# Improving outcomes of patients with advanced prostate cancer through a better understanding of provider decision-making

> **NIH NIH K08** · DUKE UNIVERSITY · 2024 · $144,761

## Abstract

PROJECT SUMMARY/ABSTRACT
Candidate: Deborah Kaye, MD, MS is a urologic oncologist and junior health services researcher focused on
improving the outcomes for patients with cancer. Dr. Kaye’s long-term goal is to become an independent
surgeon-scientist with expertise in quantitative and qualitative research methods, an in- depth understanding of
provider decision-making and intervention and clinical trial design, in order to devise, evaluate and implement
effective health care policies to improve the lives of patients with cancer.
Research Context: Numerous systemic therapies have recently been approved for the treatment of advanced
prostate cancer, demonstrating modest improvements in median survival fromtwo to five months. Unfortunately,
little is known regarding which therapies, or combinations of therapies, are most effective. What is known,
however, is that each option differs significantly in route of administration, side effects, and price. Currently,
treatment for advanced prostate cancer varies significantly based on provider specialty and location, and patient
race and income. With sparse comparative effectiveness evidence, treatment recommendations rely heavily on
physician preference and experience, which likely contributes to differential patient outcomes and payment
disparities. Economic and non-economic drivers of provider decision-making remain a critical knowledge gap in
advanced prostate cancer. Moreover, few interventions exist to decrease the out-of-pocket payments, and
therefore potentially improve outcomes for patients with advance prostate cancer.
Specific Aims: 1) To determine the factors contributing to provider decision-making for initial choice of systemic
therapy for advanced prostate cancer. 2) To develop a cost-transparency intervention to decrease patient OoP
payments for advanced prostate cancertreatment. 3) To pilot test the feasibility, acceptability, usability and initial
signals of efficacy of a cost-transparency intervention.
Research Plan: Dr. Kaye will use qualitative research methods (focus groups, patient and provider interviews)
to determine the factors impacting provider decision-making and type of first-line systemic therapy received, and
use iterative intervention design to devise a cost-transparency intervention to lower patient out-of-pocket
payments and improve outcomes for patients with advanced prostate cancer. Finally, this proposal will test the
feasibility, acceptability, usability and initial signals of efficacy of the cost-transparency intervention with a two-
arm randomized pilot trial
Career Development Plan: In parallel with the outlined research plan and under the guidance of experienced
mentors, Dr. Kaye will develop expertise in: 1) provider decision-making; 2) qualitative research methods; 3)
intervention and clinical trial design.

## Key facts

- **NIH application ID:** 10897019
- **Project number:** 5K08CA267062-03
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Deborah R. Kaye
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $144,761
- **Award type:** 5
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10897019

## Citation

> US National Institutes of Health, RePORTER application 10897019, Improving outcomes of patients with advanced prostate cancer through a better understanding of provider decision-making (5K08CA267062-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10897019. Licensed CC0.

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