Study designs of evaluations included in the review
Randomised controlled trials (RCTs) and prospective and retrospective cohort studies, focusing on early localised prostate cancer with a study group size greater than 50 but preferably greater than 100, were eligible for inclusion.
Specific interventions included in the review
No inclusion criteria relating to the intervention were specified. The interventions addressed in the review were as follows.
Diagnosis or screening: digital rectal examination (DRE), prostate- specific antigen (PSA), transrectal ultrasound imaging (TRUS) and needle biopsy. The tests were assessed both alone and in combination, e.g. DRE plus PSA.
Treatment: radical prostatectomy, radiotherapy and conservative management.
Reference standard test against which the new test was compared
No inclusion criteria relating to the reference standard were specified for the diagnostic studies. The studies included in this section of the review appear to have used needle biopsy as the reference standard.
Participants included in the review
No inclusion criteria relating to the characteristics of the participants were specified. The participants in the included studies were as follows.
Diagnosis: males who were either volunteers or were referrals for suspected prostate cancer.
Treatment: males with diagnosed prostate cancer.
Screening: volunteers, attendees at clinics, and responders to adverts.
Outcomes assessed in the review
The included studies were required to use outcome measure appropriate to diagnostic techniques or therapeutic interventions. The outcome measures used were as follows.
Diagnosis: sensitivity and specificity.
Treatment: disease progression, mortality, continence and potency.
How were decisions on the relevance of primary studies made?
The lead reviewer mainly made decisions on the relevance of primary studies, but with support from three other reviewers who were each responsible for a specific study area (epidemiology and screening; PSA studies; economic evaluations). Any disagreements were resolved by discussion.