Pd62-05 Patient Perceptions of Standardized Risk Language Used in American College of Radiology Prostate Mri Pirads Scores

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety III (PD62)1 May 2024PD62-05 PATIENT PERCEPTIONS OF STANDARDIZED RISK LANGUAGE USED IN AMERICAN COLLEGE OF RADIOLOGY PROSTATE MRI PIRADS SCORES Jeremiah R. Dallmer, Michael Luu, Rola Saouaf, Brennan Spiegel, Stephen J. Freedland, and Timothy J. Daskivich Jeremiah R. DallmerJeremiah R. Dallmer , Michael LuuMichael Luu , Rola SaouafRola Saouaf , Brennan SpiegelBrennan Spiegel , Stephen J. FreedlandStephen J. Freedland , and Timothy J. DaskivichTimothy J. Daskivich View All Author Informationhttps://doi.org/10.1097/01.JU.0001008656.89655.67.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The 21st Century Cures Act grants US patients access to their online health data including prostate MRI reports that utilize standardized language to describe the risk of clinically significant prostate cancer (csPCa). Lesions are described as "equivocal" (PIRADS 3), "likely" (PIRADS 4), and "highly likely" (PIRADS 5), which AUA guidelines note correspond to risks of 11%, 37%, and 70%, respectively. Yet, patients may misperceive risk associated with standardized language. We aimed to assess perceived risk associated with PIRADS language among men at risk for prostate cancer. METHODS: We conducted a crowdsourced survey of men matching a US prostate cancer demographic based on SEER. Participants were asked their perception of risk associated with PIRADS standardized language across increasing contexts: words only (e.g. "likely"), PIRADS sentences (e.g. "Clinically significant cancer is likely to be present"), full reports, and a full report with numeric risk estimates added. Descriptive statistics were used to describe the median (interquartile range) absolute under/overestimation of risk (EOR) compared against AUA standards. Multivariable linear mixed effects analysis compared demographic factors, health literacy, and numeracy with perceived risk. RESULTS: 1204 participants completed the survey. Participants matched the intended demographic and were highly health literate and numerate. For the words only context, absolute EOR (IQR) for "equivocal" was +39% (+39% to +63%), "likely" +38% (+31% to +48%), and "highly likely" +17% (+8% to +22%). For the PIRADS sentence context, EOR (IQR) was+39% (+39% to +39%), +38% (+31% to +44%), and +20% (+10% to +24%) for PIRADS 3, 4, and 5, respectively. For the full report context, EOR was +39% (IQR +24% to +59%), +35% (+13% to +43%), and +14% (-16% to +21%) for PIRADS 3, 4, and 5, respectively. For the full report with a probabilistic risk estimate describing a PIRADS 4 lesion, EOR was +33% (+23% to +43%). Including numeric estimates with the full report increased the correct perception of risk from 3% to 11% (p<0.001). Only numeracy was associated with correctly interpreting risk when numerical estimates were provided (OR 1.24, p=0.04). CONCLUSIONS: Men substantially overestimate risk of csPCa based on standardized PIRADS language in MRI reports, especially for PIRADS 3 and 4 lesions. This can lead to anxiety or false cancer assumptions. Changes to PIRADS language or data sharing policies for imaging reports should be considered. Source of Funding: This work was supported by Career Development Award (K08 CA230155 to TJD) from the National Cancer Institute © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1287 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jeremiah R. Dallmer More articles by this author Michael Luu More articles by this author Rola Saouaf More articles by this author Brennan Spiegel More articles by this author Stephen J. Freedland More articles by this author Timothy J. Daskivich More articles by this author Expand All Advertisement PDF downloadLoading ...