A Foundation In Medical Research
The Sperling Prostate Center recognizes the value of published, peer-reviewed research. Our work is grounded in past and current clinical research conducted by international experts in their field.
Not all research is created equal. Some studies are more valuable than others. It’s important to understand what distinguishes the importance of medical studies. Good research is both valid (does it really measure what it says it’s measuring?) and reliable (will repeated tests over time give the same results, either with the same or different populations?) A small sample of the kinds of expert, authoritative research on which we base our methods is available at our website. See https://sperlingprostatecenter.com/research-2/
One way to judge the merits of a study is how it is designed. The more rigorous the design, and the more faithfully it’s carried out, the more trustworthy the results. The design is submitted for pre-approval from a research board in terms of science, data analysis, and ethics. A solid design helps rule out factors that skew the results, such as the bias of the researchers, poorly matched test groups, etc. Here are the most common types of study designs, starting with the most valuable.
Randomized, controlled double blind studies
This is considered the “gold standard” of research. The goal of randomized studies is to compare the effect of a treatment, such as an investigative drug, with a neutral look-alike (placebo) that has no effect, e.g. an identical sugar pill. Randomized means that patients are randomly assigned to receive either the investigational agent, or the placebo. The group receiving the placebo is called the control group, hence the term “controlled study.” Double blind means that neither the patients nor the doctors know which agent the patient is receiving.
Randomized controlled studies that are not double-blinded
This type of study may be done when a comparison control goup Is needed but double blinding is not possible. For example, comparing the safety of a relatively new focal prostate cancer treatment, such as laser ablation, with one such as cryotherapy (freezing) that already has 5+ years of published safety data (control group) would not be possible to double blind because it’s not possible to disguise the treatment from either doctor or patient. Assuming that the design meets ethical standards, and that all patients enrolled in the study are equally qualified for a focal treatment, they are randomly assigned to one or the other of the two roughly matched treatment groups. Safety data would be collected after treatment over a designated period of time, and statistically analyzed. The comparison results could then be submitted for presentation or publication.
Cohort studies
When randomization is not feasible due to ethical or practical considerations, a cohort study may be undertaken. This means a study-defined population is followed over a period of time to track the results of a treatment or intervention. It can be prospective (meaning the intervention and other factors such as the follow-up period are defined in advance) or it can be an analysis of historic data such as past medical records of the defined population. In either case, the results can be compared with a comparable population that was not exposed to the intervention. This process is considered less reliable than randomized, controlled trials because the two study populations may differ from each other in other ways besides the exposure to the intervention.
Case studies or case reports
These are considered the least valid types of study, though they may generate professional interest. This type of study consists of a detailed report of a medical condition, treatment, or reaction to a treatment. Because there is no control group, there is no basis for comparison. However, if enough case studies on the same condition or treatment are reported in the literature, they may be of value for a doctor looking for a way to shed light on an individual patient’s circumstances.
Literature reviews
In addition to original research in disease, medications and treatment interventions, a useful contribution is a review of existing articles on the same topic. For example, an author might search out every published study and presentation over a five year period on incontinence rates following robotic prostatectomy. The data is pooled, and various methods of mathematical and statistical analysis can be performed to generate conclusions. Some of these reviews are more rigorous than others, depending on conditions that are defined in advance.
Research as our foundation
Sperling Prostate Center takes pride in supporting our BlueLaser® diagnosis and treatment of prostate cancer, with all imaging done using state of the art multiparametric 3T MRI. Expert research, published in peer-reviewed journals and presented before professional peers at international meetings, gives us confidence that we are on track with present success and future progress.
