Academic Journal
Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey
| العنوان: | Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey |
|---|---|
| المؤلفون: | Struck, Julian P., Hennig, Martin J. P., Hupe, Marie C., Moharam, Nadim, Paffenholz, Pia, Nestler, Tim, Frank, Tanja, Worst, Thomas S., Grabbert, Markus, Pohlmann, Philippe-Fabian, Dogan, Serkan, Hofbauer, Sebastian L., Kalogirou, Charis, Mattigk, Angelika, Brandt, Maximilian P., Krabbe, Laura-Maria, Reis, Henning, Dressler, Franz F., Kramer, Mario W., Salem, Johannes |
| سنة النشر: | 2021 |
| المجموعة: | FU Berlin: Refubium |
| مصطلحات موضوعية: | Survey, Bladder cancer, Nonmuscle invasive bladder cancer, Guideline adherence, Treatment management, ddc:610 |
| الوصف: | Introduction: Guideline recommendations are meant to help minimize morbidity and to improve the care of nonmuscle invasive bladder cancer (NMIBC) patients but studies have suggested an underuse of guideline-recommended care. The aim of this study was to evaluate the level of adherence of German and Austrian urologists to German guideline recommendations. Methods: A survey of 27 items evaluating diagnostic and therapeutic recommendations (15 cases of strong consensus and 6 cases of consensus) for NMIBC was administered among 14 urologic training courses. Survey construction and realization followed the checklist for reporting results of internet e-surveys and was approved by an internal review board. Results: Between January 2018 and June 2019, a total of 307 urologists responded to the questionnaire, with a mean response rate of 71%. The data showed a weak role of urine cytology (54%) for initial diagnostics although it is strongly recommended by the guideline. The most frequently used supporting diagnostic tool during transurethral resection of the bladder was hexaminolevulinate (95%). Contrary to the guideline recommendation, 38% of the participants performed a second resection in the case of pTa low-grade NMIBC. Correct monitoring of Bacille Calmette-Guerin (BCG) response with cystoscopy and cytology was performed by only 34% of the urologists. Conclusions: We found a discrepancy between certain guideline recommendations and daily routine practice concerning the use of urine cytology for initial diagnostics, instillation therapy with a low monitoring rate of BCG response, and follow-up care with unnecessary second resection after pTa low-grade NMIBC in particular. Our survey showed a moderate overall adherence rate of 73%. These results demonstrate the need for sharpening awareness of German guideline recommendations by promoting more intense education of urologists to optimize NMIBC care thus decreasing morbidity and mortality rates. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| Relation: | https://refubium.fu-berlin.de/handle/fub188/40048; http://dx.doi.org/10.17169/refubium-39770 |
| DOI: | 10.17169/refubium-39770 |
| DOI: | 10.1159/000518166 |
| الاتاحة: | https://refubium.fu-berlin.de/handle/fub188/40048 https://doi.org/10.17169/refubium-39770 https://doi.org/10.1159/000518166 |
| رقم الانضمام: | edsbas.E6164212 |
| قاعدة البيانات: | BASE |
| DOI: | 10.17169/refubium-39770 |
|---|