Unsolicited written comments: an untapped data source.

PURPOSE/OBJECTIVES: To explore methods for analysis of unsolicited comments written on forced-choice surveys related to health-related quality of life (HRQOL) among men treated for prostate cancer. DATA SOURCES: Unsolicited comments written on surveys administered as part of a study investigating HRQOL for men receiving surgery, external beam radiation therapy, or brachytherapy for prostate cancer were abstracted from the parent study database at baseline (pretreatment) and 1, 2, 4, 8, 12, 18, and 24 months after treatment. DATA SYNTHESIS: Researchers read through all of the comments for each timepoint. They coded each comment for the main idea expressed by each statement in each written comment. They grouped codes into categories and counted the number of participants writing comments in each category at each timepoint. They were displayed graphically. Of 375 subjects completing surveys, 87% wrote unsolicited comments on at least one of the surveys. Thirty-four codes were derived from 3,175 comments. Grouping of the codes resulted in eight categories. CONCLUSIONS: Analyzing unsolicited comments proved to be feasible and useful in revealing additional information about respondent concerns. IMPLICATIONS FOR NURSING: This type of analysis has value in its ability to reveal patterns in previously unused data that then can be used to explain or deepen survey findings or suggest avenues for more in-depth qualitative or quantitative nursing investigation.

Flutamide in men with prostatic intraepithelial neoplasia: a randomized, placebo-controlled chemoprevention trial.

High-grade prostatic intraepithelial neoplasia (HGPIN) has been identified as a premalignant change in the prostate that indicates increased risk of the subsequent development of prostate adenocarcinoma. Prior studies have suggested that androgen deprivation therapy causes a regression of HGPIN. We therefore conducted a chemoprevention trial assessing the efficacy of flutamide in reducing the rate of prostate adenocarcinoma development in men with HGPIN. Men with biopsyproven HGPIN but no evidence of prostate adenocarcinoma were randomized in a double-blind manner to either flutamide 250 mg/d or a placebo. Treatment was continued for 1 year. Repeat biopsies were obtained at 12 and 24 months. Quality of life and toxicities related to treatment were also measured. Sixty patients were randomized and began therapy with either flutamide or placebo. At 1 year, 14% of men receiving flutamide and 10% of men receiving placebo had developed prostate adenocarcinoma. Flutamide-associated toxicities were mild to moderate in severity. Quality-of-life measures did not show any differences between the 2 groups. This study showed no evidence of benefit from flutamide as a chemoprevention agent in men with HGPIN.