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Andrew J. Stephenson, M.D. (RWJ)
Associate Professor of Surgery (Urology)
Case Western Reserve University School of Medicine
Project Title: “Decision Analysis Model to Facilitate Treatment Decision Making for Localized Prostate Cancer: A Randomized Trial”
About the Project:
This project built upon Dr. Stephenson’s previous work developing nomograms to predict oncological and quality-of-life outcomes (urinary, sexual and bowel dysfunction) following definitive local therapy.
Andrew J. Stephenson, M.D. is Chief of Urologic Oncology at Cleveland Clinic’s Glickman Urological and Kidney Institute and Associate Professor of Surgery at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. Dr. Stephenson graduated from Colgate University in 1993 with a Bachelor’s degree in molecular biology. He obtained his M.D. degree from University of Western Ontario in London, Canada in 1997 and completed urology residency at McGill University in Montreal. This was followed by fellowship training in urologic oncology and outcomes research at Memorial Sloan-Kettering Cancer Center in New York. He joined Cleveland Clinic in 2006.
Dr. Stephenson is board-certified in urology by the American Board of Urology and the Royal College of Physicians and Surgeons of Canada. He has received several awards from organizations such as the Prostate Cancer Foundation, American Society of Clinical Oncology, and Society of Urologic Oncology. He is listed as one of the Best Doctors in America. This year, he received the Urology Teacher of the Year award from Cleveland Clinic. He is on the editorial board for several urology journals, including Urology, and is an ad hoc reviewer for Journal of the National Cancer Institute, Journal of Clinical Oncology, and Journal of Urology. He is a frequent invited contributor to Nature Reviews Urology.
His clinical and research focus is the treatment of patients with cancers of prostate, bladder and testis. He has published over 50 articles in peer-reviewed journals since 2002 on issues related to prostate, bladder and testicular cancer, many of which have received international mainstream media attention. He has been invited to speak at several major international oncology conferences on these subjects. His research focus is on the development of prognostic statistical models called nomograms. These prognostic models provide accurate predictions of treatment outcome for prostate cancer and are widely used for patient counseling.
For his Physician Faculty Scholar Program project entitled “Decision Model to Facilitate Treatment Decision-Making for Localized Prostate Cancer: a Randomized Trial”, Dr. Stephenson developed a Markov-based decision analysis model for patients with localized prostate cancer that considers individualized predictions of cancer outcome, treatment-related morbidity, and patient-specific utilities for important health states to facilitate treatment decision making. The health states he assessed included living with untreated prostate cancer, erectile dysfunction, bladder dysfunction, bowel dysfunction, and cancer progression. The model estimated the quality-adjusted survival for each treatment option (radical prostatectomy, external-beam radiotherapy, brachytherapy, and active surveillance) and recommended to the patient the treatment option that ranks first. Thus, treatment will be more accurately tailored to the specific characteristics of his cancer and his own values. In a randomized clinical trial, he tested the hypothesis that a decision model as a supplement to standard counseling versus standard physician-patient interactions alone will lead to higher quality treatment decisions that are congruent with a patient’s values leading to reduced decisional regret, improved treatment satisfaction, reduced decisional conflict, and increased likelihood of achieving a patient’s desired health state.
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