Paul H Chung1, Alex J Vanni2, Benjamin N Breyer3, Bradley A Erickson4, Jeremy B Myers5, Nejd Alsikafi6, Jill Buckley7, Sean P Elliott8, Lee C Zhao9, Bryan B Voelzke10. 1. Department of Urology, Thomas Jefferson University, Philadelphia, PA. Electronic address: paul.chung@jefferson.edu. 2. Department of Urology, Lahey Clinic, Burlington, MA. 3. Department of Urology, University of California San Francisco, CA. 4. Department of Urology, University of Iowa, Iowa City, IA. 5. Division of Urology, University of Utah, Salt Lake City, UT. 6. UroPartners, Chicago, IL. 7. Department of Urology, University of California San Diego, San Diego, CA. 8. Department of Urology, University of Minnesota, Minneapolis, MN. 9. Department of Urology, New York University Langone Health, New York City, NY. 10. Department of Urology, University of Washington Medical Center, Seattle, WA.
Abstract
OBJECTIVE: To compare the utility of generic health quality of life (QOL) and condition specific indicators as patient reported outcomes measures for urethral stricture surgery. MATERIALS AND METHODS: Patient data were obtained from the Trauma and Urologic Reconstructive Network of Surgeons collaborative database. Patients who underwent any successful urethroplasty and completed both pre- and postoperative generic and condition-specific questionnaires were included. RESULTS: A total of 201 patients met inclusion criteria. Urethral-stricture specific measures improved after surgery: mean LUTS score (13.1-4.0, p<0.05), Peeling curve (3.1-1.7, p < 0.05), and overall interference of urinary symptoms on life (3.0-1.6, p < 0.05). Mean overall health status visual analog scale (74.2-80.0, p < 0.05) and generic health QOL EQ-5D index scores (0.90-0.95, p < 0.05) also improved; however, individual EQ-5D measures assessing mobility, self-care, and activity level did not change. EQ-5D measures for pain/discomfort (1.48-1.23, p < 0.05) and anxiety/depression (1.33-1.21, p < 0.05) improved, but not to the same extent as stricture-specific measures. More patients reported improvement in condition-specific urethra/penis pain and bladder pain compared to improvement in generic EQ-5D pain/discomfort (p < 0.001). CONCLUSION: Generic health QOL indicators are less meaningful in the assessment of urethral stricture surgery and should be replaced with condition-specific outcomes measures. It is important to ensure that appropriate condition-specific outcomes measures are utilized as patient reported outcomes measures become more prevalent in medicine and potentially become utilized to evaluate surgeon outcomes and determine surgeon reimbursement.
OBJECTIVE: To compare the utility of generic health quality of life (QOL) and condition specific indicators as patient reported outcomes measures for urethral stricture surgery. MATERIALS AND METHODS:Patient data were obtained from the Trauma and Urologic Reconstructive Network of Surgeons collaborative database. Patients who underwent any successful urethroplasty and completed both pre- and postoperative generic and condition-specific questionnaires were included. RESULTS: A total of 201 patients met inclusion criteria. Urethral-stricture specific measures improved after surgery: mean LUTS score (13.1-4.0, p<0.05), Peeling curve (3.1-1.7, p < 0.05), and overall interference of urinary symptoms on life (3.0-1.6, p < 0.05). Mean overall health status visual analog scale (74.2-80.0, p < 0.05) and generic health QOL EQ-5D index scores (0.90-0.95, p < 0.05) also improved; however, individual EQ-5D measures assessing mobility, self-care, and activity level did not change. EQ-5D measures for pain/discomfort (1.48-1.23, p < 0.05) and anxiety/depression (1.33-1.21, p < 0.05) improved, but not to the same extent as stricture-specific measures. More patients reported improvement in condition-specific urethra/penis pain and bladder pain compared to improvement in generic EQ-5D pain/discomfort (p < 0.001). CONCLUSION: Generic health QOL indicators are less meaningful in the assessment of urethral stricture surgery and should be replaced with condition-specific outcomes measures. It is important to ensure that appropriate condition-specific outcomes measures are utilized as patient reported outcomes measures become more prevalent in medicine and potentially become utilized to evaluate surgeon outcomes and determine surgeon reimbursement.
Authors: Malte W Vetterlein; Almut Gödde; Luis A Kluth; Valentin Zumstein; Philipp Gild; Phillip Marks; Armin Soave; Christian P Meyer; Silke Riechardt; Roland Dahlem; Margit Fisch Journal: World J Urol Date: 2021-03-11 Impact factor: 4.226