Austin Health

Title
Robotic-assisted vs. open radical prostatectomy: A machine learning framework for intelligent analysis of patient-reported outcomes from online cancer support groups.
Publication Date
2018-12
Author(s)
Ranasinghe, Weranja K B
de Silva, Daswin
Bandaragoda, Tharindu
Adikari, Achini
Alahakoon, Damminda
Persad, Raj
Lawrentschuk, Nathan
Bolton, Damien M
Subject
Emotions
Intelligent analysis
Machine learning
Outcomes
Robotic Prostatectomy
Type of document
Journal Article
OrcId
0000-0002-5145-6783
0000-0001-8553-5618
0000-0002-4006-0388
DOI
10.1016/j.urolonc.2018.08.012
Abstract
The advantages of Robot-assisted laparoscopic prostatectomy (RARP) over open radical prostatectomy (ORP) in Prostate cancer perioperatively are well-established, but quality of life is more contentious. Increasingly, patients are utilising online cancer support groups (OCSG) to express themselves. Currently there is no method of analysis of these sophisticated data sources. We have used the PRIME-2 (Patient Reported Information Multidimensional Exploration version 2) framework for automated identification and intelligent analysis of decision-making, functional and emotional outcomes in men undergoing ORP vs. RARP from OCSG discussions. The PRIME-2 framework was developed to retrospectively analyse individualised patient-reported information from 5,157 patients undergoing RARP and 579 ORP. The decision factors, side effects, and emotions in 2 groups were analysed and compared using Chi-squared, t tests, and Pearson correlation. There were no differences in Gleason score, Prostate Specific Antigen (PSA), and age between the groups. Surgeon experience and preservation of erectile function (P < 0.01) were important factors in the decision making process. There were no significant differences in urinary, sexual, or bowel symptoms between ORP and RARP on a monthly basis during the initial 12 months. Emotions expressed by patients undergoing RARP were more consistent and positive while ORP expressed more negative emotions at the time of surgery and 3 months postsurgery (P < 0.05), due to pain and discomfort, and during ninth month due to fear and anxiety of pending PSA tests. ORP and RARP demonstrated similar side effect profiles for 12 months, but PRIME-2 enables identification of important quality of life features and emotions over time. It is timely for clinicians to accept OCSG as an adjunct to Prostate cancer care.
Link
Citation
Urologic oncology 2018; 36(12): 529.e1-529.e9
Jornal Title
Urologic oncology

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