Learning Curve of Digital Rectal Examination for Prostate Cancer Among Internship

Study Overview
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Brief Summary
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The investigators conduct this prospective study to investigate the learning curve of digital rectal examination (DRE) for prostate cancer among internship. The investigators want to know how many DRE are usually needed for internship to be performed in urological practice to obtain a stable DRE accuracy.

Detailed Description
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Digital rectal examination (DRE) is a basic physical examination in routine practice in Urology. The DRE is a very important daily practice for screen prostate cancer, and each internship in Urology is required to perform this for patients suspected of prostate cancer or benign prostate hyperplasia. However, how many DRE are usually needed for a internship to perform so as to obtain a stable accuracy in daily practice is currently unknown. The investigators thus conduct this prospective trial to investigate the learning curve of DRE among internship.

Official Title
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Learning Curve of Digital Rectal Examination for Prostate Cancer Among Internship

Conditions
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Prostatic Neoplasms, Digital Rectal Examination, Benign Prostatic Hyperplasia

Intervention / Treatment
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* Behavioral: Routine review of DRE results by attending doctors


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Internship just graduate from the medical school, and agree to attend the study. Internship have less than 5 DREs of prostate cancer. Patients of any age who are included for prostate biopsy are eligible, the indications for prostate biopsy are as follows: PSA>4ng/ml, fPSA/tPSA<0.16, with suspected palpable nodes in the prostate by DRE of attending doctor, suspected mass in prostate detected by ultrasound examination, magnetic resonance imaging, or computed tomography. Exclusion Criteria: Internship who are not willing to attend the study. Internship stop doing DRE for continuously 3 months after entering the study.
Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1<br>In this group, internship are given the pathology outcome of each prostate biopsy regularly twice a month. | Behavioral: Routine review of DRE results by attending doctors<br>* Let the internship regularly compare DRE result and the pathology outcome of prostate biopsy of each patient.<br>|
| Group 2<br>In this group, internship are not given the pathology outcome of each prostate biopsy. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensitivity and specificity of DRE performed by internship will be confirmed by prostate biopsy | To examine the sensitivity and specificity of the DRE performed by internship to reference standard of prostate biopsy in a prospective longitudinal cohort of around 700 participants who will undergo prostate biopsy due to suspect of prostate cancer. The investigators will investigate the sensitivity and specificity of DRE by different internship monthly. | One year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensitivity and specificity of DRE performed by internship with different training plan will be confirmed by prostate biopsy | To examine the sensitivity and specificity of the DRE performed by internship (group 1 with routinely review of pathologic outcome of prostate biopsy twice a month, and group 2 internship who are not told the results of prostate biopsy) to standard reference of prostate biopsy. | One year | 
| Sensitivity and specificity of DRE performed by internship will be compared to the results of fPSA/tPSA and MRI. | To compare the sensitivity and specificity of DRE to fPSA/tPSA and MRI (not any patients are required to have MRI examination of prostate, this will be determined at the discretion of attending doctor) to reference standard of prostate biopsy. | One year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prostate cancer; Benign Prostatic Hyperplasia; Digital Rectal Examination; Accuracy