible)
" History of prostatic cancer in the family
" Patient history of prostatic disease
" Patients request
" Individual doctor criteria
" Other, please specify:
" Don't know / do not answer
16. What is the frequency of the call-up schedule, for participants to the PC screening?
" Once a year
" Once in two years
" No formal schedule
" Other: please specify
" Don't know / do not answer.
17. Are there information materials used to inform participants to the PC screening?
yes / no
If yes, please answer the following questions.
· Of what kind? (more than one answer is possible)
" Information on paper (a brochure or leaflet)
" Information on a videotape
" Audio information with participation of the doctor
" Other: please specify
" Don´t know / do not answer.
· Which items do these information materials contain or deal with?
(more than one answer is possible)
" The natural history of the disease
" The benefits of screening
" Possible therapeutic options
" The screening procedure and who is involved in the performance
" The risks and consequences of screening and treatment
" Informed consent procedures
" Second opinion possibility
" Other: please specify
" Don't know / do not answer
Evaluation of prostate cancer screening
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18. Do regional or national schemes exist for monitoring the volume
or amount of the performed tests? yes / no
19. Do regional or national schemes exist for monitoring the quality
of the performance of the tests? yes / no
20. Do regional or national schemes exist for monitoring the
appropriateness of the screening? yes / no
21 Do regional or national schemes exist for monitoring the
results? yes / no
22. Is there an evaluation study attached to the performed
screening? yes / no
IF YES,
· What is the design of this evaluation study?
" Clinical serie
" randomised clinical trial
" observational study
" Other, please specify:
" Don't know / don't answer
· What is the follow up shedule used for patients enrolled in the
study?
" Twice in a year
" once in a year
" once every two years
" Other, please specify:
" Don't know / don't answer
·What are the outcome measures of the study? (more than one answer is
possible)
" Survival / mortality
" Quality of life
" Side effects of the therapy
" PSA
" Relapses
" Metastases
" Other, please specify:
" Don't know / do not answer
· Who funds the evaluation study?
" Specific research fundsd
" National insurance scheme
" Private insurance
" Out of Pocket money
" Other, please specify:
" Don't know / do not answer
23. What is the typology of the Health service in your country?
" National health service
" Health Insurance Based System
" Fee for service
" Managed care
" Other, please specify:
" Don't know / do not answer
24. How is the prostate cancer screening funded?
" Research funds
" National insurance scheme
" Social security
" Private insurance
" Out of Pocket money
" Other, please specify:
" Don't know / do not answer
--END--
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Albert Jovell <[log in to unmask]>
Agencia d'Avaluacio de Tecnologia Medica
Servei Catala de la Salut
Pavello Ave Maria
Travessera de Les Corts 131-159
08028 Barcelona
http://www.aatm.es
Tel:+3493 227 29 00
Fax:+3493 227 29 98
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