Jennifer M. Gierisch, PhD, MPH; Evan R. Myers, MD, MPH; Kristine M. Schmit, MD, MPH; Matthew J. Crowley, MD; Douglas C. McCrory, MD, MHS; Ranee Chatterjee, MD, MPH; Remy R. Coeytaux, MD, PhD; Amy Kendrick, RN, MSN; Gillian D. Sanders, PhD
Disclaimer: The authors of this article are responsible for its content. Statements in this article should not be construed as endorsement by the U.S. Department of Veterans Affairs.
Acknowledgment: The authors thank Megan von Isenburg, MSLS, for help with the literature search and retrieval; Megan M. Chobot, MSLS, for project coordination; and Rebecca Gray, DPhil, for editorial assistance. They also gratefully acknowledge the contributions of members of the stakeholder panel (Peter Beitsch, MD; Laura Esserman, MD, MBA; Temeika Fairley, PhD; Brandel France de Bravo, MPH; Worta McCaskill-Stevens, MD, MS; Donna Pinto; Rinaa Punglia, MD, MPH; Joy Simha; and Debbie Saslow, PhD).
Grant Support: By a contract from PCORI.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2548.
Requests for Single Reprints: Jennifer M. Gierisch, PhD, MPH, Department of Medicine, Duke University Medical Center, Campus Box 104427 DUMC, Durham, NC 27701; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Gierisch: Department of Medicine, Duke University Medical Center, Campus Box 104427 DUMC, Durham, NC 27701.
Dr. Myers: Duke University Medical Center, Box 3279, 244 Baker House, Durham, NC 27710.
Drs. Schmit, McCrory, Coeytaux, and Sanders and Ms. Kendrick: Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715.
Dr. Crowley: Durham Veterans Affairs Medical Center, Health Services Research & Development Service (152), 508 Fulton Street, Durham, NC 27705.
Dr. Chatterjee: Sutton Station Internal Medicine, 5832 Fayetteville Road, Suite 113, Durham, NC 27713.
Author Contributions: Conception and design: J.M. Gierisch, D.C. McCrory, A. Kendrick, G.D. Sanders.
Analysis and interpretation of the data: J.M. Gierisch, E.R. Myers, R. Chatterjee, R.R. Coeytaux, G.D. Sanders.
Drafting of the article: J.M. Gierisch, E.R. Myers, G.D. Sanders.
Critical revision of the article for important intellectual content: J.M. Gierisch, E.R. Myers, M.J. Crowley, D.C. McCrory, G.D. Sanders.
Final approval of the article: J.M. Gierisch, E.R. Myers, M.J. Crowley, D.C. McCrory, R. Chatterjee, R.R. Coeytaux, A. Kendrick, G.D. Sanders.
Provision of study materials or patients: G.D. Sanders.
Statistical expertise: J.M. Gierisch.
Obtaining of funding: J.M. Gierisch, G.D. Sanders.
Administrative, technical, or logistic support: A. Kendrick.
Collection and assembly of data: J.M. Gierisch, E.R. Myers, K.M. Schmit, M.J. Crowley, R. Chatterjee, R.R. Coeytaux, A. Kendrick, G.D. Sanders.
Ductal carcinoma in situ is a common finding in women having mammography screening, and there is considerable uncertainty about the balance of harms and benefits of different management options. This article outlines the process for developing a prioritized research agenda for the Patient-Centered Outcomes Research Institute as informed by a diverse group of stakeholders on the management of ductal carcinoma in situ. Evidence gaps were identified by reviewing existing literature and engaging diverse stakeholders to refine these gaps. Stakeholders ranked evidence gaps by importance from their perspectives using a forced-ranking prioritization method. PubMed was searched for relevant recent studies, and ClinicalTrials.gov was searched for relevant ongoing trials for the 10 highest-ranked evidence gaps. Strengths and limitations of different study designs were assessed to address gaps. Stakeholders prioritized evidence gaps related to incorporation of patient-centered outcomes into future research, development of better methods to predict risk for invasive cancer, evaluation of a strategy of active surveillance, and testing of decision-making tools. The degree to which prioritized evidence gaps may have already been addressed is uncertain because a comprehensive systematic review has not been done.
Overview of prioritization process
Adapted from reference 12. ESG = Evidence Synthesis Group; PCORI = Patient-Centered Outcomes Research Institute.
DCIS = ductal carcinoma in situ; FRN = future research need; MRI = magnetic resonance imaging.
Appendix Table. Final Ranking of Future Research Needs for Management Strategies for DCIS
Table. Study Designs Suggested for Top-Tier Future Research Needs for Management Strategies for DCIS
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Gierisch JM, Myers ER, Schmit KM, Crowley MJ, McCrory DC, Chatterjee R, et al. Prioritization of Research Addressing Management Strategies for Ductal Carcinoma In Situ. Ann Intern Med. 2014;160:484-491. doi: 10.7326/M13-2548
Download citation file:
Published: Ann Intern Med. 2014;160(7):484-491.
Breast Cancer, Hematology/Oncology, Research and Reporting Methods.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only