Adherence to the European Association of Urology Guidelines: A National Survey among Italian Urologists

Cacciamani, Giovanni; Artibani, Walter; Briganti, Alberto; N’Dow, James

doi:10.1159/000486344

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…As discussed above, the EAU CPG provide guidance to urologists and other key stakeholders as an essential decision-making tool for day-to-day practice and for efficient healthcare provision. 9 Moreover, the adherence to the international guidelines has been considered a high-quality tool for evaluating the quality of care, at the international, national, or local level. The percentage of adherence to EAU guidelines is not homogeneous with several differences among Countries and in terms of diseases.…”

Section: Adherence To International Guidelines and The Utility For CLmentioning

confidence: 99%

Guidelines in urology: Lights and shadows

et al. 2020

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Clinical practice guidelines have become increasingly important in the decision-making process in many clinical conditions and have been recognized as key instruments to improve the quality of care. On the one hand, guidelines represent a good tool for improving patient’s outcome, and on the other hand, the adherence to guidelines and good practice recommendations is mandatory to reduce the risk of legal disputes. A recent revision by the Italian Parliament of the legal system that rules the responsibilities of health professionals and health care safety stimulated all clinicians to improve their adhesion to clinical guidelines. It is justified by the high-quality level obtained in the recent years by the international guidelines. In the recent years, a revision of the clinical guideline development has been done. In particular, the European Association of Urology Guideline Office changed the “Guidelines for Guidelines,” and a rigorous development process has been established. A clinical recommendation is produced after a rigorous methodological process using an analysis of all published clinical trials, and the expert opinion is not yet considered. For oncological guidelines, the adherence to the producing process is easily feasible due to the high number of clinical trials; for non-oncological guidelines, instead, the small number of clinical trials could represent a problem for obtaining recommendation based on rigorous methodology. Here, on the basis of these considerations, we aim to discuss the lights and the shadows of the clinical applicability of guidelines in urology.

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Section: Adherence To International Guidelines and The Utility For CLmentioning

confidence: 99%

Guidelines in urology: Lights and shadows

et al. 2020

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“…Surveys from different European countries have demonstrated significant differences regarding diagnostic and treatment strategies. Urologists working in university hospitals are more inclined to adopt guidelines compared to those who practice in non-academic centers [ 9 , 10 , 11 ]. The aim of this study is to control the adherence of European countries to the EAU guidelines of urolithiasis and demonstrate different trends in diagnostic and treatment approach in a European level.…”

Section: Introductionmentioning

confidence: 99%

Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups

Güven

Sönmez

Somani

et al. 2022

Cent european J Urol

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Introduction Renal colic due to ureteral stones represents the primary acute condition in urology. Although guideline recommendations are available the institution, urologist, and patient preferences in diagnosis and treatment may differ. We aimed to evaluate the adherence of different European countries to the European Association of Urology (EAU) guidelines of urolithiasis and demonstrate trends in diagnostic and treatment approaches. Material and methods We used a survey including 33 questions clustered in four sections. The survey was circulated to the representatives of the main urological centers in Europe using the European Section of Uro-technology (ESUT), the European Section of Urolithiasis (EULIS), the Young Academic Urologists (YAU), and the European Urology Residents Education Programme (EUREP) mailing lists. The first section included participant and institution demographics, the second assessed the common diagnostic and treatment pathways, the third discussed the advantages and disadvantages of treatment strategies and the fourth investigated treatment preferences in different clinical scenarios. A descriptive analysis was performed. Results Of all participants, 84.21% stated that their departments follow specific guidelines, with no significant differences between institutions (p = 0.18). Preferred treatment practice difference in the case scenarios was significantly influenced by the Department bed capacities (p = 0.01), and complications varied between institutions (p = 0.02). Interestingly, 37–45% of participants were unaware of the different treatment costs. Conclusions Although urologists generally decide according to local or international guidelines when approaching renal colic patients, there are deviations in clinical practice due to ‘doctor preference’ and ‘bed availability’. Many urologists are unaware of treatment costs.

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“…In the US, approximately 95% of urologists reported using the AUA CPGs in regular clinical decision-making [8]. Figures are more variable in European cohorts where Italian urologists' adherence to non-oncologic urology CPGs ranged from 45% to 88% [9], while Croatian urologists' compliance with EAU recommendations ranged from 8% to 100% [10]. More specifically, CPG uptake varies when consulting for pathology and symptom-specific cases such as benign prostatic hyperplasia [11], bladder cancer [12] and asymptomatic hematuria [13].…”

Section: Introductionmentioning

confidence: 99%

“…More specifically, CPG uptake varies when consulting for pathology and symptom-specific cases such as benign prostatic hyperplasia [11], bladder cancer [12] and asymptomatic hematuria [13]. Younger age and academic practice settings have been found to be associated with greater CPG adherence [8,9]. The uptake of CPGs has not been extensively measured within urology settings of varied resource-levels.…”

Section: Introductionmentioning

confidence: 99%

Use of Urology-Based Clinical Practice Guidelines in International Settings

Patiño

Thomas

Cohen³

et al. 2021

Société Internationale D’Urologie Journal

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Objective Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process. Methods This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software. Result A total of 249 practicing urologists from 28 countries completed the survey. The majority of participants were males, aged 36 to 45, and practiced in a non-academic setting. Ninety-three percent of urologists used CPGs in their everyday clinical practice, and 43% believed CPGs were very important to medical decision-making. However, barriers such as the lack of adaptability or applicability of CPGs to local settings were mentioned by 29% and 24% of participants, respectively. Urologists believed scientific associations (81%), national urology boards (68%), and ministries of health (56%), were important stakeholders to consult to foster the development of local CPGs. Conclusions Globally, CPGs are widely used tools for clinical practice. However, there are concerns about the adaptability and applicability of CPGs to settings that may lack the resources to implement their recommendations. Efforts should be directed towards incorporating scientific and medical stakeholders into the review and adaptation of urology CPGs to suit the unique features of local health care systems.

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Adherence to the European Association of Urology Guidelines: A National Survey among Italian Urologists

Cited by 11 publications

References 25 publications

Guidelines in urology: Lights and shadows

Guidelines in urology: Lights and shadows

Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups

Use of Urology-Based Clinical Practice Guidelines in International Settings

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