Loeb, Stacy

The use of social media continues to increase in health care and academia. Health care practice, particularly the oncologic field, is constantly changing because of new knowledge, evidence-based research, clinical trials, and government policies. Therefore, oncology trainees and professionals continue to strive to stay up-to-date with practice guidelines, research, and skills. Although social media as an educational and professional development tool is no longer completely new to medicine and has been embraced, it is still under-researched in terms of various outcomes. Social media plays several key roles in professional development and academic advancement. We reviewed the literature to evaluate how social media can be used for professional development and academic promotion of oncology professionals.

Objective To examine the use of the Prostate Health Index ( PHI ) as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicentre US study. Materials and Methods The study population included 728 men, with prostate‐specific antigen ( PSA ) levels of 2–10 ng/ mL and a negative digital rectal examination, enrolled in a prospective, multi‐site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score ≥7. First, we evaluated whether the addition of PHI improves the performance of currently available risk calculators (the Prostate Cancer Prevention Trial [ PCPT ] and European Randomised Study of Screening for Prostate Cancer [ ERSPC ] risk calculators). We also designed and internally validated a new PHI ‐based multivariable predictive model, and created a nomogram. Results Of 728 men undergoing biopsy, 118 (16.2%) had aggressive prostate cancer. The PHI predicted the risk of aggressive prostate cancer across the spectrum of values. Adding PHI significantly improved the predictive accuracy of the PCPT and ERSPC risk calculators for aggressive disease. A new model was created using age, previous biopsy, prostate volume, PSA and PHI , with an area under the curve of 0.746. The bootstrap‐corrected model showed good calibration with observed risk for aggressive prostate cancer and had net benefit on decision‐curve analysis. Conclusion Using PHI as part of multivariable risk assessment leads to a significant improvement in the detection of aggressive prostate cancer, potentially reducing harms from unnecessary prostate biopsy and overdiagnosis.

Objective To evaluate whether genetic correction using the genetic variants prostate‐specific antigen ( PSA )‐single nucleotide polymorphisms ( SNPs ) could reduce potentially unnecessary and/or delayed biopsies in A frican‐ A merican men. Subjects and Methods We compared the genotypes of four PSA ‐ SNPs between 964 C aucasian and 363 A frican‐ A merican men without known prostate cancer ( PCa ). We adjusted the PSA values based on an individual's PSA‐SNP carrier status, and calculated the percentage of men that would meet commonly used PSA thresholds for biopsy (≥2.5 or ≥4.0 ng/mL) before and after genetic correction. Potentially unnecessary and delayed biopsies were defined as those men who were below and above the biopsy threshold after genetic correction, respectively. Results Overall, 349 (96.1%) and 354 (97.5%) A frican‐ A merican men had measured PSA levels <2.5 and <4.0 ng/mL. Genetic correction in A frican‐ A merican men did not avoid any potentially unnecessary biopsies, but resulted in a significant ( P < 0.001) reduction in potentially delayed biopsies by 2.5% and 3.9%, based on the biopsy threshold level. Conclusions There are significant differences in the influence of the PSA ‐ SNPs between A frican‐ A merican and C aucasian men without known PCa , as genetic correction resulted in an increased proportion of A frican‐ A merican men crossing the threshold for biopsy. These results raise the question of whether genetic differences in PSA might contribute to delayed PCa diagnosis in A frican‐ A merican men.