Concordance between patient-reported and physician-reported sexual function after radical prostatectomy

Area of Science:

• Urology
• Health Services Research

Background:

• Accurate tracking of health-related quality-of-life post-radical prostatectomy is crucial for patient counseling and surgical technique refinement.
• Physicians frequently overestimate functional recovery in patients after this procedure.

Purpose of the Study:

• To measure concordance between surgeon-assessed and patient-reported outcomes following radical prostatectomy.
• To evaluate a novel feedback system aimed at improving surgeon awareness of functional recovery discrepancies.

Main Methods:

• Men undergoing radical prostatectomy completed the International Index of Erectile Function-6 questionnaire.
• Physicians assessed sexual function on a 5-point scale; erectile dysfunction (ED) was defined by specific score thresholds.
• A feedback system (Amplio) was implemented in May 2013 to report concordance data to physicians.

Main Results:

• Data from 3,053 men (2009-2015) showed 83% agreement on ED before feedback implementation.
• Physicians overestimated function in 10% of cases and reported ED when patients did not in 7% of cases.
• Agreement showed a non-significant increase post-feedback, potentially due to a ceiling effect and high baseline concordance.

Conclusions:

• Baseline agreement between patient-reported and physician-assessed outcomes was high, limiting the significant impact of the feedback system.
• Systematic capture of patient-reported outcomes in routine clinical care may contribute to high agreement rates.