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Rojanasarot S, Cutone B, Durand K, Zorn KC, Chughtai B, Bhojani N, Elterman D. Patients' perspectives on attributes while choosing minimally invasive surgery for benign prostatic hyperplasia procedures: Experience from men undergoing water vapor thermal therapy. J Endourol 2023; 37:575-580. [PMID: 36762936 DOI: 10.1089/end.2022.0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Objective To understand which attributes patients consider important when selecting treatment options for benign prostatic hyperplasia (BPH) given differences in clinical and economic outcomes. Methods Men (n=170) with lower urinary tract symptoms due to BPH who underwent water vapor thermal therapy (WVTT) between April 2019 and November 2020 in a Toronto urological clinic were invited to participate in an online survey. The survey included eight attributes of BPH surgical procedures and five attributes of WVTT. Patients were asked how important each attribute was to them before they selected a BPH procedure and decided to undergo WVTT. Results In total, 128 respondents (75%) completed the survey. A majority of the respondents were White (88%), married (83%), and aged 60-69 years old (45%). Approximately 97% of respondents rated the ability to avoid further BPH treatments as "very important" or "extremely important", followed by duration to return to normal activities (79%), and wait times to receive the procedure (57%). Only 47% of patients reported post-procedural catheterization was important. For WVTT, 98% of the respondents rated avoiding more invasive surgical treatments and 88% rated a quick recovery as important attributes. Conclusions Among men with moderate-to-severe BPH undergoing WVTT, the most important attributes for selecting a BPH surgical procedure were avoiding further BPH treatments, returning quickly to normal activities, and reducing treatment wait times. The majority of men chose WVTT to avoid more invasive procedures and had a quick recovery.
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Affiliation(s)
- Sirikan Rojanasarot
- Boston Scientific, Health Economics & Market Access, 300 Boston Scientific Way, Marlborough, Massachusetts, United States, 01752;
| | - Ben Cutone
- Boston Scientific, Marlborough, Massachusetts, United States;
| | - Kathryn Durand
- Boston Scientific, Marlborough, Massachusetts, United States;
| | | | - Bilal Chughtai
- Weill Cornell Medical Center, Urology, 425 East 61st Street, 12th Floor, new york, New York, United States, 10065;
| | - Naeem Bhojani
- Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9;
| | - Dean Elterman
- University Health Network, 7989, Urology, 399 Bathurst Street, MP-8-317, Toronto, Ontario, Canada, M5T2S8.,Surgery (Urology), 399 Bathurst Street, MP-8-317, Toronto, Ontario, Canada, M5T2S8;
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Bouhadana D, Lu XH, Luo JW, Assad A, Deyirmendjian C, Guennoun A, Nguyen DD, Kwong JCC, Chughtai B, Elterman D, Zorn KC, Trinh QD, Bhojani N. Clinical Applications of Machine Learning for Urolithiasis and Benign Prostatic Hyperplasia: A Systematic Review. J Endourol 2022; 37:474-494. [PMID: 36266993 DOI: 10.1089/end.2022.0311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Previous systematic reviews related to machine learning (ML) in urology often overlooked the literature related to endourology. Therefore, we aim to conduct a more focused systematic review examining the use of ML algorithms for benign prostatic hyperplasia (BPH) or urolithiasis. In addition, we are the first group to evaluate these articles using the STREAM-URO framework. METHODS Searches of MEDLINE, Embase, and the Cochrane CENTRAL databases were conducted from inception through July 12, 2021. Keywords included those related to ML, endourology, urolithiasis, and BPH. Two reviewers screened the citations that were eligible for title, abstract and full-text screening, with conflicts resolved by a third reviewer. Two reviewers extracted information from the studies, with discrepancies resolved by a third reviewer. The data collected was then qualitatively synthesized by consensus. Two reviewers evaluated each article according to the STREAM-URO checklist with discrepancies resolved by a third reviewer. RESULTS After identifying 459 unique citations, 63 articles were retained for data extraction. Most articles consisted of tabular (n=32) and computer vision (n=23) tasks. The two most common problem types were classification (n=40) and regression (n=12). In general, most studies utilized neural networks as their ML algorithm (n=36). Among the 63 studies retrieved, 58 were related to urolithiasis and five focused on BPH. The urolithiasis studies were designed for outcome prediction (n=20), stone classification (n=18), diagnostics (n=17), and therapeutics (n=3). The BPH studies were designed for outcome prediction (n=2), diagnostics (n=2), and therapeutics (n=1). On average, the urolithiasis and BPH articles met 13.8 (SD 2.6), and 13.4 (4.1) of the 26 STREAM-URO framework criteria, respectively. CONCLUSIONS The majority of the retrieved studies successfully helped with outcome prediction, diagnostics, and therapeutics for both urolithiasis and BPH. While ML shows great promise in improving patient care, it is important to adhere to the recently developed STREAM-URO framework to ensure the development of high-quality ML studies.
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Affiliation(s)
- David Bouhadana
- McGill University Faculty of Medicine and Health Sciences, 12367, 3605 de la Montagne, Montreal, Quebec, Canada, H3G 2M1;
| | - Xing Han Lu
- McGill University School of Computer Science, 348406, Montreal, Quebec, Canada;
| | - Jack W Luo
- McGill University Faculty of Medicine and Health Sciences, 12367, Montreal, Quebec, Canada;
| | - Anis Assad
- University of Montreal Hospital Centre, 25443, Urology, Montreal, Quebec, Canada;
| | | | - Abbas Guennoun
- University of Montreal Hospital Centre, 25443, Urology, Montreal, Quebec, Canada;
| | | | | | - Bilal Chughtai
- Weill Cornell Medical Center, Urology, New York, New York, United States;
| | - Dean Elterman
- University of Toronto, 7938, Urology, Toronto, Ontario, Canada;
| | | | - Quoc-Dien Trinh
- Brigham and Women's Hospital, Urology, Boston, Massachusetts, United States;
| | - Naeem Bhojani
- University of Montreal Hospital Centre, 25443, Urology, Montreal, Quebec, Canada;
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Budäus L, Morgan M, Abdollah F, Zorn KC, Sun M, Johal R, Thuret R, Abdo A, Schmitges J, Isbarn H, Jeldres C, Perrotte P, Graefen M, Karakiewicz PI. Impact of annual surgical volume on length of stay in patients undergoing minimally invasive prostatectomy: a population-based study. Eur J Surg Oncol 2011; 37:429-34. [PMID: 21492776 DOI: 10.1016/j.ejso.2011.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 01/29/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND On average, patients remain hospitalized no more than 2 days after MIRP. The aim of our study was to examine the temporal trends in length of stay ≥ 3 days and to test the relationship between annual surgical volume (ASV) and annual hospital volume (AHV) and length of stay ≥ 3 days in patients undergoing MIRP. MATERIAL AND METHODS Within the Florida Hospital Inpatient Datafile, 2439 men who were treated with MIRP for prostate cancer between 2005 and 2008 were identified. Temporal trends were assessed and uni and multi-variable logistic regression models tested the relationship between ASV, AHV and length of stay ≥ 3 days. RESULTS The average length of stay decreased from 2.4 in 2005 to 1.7 days in 2008. Length of stay ≥ 3 days was recorded in 13.6% of patients and the proportion of patients staying more than ≥ 3 days decreased over time (25.5-12.2%; Chi Square trend p < 0.001). After stratification into low (<1-15 MIRPs) vs. intermediate (16-63 MIRPs) vs. high ASV tertiles (≥ 64 MIRPs) the proportion of patients with length of stay ≥ 3 days were 29.1; 13.2 and 11.1%. In multivariable logistic regression models predicting length of stay ≥ 3 days, ASV, year of surgery and comorbidities achieved independent predictor status and MIRP patients operated by highest ASV tertile surgeons were 71% (p < 0.001) less likely to be hospitalized for more than 3 days. CONCLUSION The length of stay after MIRP decreased between 2005 and 2008. Surgical expertise represented one of the main determinants of shorter length of stay.
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Affiliation(s)
- L Budäus
- Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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