دورية أكاديمية
Surgeon, and Institution Characteristics Associated Surgical Preferences in the Pediatric KIDney Stone Care Improvement Network.
| العنوان: | Surgeon, and Institution Characteristics Associated Surgical Preferences in the Pediatric KIDney Stone Care Improvement Network. |
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| المؤلفون: | Fernandez N; Department of Surgery, Division of Urology, Seattle Children's Hospital, Seattle, WA., Ellison JS; Children's Wisconsin and Medical College of Wisconsin, Milwaukee, WI., Wang Z; Department of Biostatistics, Epidemiology, and Informatics; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA., Huang J; Department of Biostatistics, Epidemiology, and Informatics; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA., Chu DI; Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Urology. Chicago, IL., Sturm R; Mattel Children's Hospital, Department of Urology, University of California, Los Angeles, CA., Stec AA; Division of Urology, Nemours Children's Health, Jacksonville, FL., Hsi RS; Department of Urology, Vanderbilt University Medical Center, Nashville, TN., Wu W; Division Pediatric Urology, Cohen Children's Medical Center of New York, Zucker School of Medicine at Hofstra/Northwell, Long Island, NY., Nelson C; Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, MA., Ching C; Kidney and Urinary Tract Center, Department of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH., Augelli B; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Lorenzo M; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Bi-Karchin J; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Tasian GE; Department of Biostatistics, Epidemiology, and Informatics; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address: tasiang@chop.edu. |
| المصدر: | Urology [Urology] 2024 May; Vol. 187, pp. 64-70. Date of Electronic Publication: 2024 Mar 06. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York : Elsevier Science Original Publication: Ridgewood, N.J., Professional Medical Services Co. |
| مواضيع طبية MeSH: | Kidney Calculi*/surgery , Kidney Calculi*/therapy , Practice Patterns, Physicians'*/statistics & numerical data, Humans ; Cross-Sectional Studies ; Child ; Male ; Female ; Nephrolithotomy, Percutaneous/methods ; Ureteroscopy ; Lithotripsy ; Surveys and Questionnaires ; Ureteral Calculi/surgery ; Ureteral Calculi/therapy |
| مستخلص: | Objective: To reveal barriers and opportunities to implement evidence for the management of pediatric kidney stone disease, we determined surgeon and institutional factors associated with preferences for the type of surgical intervention for kidney and ureteral stones. Methods: We conducted a cross-sectional study of urologists participating in the Pediatric KIDney Stone Care Improvement Network (PKIDS) trial. Questionnaires ascertained strengths of urologists' preferences for types of surgery as well as characteristics of participating urologists and institutions. The outcome was the strength of preferences for ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotomy for four scenarios for which two alternative procedures are recommended by the AUA guidelines: (1) 2 cm kidney stone, (2) 9 mm proximal ureteral stone, (3) 1.5 cm lower pole kidney stone, (4) 1 cm nonlower pole kidney stone. Principal component analysis was performed to identify unique clusters of factors that explain surgical preferences. Results: One hundred forty-eight urologists at 29 sites completed surveys. Stated preferences were highly skewed except for the choice between ureteroscopy and percutaneous nephrolithotomy for a 1.5 cm kidney stone. Shockwave lithotripsy ownership and local practice patterns most frequently associated with the strength of surgeons' preferences for the type of surgery. Principal component analysis revealed that three clusters of stone, patient, and heterogenous characteristics explained 30% of the variance in preferences. Conclusion: There is wide variation in the strengths of preferences for surgical interventions supported by current guidelines that are partially explained by surgeon and institutional characteristics. These results reveal opportunities to develop strategies for guidelines that consider real-world drivers of care. Competing Interests: Declaration of Competing Interest Jonathan S. Ellison, Brian Augelli, Matt Lorenzo, Jing Bi-Karchin, and Gregory E. Tasian “Study Investigator Funded by Sponsor.” The other authors have no conflict of interest to declare. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20240308 Date Completed: 20240609 Latest Revision: 20240722 |
| رمز التحديث: | 20240723 |
| DOI: | 10.1016/j.urology.2024.02.040 |
| PMID: | 38458327 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1527-9995 |
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| DOI: | 10.1016/j.urology.2024.02.040 |