Variability in adherence to guidelines based management of nonmuscle invasive bladder cancer among Society of Urologic Oncology (SUO) members.
Biomarkers, Tumor
/ analysis
Cystectomy
Cystoscopy
/ standards
Disease Progression
Evidence-Based Medicine
/ standards
Guideline Adherence
/ statistics & numerical data
Humans
Medical Oncology
/ standards
Medical Overuse
/ statistics & numerical data
Muscle, Smooth
/ diagnostic imaging
Neoplasm Grading
Neoplasm Recurrence, Local
/ diagnosis
Neoplasm Staging
Practice Guidelines as Topic
Practice Patterns, Physicians'
/ standards
Risk Assessment
Societies, Medical
/ standards
Surveys and Questionnaires
/ statistics & numerical data
Urinary Bladder
/ diagnostic imaging
Urinary Bladder Neoplasms
/ diagnosis
Urology
/ standards
Watchful Waiting
/ standards
Bladder cancer
Guidelines
Society of urologic oncology
Survey
Journal
Urologic oncology
ISSN: 1873-2496
Titre abrégé: Urol Oncol
Pays: United States
ID NLM: 9805460
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
06
02
2020
revised:
25
03
2020
accepted:
24
04
2020
pubmed:
21
5
2020
medline:
29
6
2021
entrez:
21
5
2020
Statut:
ppublish
Résumé
The American Urological Association (AUA) introduced evidence-based guidelines for the management of nonmuscle invasive bladder cancer (NMIBC) in 2016. We sought to assess the implementation of these guidelines among members of the Society of Urologic Oncology (SUO) with an aim to identifying addressable gaps. An SUO approved survey was distributed to 747 members from December 28, 2018 to February 2, 2019. This 14-question online survey (Qualtrics, SAP SE, Germany) consisted of 38 individual items addressing specific statements from the AUA NMIBC guidelines within 3 broad categories - initial diagnosis, surveillance, and imaging/biomarkers. Adherence to guidelines was assessed by dichotomizing responses to each item that was related to recommended action statement within the guidelines. Statistical analysis was applied using Pearson's chi-squared test, where a P-value of <0.05 was considered statistically significant. A total of 121 (16.2%) members completed the survey. Members reported a mean of 71% guidelines adherence; adherence was higher for the intermediate- and high-risk subgroups (82% and 76%, respectively) compared to low-risk (58%). Specifically, adherence to guideline recommended cystoscopic surveillance intervals for low-risk disease differed based on clinical experience (60.9% [<10 years] vs. 36.8% [≥10 years], P = 0.01) and type of fellowship training (55.2% [urologic oncology] vs. 28.0% [none/other], P = 0.02). Adherence to guidelines across risk-categories was higher for intermediate- and high-risk patients. Decreased adherence observed for low-risk patients resulted in higher than recommended use of cytology, imaging, and surveillance cystoscopy. These results identify addressable gaps and provide impetus for targeted interventions to support high-value care, especially for low-risk patients.
Identifiants
pubmed: 32430255
pii: S1078-1439(20)30181-2
doi: 10.1016/j.urolonc.2020.04.026
pii:
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
796.e1-796.e6Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.