Pereira-Azevedo Nuno, Osório Luís, Fraga Avelino, Roobol Monique J
Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands.
Urology Department, Porto Hospital Centre, Porto, Portugal.
JMIR Cancer. 2017 Jan 6;3(1):e1. doi: 10.2196/cancer.6750.
The use of prostate cancer screening tools that take into account relevant prebiopsy information (ie, risk calculators) is recommended as a way of determining the risk of cancer and the subsequent need for a prostate biopsy. This has the potential to limit prostate cancer overdiagnosis and subsequent overtreatment. mHealth apps are gaining traction in urological practice and are used by both practitioners and patients for a variety of purposes.
The impetus of the study was to design, develop, and assess a smartphone app for prostate cancer screening, based on the Rotterdam Prostate Cancer Risk Calculator (RPCRC).
The results of the Rotterdam arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC) study were used to elaborate several algorithms that allowed the risk of prostate cancer to be estimated. A step-by-step workflow was established to ensure that depending on the available clinical information the most complete risk model of the RPCRC was used. The user interface was designed and then the app was developed as a native app for iOS. The usability of the app was assessed using the Post-Study System Usability Questionnaire (PSSUQ) developed by IBM, in a group of 92 participants comprising urologists, general practitioners, and medical students.
A total of 11 questions were built into the app, and, depending on the answers, one of the different algorithms of the RPCRC could be used to predict the risk of prostate cancer and of clinically significant prostate cancer (Gleason score ≥7 and clinical stage >T2b). The system usefulness, information quality, and interface quality scores were high-92% (27.7/30), 87% (26.2/30), and 89% (13.4/15), respectively. No usability problems were identified.
The RPCRC app is helpful in predicting the risk of prostate cancer and, even more importantly, clinically significant prostate cancer. Its algorithms have been externally validated before and the usability score shows the app's interface is well designed. Further usability testing is required in different populations to verify these results and ensure that it is easy to use, to warrant a broad appeal, and to provide better patient care.
推荐使用考虑活检前相关信息的前列腺癌筛查工具（即风险计算器）来确定癌症风险以及后续进行前列腺活检的必要性。这有可能限制前列腺癌的过度诊断及后续的过度治疗。移动健康应用程序在泌尿外科实践中越来越受到关注，从业者和患者都出于各种目的使用这些应用程序。
本研究的目的是基于鹿特丹前列腺癌风险计算器（RPCRC）设计、开发并评估一款用于前列腺癌筛查的智能手机应用程序。
欧洲前列腺癌筛查随机研究（ERSPC）鹿特丹研究组的结果被用于精心设计几种算法，以估计前列腺癌风险。建立了一个逐步的工作流程，以确保根据可用的临床信息使用最完整的RPCRC风险模型。设计了用户界面，然后将该应用程序开发为适用于iOS的原生应用程序。使用IBM开发的研究后系统可用性问卷（PSSUQ）对一组由泌尿科医生、全科医生和医学生组成的92名参与者评估该应用程序的可用性。
该应用程序总共内置了11个问题，根据答案，可以使用RPCRC的不同算法之一来预测前列腺癌和临床显著前列腺癌（ Gleason评分≥7且临床分期>T2b）的风险。系统有用性、信息质量和界面质量得分分别很高，为92%（27.7/30）、87%（26.2/30）和89%（13.4/15）。未发现可用性问题。
RPCRC应用程序有助于预测前列腺癌风险，更重要的是，有助于预测临床显著前列腺癌的风险。其算法此前已在外部得到验证，可用性评分表明该应用程序的界面设计良好。需要在不同人群中进行进一步的可用性测试，以验证这些结果，并确保其易于使用，具有广泛的吸引力，并提供更好的患者护理。
