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Semantics in active surveillance for men with localized prostate cancer — results of a modified Delphi consensus procedure

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Bruinsma, SM 
Roobol, MJ 
Carroll, PR 
Klotz, L 
Pickles, T 


Active surveillance (AS) is broadly described as a management option for men with low-risk prostate cancer, but semantic heterogeneity exists in both the literature and in guidelines. To address this issue, a panel of leading prostate cancer specialists in the field of AS participated in a consensus-forming project using a modified Delphi method to reach international consensus on definitions of terms related to this management option. An iterative three-round sequence of online questionnaires designed to address 61 individual items was completed by each panel member. Consensus was considered to be reached if ≥70% of the experts agreed on a definition. To facilitate a common understanding among all experts involved and resolve potential ambiguities, a face-to-face consensus meeting was held between Delphi survey rounds two and three. Convenience sampling was used to construct the panel of experts. In total, 12 experts from Australia, France, Finland, Italy, the Netherlands, Japan, the UK, Canada and the USA participated. By the end of the Delphi process, formal consensus was achieved for 100% (n = 61) of the terms and a glossary was then developed. Agreement between international experts has been reached on relevant terms and subsequent definitions regarding AS for patients with localized prostate cancer. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.



cancer therapy, prostate cancer, scientific community and society

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Nature Reviews Urology

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Nature Publishing Group
This study is linked to a larger project, The Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative, which is a collaboration between institutions, hospitals and research centres from the USA, Canada, Australia, Singapore, Japan, Korea, UK, Ireland, the Netherlands, France, Sweden, Finland, Switzerland, Italy and Spain. The Movember Foundation has invested 1,664,950 euros in GAP3 to create the largest centralized prostate cancer active surveillance database to date. This funder did not have any role in the study design, collection, analysis or interpretation of data, or in the drafting of this paper. For information, contact M.J.R.