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Expanded Prostate Cancer Index Composite (EPIC)

What is EPIC?

The Expanded Prostate Cancer Index Composite (EPIC) is a comprehensive instrument designed to evaluate patient function and bother after prostate cancer treatment. Content from the original UCLA-Prostate Cancer Index (PCI) was expanded with guidance from a development cohort of localized prostate cancer patients and an expert panel comprised of urological oncologists, radiation oncologists (including brachytherapy expertise), survey researchers, and prostate cancer nurses. These experts, patients, and review of the literature suggested a need to augment the UCLA-PCI with items to capture additional concerns relevant to brachytherapy, external beam radiation, radical prostatectomy, and androgen deprivation. Accordingly, the UCLA-PCI was supplemented with specific items addressing irritative and obstructive voiding symptoms (the original UCLA-PCI had queried principally incontinence only in urinary function assessment), hematuria, additional bowel symptoms (to improve the suboptimal bowel function scale from the original UCLA-PCI) and hormonal symptoms. Symptom-specific bother items corresponding to each symptom item were added to elicit multi-item bother scales for each HRQOL domain. Responses and comments from the development cohort were incorporated to derive the final instrument: the Expanded Prostate cancer Index Composite (EPIC)

EPIC Instruments

Most Recent Version of EPIC
26-item short-form version of EPIC
EPIC + SF12 and AUASI
EPIC - Urinary Domain only
EPIC - Bowel Domain only
EPIC - Sexual Domain only
EPIC - Hormonal Domain only
EPIC - Demographics add-on*

*This instrument can be added on to the end of any of the other EPIC instruments to collect demographic information.

Peer-reviewed Articles

"Development and Validation of the Expanded Prostate Cancer Index Composite (EPIC) for Comprehensive Assessment of Health-Related Quality of Life in Men with Prostate Cancer", Urology. 56: 899-905, 2000.

"Comprehensive comparison of health-related quality of life after contemporary therapies for localized prostate cancer ", Journal of Clinical Oncology. 20(2): 557-66, 2002.

"Neoadjuvant hormonal therapy and older age are associated with adverse sexual health-related quality-of-life outcome after prostate brachytherapy ", Urology. 59: 480-4, 2002.

"Determinants of Long-Term Sexual HRQOL After Radical Prostatectomy Measured by a Validated Instrument", Journal of Urology. 169: 1453-7, 2003.

Scoring Utilities

Scoring Documentation
Scoring Instructions for the EPIC-26
SAS Macro for scoring EPIC*
SAS Macro for scoring EPIC-26*

 


* Choose the 'Save to Disk' option after clicking on the SAS Macro name. If your browser displays the macro on the screen as a text file. Choose File -> Save As, and then choose a location to save the macro.

Sample Size Table & Suggested Endpoint

Number of EPIC domains as primary endpoints
Domain-specific significance level (for overall significance of 5%)
Potential Endpoints
Required Sample Size Per Treatment Group (Based on Effect Size of 0.5)
80% Power

90% Power

1
0.05
Any 1 of the summary scores - Urinary, Bowel, Sexual, Hormonal
64
86
4
0.0125
Urinary, Bowel, Sexual, and Hormonal Summary Scores
91
116
5
0.01
Urinary Irritative, Urinary Incontinence, Bowel, Sexual, and Hormonal Summary Scores
96
121
6

0.0083

 

Urinary Irritative, Urinary Incontinence, Bowel, Sexual, and Hormonal Summary Scores and SF-12 PCS
99
125
10

0.005

 

Urinary Irritative, Urinary Incontinence, and Function and Bother subscales for Urinary, Bowel, Sexual, and Hormonal Domains
109
136
12
0.0042
Urinary Irritative, Urinary Incontinence, Function and Bother subscales for Urinary, Bowel, Sexual, and Hormonal Domains, and SF-12 PCS and MCS Scores
112
140

If less than 100% response rate is anticipated, then sample sizes will need to be adjusted. For example, an expected 75% response rate at 2 years for a study with a single endpoint and 80% power would require 86 subjects (64/0.75 = 85.33)

Control-based Norms and Other Statistics

Characteristics of EPIC domain-specific summary and subscale scores for 112 controls without prostate cancer

Validation of EPIC-26 (EPIC Short Form)

Statistics for the validation process of the EPIC-26

Frequently Asked Questions

What does EPIC stand for?
EPIC stands for the Expanded Prostate Cancer Index Composite.

What is EPIC?
EPIC is a comprehensive instrument designed to evaluate patient function and bother after prostate cancer treatment.


Am I allowed to make copies of EPIC?
Yes, you are free to make copies and distribute EPIC


Do I need to pay a fee to use EPIC?
No, there is no fee required to use EPIC.


When reporting my findings, what article should I reference?
For any manuscript published that uses EPIC, you should reference the EPIC validation paper published in the December 2000 issue of Urology. The full reference is:
Wei J, Dunn R, Litwin M, Sandler H, and Sanda M. "Development and Validation of the Expanded Prostate Cancer Index Composite (EPIC) for Comprehensive Assessment of Health-Related Quality of Life in Men with Prostate Cancer", Urology. 56: 899-905, 2000.


How come I cannot open the PDF files?
This is most likely due to the fact that you are either not using Adobe Acrobat Reader or are using a previous version of the reader. These files were created using version 4.0 of Adobe Acrobat, so version 4.0x or higher of the reader is required to view them. This is available as a FREE download, which can be obtained by clicking on the following icon:

Contact Information

Martin G. Sanda, M.D.
Division of Urology
Beth Israel-Deaconess Medical Center
330 Brookline Ave
Boston, MA 02215
Phone: (310) 794-7960 Fax: (310) 206-5343
msanda@bidmc.harvard.edu


John T. Wei, M.D.
University of Michigan
Department of Urology
Room 1013, Women's Trailer
1500 E. Medical Center Drive
Ann Arbor, MI 48109-5759
Phone: (734) 615-3040 Fax: (734) 936-9536
jtwei@med.umich.edu


Mark S. Litwin, M.D., M.P.H.
UCLA Department of Urology
Box 951738
Los Angeles, CA 90095-1738
Phone: (734) 615-3040 Fax: (734) 936-9127
mlitwin@mednet.ucla.ed

For information on the use of the SAS scoring macro, please contact:

Rodney L. Dunn, M.S.
University of Michigan
Department of Urology
Room 1011, Women's Trailer
1500 E. Medical Center Drive
Ann Arbor, MI 48109-5759
Phone: (734) 615-1396 Fax: (734) 936-9536
rldunn@med.umich.edu



Urologic Oncology Research Initiative