BACKGROUND: Among the approximately 53,000 patients newly diagnosed with early-stage (superficial) bladder cancer each year, there is substantial variability in the progression to muscle-invasive disease. Enhancing risk stratification and risk-stratified surveillance could minimize risks and harms to patients, as well as unnecessary costs to health systems. OBJECTIVES: As a preliminary step in developing and validating a risk assessment tool for superficial bladder cancer in a population-based clinical cohort, we interviewed urologists who might use such a tool to assess need, determine potential use cases, and identify key features to include. METHODS: Using an opportunistic and purposeful sampling design, we invited 13 urologists from a variety of practice settings and with a wide range of clinical experience to take part in qualitative interviews; 9 (5 urologic oncologists and 4 general urologists) participated. RESULTS: All urologists reported using some form of risk stratification to determine surveillance schedules for patients with bladder cancer. The following use cases were endorsed by 4 or more interviewees: 1) provide evidence to guide clinical management in specific situations, 2) generate patient-facing communication aids, 3) improve documentation about recurrence/progression risk, and 4) create scheduling and callback supports to improve the quality of follow-up care. CONCLUSION: Our findings demonstrated several potential clinical-use cases for a risk calculator and clinical decision-support tool for patients with superficial bladder cancer. Clinicians stressed the potential utility of such a tool to improve patient communication, scheduling, and tracking in general urology practice.
BACKGROUND: Among the approximately 53,000 patients newly diagnosed with early-stage (superficial) bladder cancer each year, there is substantial variability in the progression to muscle-invasive disease. Enhancing risk stratification and risk-stratified surveillance could minimize risks and harms to patients, as well as unnecessary costs to health systems. OBJECTIVES: As a preliminary step in developing and validating a risk assessment tool for superficial bladder cancer in a population-based clinical cohort, we interviewed urologists who might use such a tool to assess need, determine potential use cases, and identify key features to include. METHODS: Using an opportunistic and purposeful sampling design, we invited 13 urologists from a variety of practice settings and with a wide range of clinical experience to take part in qualitative interviews; 9 (5 urologic oncologists and 4 general urologists) participated. RESULTS: All urologists reported using some form of risk stratification to determine surveillance schedules for patients with bladder cancer. The following use cases were endorsed by 4 or more interviewees: 1) provide evidence to guide clinical management in specific situations, 2) generate patient-facing communication aids, 3) improve documentation about recurrence/progression risk, and 4) create scheduling and callback supports to improve the quality of follow-up care. CONCLUSION: Our findings demonstrated several potential clinical-use cases for a risk calculator and clinical decision-support tool for patients with superficial bladder cancer. Clinicians stressed the potential utility of such a tool to improve patient communication, scheduling, and tracking in general urology practice.
Authors: Robert S Svatek; Brent K Hollenbeck; Sten Holmäng; Richard Lee; Simon P Kim; Arnulf Stenzl; Yair Lotan Journal: Eur Urol Date: 2014-01-21 Impact factor: 20.096
Authors: Marko Babjuk; Andreas Böhle; Maximilian Burger; Otakar Capoun; Daniel Cohen; Eva M Compérat; Virginia Hernández; Eero Kaasinen; Joan Palou; Morgan Rouprêt; Bas W G van Rhijn; Shahrokh F Shariat; Viktor Soukup; Richard J Sylvester; Richard Zigeuner Journal: Eur Urol Date: 2016-06-17 Impact factor: 20.096
Authors: Andrew J Stephenson; Peter T Scardino; James A Eastham; Fernando J Bianco; Zohar A Dotan; Christopher J DiBlasio; Alwyn Reuther; Eric A Klein; Michael W Kattan Journal: J Clin Oncol Date: 2005-10-01 Impact factor: 44.544
Authors: Richard J Sylvester; Adrian P M van der Meijden; Willem Oosterlinck; J Alfred Witjes; Christian Bouffioux; Louis Denis; Donald W W Newling; Karlheinz Kurth Journal: Eur Urol Date: 2006-01-17 Impact factor: 20.096
Authors: Sam S Chang; Stephen A Boorjian; Roger Chou; Peter E Clark; Siamak Daneshmand; Badrinath R Konety; Raj Pruthi; Diane Z Quale; Chad R Ritch; John D Seigne; Eila Curlee Skinner; Norm D Smith; James M McKiernan Journal: J Urol Date: 2016-06-16 Impact factor: 7.450