Factors Influencing Selection of XXXX for Localized @entity263 .

@entity1 @entity263 @entity5 @entity2357 @entity3457
OBJECTIVE: To determine how well demographic and clinical factors predict the initiation of @entity3457 ( @entity3457 ). BACKGROUND: @entity3457 has been suggested as a way to diminish overtreatment of @entity1 with @entity263 ; however, factors associated with the decision to choose @entity3457 are poorly quantified. METHODS: Using the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry we identified 2,977 @entity1 with @entity263 who made treatment decisions from January 1, 2012 through December 31, 2013. We used chi-square and Wilcoxon tests to examine the association between factors and initiation of @entity3457 . @entity2357 models were fit for D'Amico risk categories. Measures of model discrimination and calibration were estimated including area-under-the-curve (AUC) and Brier score (BS). RESULTS: @entity1 age, Gleason score (GS), clinical T-stage, urology practice, and @entity5 volume (greatest percent of a core involved with @entity5 (GPC) and proportion of positive cores) were associated with the decision in the intermediate-risk cohort (AUC = 0.875, BS = 0.07) and the complete cohort (AUC = 0.89, BS = 0.10). @entity1 age, urology practice, and @entity5 volume were significant in the low-risk cohort (AUC = 0.71, BS = 0.22). The addition of urology practice increased AUC in the low risk cohort from 0.71 to 0.76 and reduced BS score from 0.22 to 0.21. CONCLUSIONS: The urology practice at which a @entity1 is seen is an important predictor for whether @entity1 will initiate @entity3457 . Predictions were least accurate for low-risk @entity1 suggesting factors such as @entity1 preference, play a role in treatment decisions.
