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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Mixed-methods approach to exploring patients’ perspectives on the acceptability of a urinary biomarker test in replacing cystoscopy for bladder cancer surveillance
BJU International, Volume 124, No. 3, Year 2019
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Description
Objectives: To determine the minimal accepted sensitivity (MAS) of a urine biomarker that patients are willing to accept to replace cystoscopy and to assess qualitatively their views and reasons. Patients and Methods: Patients were part of a prospective multicentre observational study recruiting people with bladder cancer for a urine biomarker study (DETECT II; ClinicalTrials.gov: NCT02781428). A mixed-methods approach comprising (1) a questionnaire to assess patients’ experience with cystoscopy and patients’ preference for cystoscopy vs urinary biomarker, and (2) semi-structured interviews to understand patient views, choice and reasons for their preference. Results: A urine biomarker with an MAS of 90% would be accepted by 75.8% of patients. This was despite a high self-reported prevalence of haematuria (51.0%), dysuria/lower urinary tract symptoms (69.1%) and urinary tract infection requiring antibiotics (25.8%). There was no association between MAS with patient demographics, adverse events experienced, cancer characteristics or distance of patients’ home to hospital. The qualitative analysis suggested that patients acknowledge that cystoscopy is invasive, embarrassing and associated with adverse events but are willing to tolerate the procedure because of its high sensitivity. Patients have confidence in cystoscopy and appreciate the visual diagnosis of cancer. Both low- and high-risk patients would consider a biomarker with a reported sensitivity similar to that of cystoscopy. Conclusion: Patients value the high sensitivity of cystoscopy despite the reported discomfort and adverse events experienced after it. The sensitivity of a urinary biomarker must be close to cystoscopy to gain patients’ acceptance. © 2019 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International
Authors & Co-Authors
Tan, Weishen
United Kingdom, London
University College London
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Feber, Andrew
United Kingdom, London
University College London
United Kingdom, London
Ucl Cancer Institute
Williams, Norman R.
United Kingdom, London
University College London
Brew-Graves, Chris
United Kingdom, London
University College London
Kelly, John D.
United Kingdom, London
University College London
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Khetrapal, Pramit
Unknown Affiliation
Baker, Hilary
Unknown Affiliation
Evans, Steve A.
Unknown Affiliation
Cook, Jonathan A.
Unknown Affiliation
Mills, Robert D.
Unknown Affiliation
Rané, Abhay R.M.
Unknown Affiliation
Collins, Gary S.
Unknown Affiliation
Harris, Marion T.
Unknown Affiliation
Wilson, David C.
Unknown Affiliation
Madaan, Sanjeev
Unknown Affiliation
Moore, James L.
Unknown Affiliation
Cain, Mark P.
Unknown Affiliation
Gregory, Helen
Unknown Affiliation
Mostafid, Hugh A.
Unknown Affiliation
Morrison, John C.
Unknown Affiliation
McDonald, K.
Unknown Affiliation
Henderson, Alex
Unknown Affiliation
Kotze, Maritha J.
Unknown Affiliation
Poile, Charlotte
Unknown Affiliation
Barber, Neil J.
Unknown Affiliation
Statistics
Citations: 13
Authors: 25
Affiliations: 4
Identifiers
Doi:
10.1111/bju.14690
ISSN:
14644096
Research Areas
Cancer
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Qualitative