Karen Goldstein, MD, associate professor of Medicine in the Division of General Internal Medicine at the Duke Department of Medicine (DOM), has co-authored a significant systematic review titled “Impact of Genomic Classifiers on Risk Stratification and Treatment Intensity in Patients With Localized Prostate Cancer: A Systematic Review,” published in Annals of Internal Medicine. Recognized as one of the most influential journals in medicine, Annals is the most cited general internal medicine journal globally, with a 2023 impact factor of 19.6.
The study, conducted through the Durham VA Evidence Synthesis Program (ESP), evaluates how genomic classifiers—tools that analyze tumor biology at a molecular level—affect risk assessment and treatment decisions in localized prostate cancer. The review synthesizes existing research and provides valuable insights into how these emerging tools shape clinical decision-making and patient outcomes.
Commissioned by a national VA operations partner seeking evidence-based guidance for prostate cancer care, this work exemplifies the Durham VA ESP's mission to support policy decisions through rigorous research. Dr. Goldstein, co-director of the program, emphasizes the significance of this approach:
“Our team’s work ensures that clinical decision-makers have access to a high-quality synthesis of currently available evidence when determining what care to provide and how,” she states. “By systematically analyzing the research, we can help clinicians and policymakers make informed, evidence-based decisions that directly impact patient outcomes.”
Dr. Goldstein’s passion for evidence synthesis stems from her interest in research methodology and its application to health policy. She values the opportunity to collaborate with health care leaders, translating complex data into clear, actionable insights that guide policy and practice.
Beyond this publication, the Durham VA ESP conducts systematic reviews on a wide range of health care topics. Recent projects have examined post-discharge contact after hospitalization, women Veterans’ health, long-term maintenance of physical therapy, and patient education strategies like the teach-back method. Dr. Goldstein is currently leading a review on the effectiveness and implementation of teach-back, a communication strategy to improve patient comprehension and adherence to medical instructions.
For more information about the Durham VA Evidence Synthesis Program and its recent reports, visit the ESP website.