Critical Review of Guidelines for BPH Diagnosis and Treatment Strategy

Novara, Giacomo; Galfano, Antonio; Gardi, Mario; Ficarra, Vincenzo; Boccon-Gibod, L; Artibani, Walter

doi:10.1016/j.eursup.2006.02.005

Cited by 48 publications

(38 citation statements)

References 40 publications

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“…In contrast to the linear relationship noted by Novara and colleagues and Irani and colleague that high-score guidelines recommended fewer tests, 19,20 our findings did not reveal any correlation with the number of recommended tests and score of the guidelines. In fact the AGREE II assessment of a guideline mainly focused on how well the guideline was developed, processed, and reported; it does not guarantee that a highly scored guideline will provide excellent recommendations.…”

Section: Discussioncontrasting

confidence: 56%

“…19 Their assessments were based on AGREE appraisal instruments, and they found that the 2000 Australian National Health and Medical Research Council (NHMRC) and the AUA 2004 guidelines had the highest overall scores. In contrast to their critical review, with the updated AGREE II tool CPG assessment used in our critical review, we were able to determine that the NICE guideline, AUA and EAU guidelines have higher scores among the recent guidelines available for non-neurogenic male LUTS.…”

Section: Discussionmentioning

confidence: 99%

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A critical review of recent clinical practice guidelines on the diagnosis and treatment of non-neurogenic male lower urinary tract symptoms

Chua

Mendoza²,

See

et al. 2015

CUAJ

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Introduction:We provide an overview of the quality of recent clinical clinical practice guidelines (CPGs) for non-neurogenic male lower urinary tract symptoms (LUTS) and summarize the recommendations for their diagnosis, assessment, and treatment. Methods: We systematically searched recent (2008)(2009)(2010)(2011)(2012)(2013) CPGs for non-neurogenic male LUTS. Eligible CPGs were assessed and appraised using Appraisal of Guidelines, Research and Evaluation II (AGREE II) tool by a CPG-appraisal group. The appraisal scores for each guideline were summarized according to each domain and in total. A recommendation summary was made across the guidelines for diagnostics, conservative management, medical, minimally invasive therapy, and surgical management. Results: A total of 8 guidelines were considered. According to AGREE II appraisal of guidelines, the National Institute for Health and Clinical Excellence (NICE), American Urological Association (AUA) and European Association of Urology (EAU) consistently scored high on the guideline domains assessed. Recommendations on diagnostics, conservative management, medical, and surgical management were consistent among the top 3 guidelines. However, we noted a discrepancy in recommending minimally invasive therapy as an alternative management of moderate to severe or bothersome non-neurogenic male LUTS secondary to benign prostatic enlargement (BPE); the NICE guideline, in particular, does not recommend using minimally invasive therapy. Conclusion:The quality of recent CPGs on non-neurogenic male LUTS was appraised and summarized. The guidelines from NICE, AUA and EAU were considered highly compliant to the AGREE II proposition for guideline formation and development.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

A critical review of recent clinical practice guidelines on the diagnosis and treatment of non-neurogenic male lower urinary tract symptoms

Chua

Mendoza²,

See

et al. 2015

CUAJ

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“…A sociedade australiana é mais detalhada, sugerindo a abordagem dos hábitos do trânsito intestinal, das outras comorbilidades (demência, perturbação da ansiedade, diabetes mellitus ou patologia cardiovascular documentada), da medicação habitual (diuréticos, antidepressivos, antihipertensores) e do contexto socioeconômico 15 . As diretrizes convergem no uso de escalas validadas, sendo a International Prostate Symptom Score (IPSS) a mais usada 12,[14][15][16][17] . Esta é considerada fundamental na decisão de avanço para os passos clínicos seguintes como a solicitação do PSA, abordagem terapêutica e follow-up 17 .…”

Section: Introdução: As Diretrizes E a Sua Importânciaunclassified

“…As diretrizes convergem no uso de escalas validadas, sendo a International Prostate Symptom Score (IPSS) a mais usada 12,[14][15][16][17] . Esta é considerada fundamental na decisão de avanço para os passos clínicos seguintes como a solicitação do PSA, abordagem terapêutica e follow-up 17 .…”

Section: Introdução: As Diretrizes E a Sua Importânciaunclassified

“…Apesar de o toque retal subestimar o volume prostático, a evidência sugere que as prostátas sentidas como volumosas no exame físico são confirmadas como aumento ecográfico do tamanho do órgão 17 . A American Urological Association (AUA) destaca ainda a necessidade de proceder a um exame neurológico que vá desde a avaliação do estado mental até ao tônus do esfíncter anal 12 .…”

Section: Introdução: As Diretrizes E a Sua Importânciaunclassified

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Hiperplasia Prostática Benigna e PSA: o efeito dominó

Santos

2012

Rev Bras Med Fam Comunidade

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ResumoApós a publicação de uma recomendação contra o rastreio câncer prostático pela U.S. Preventive Services Task Force, a comunidade médica não poderá desvincular-se das particularidades relacionadas com o antígeno prostático específico (PSA). O enfoque dado às guidelines da Hiperplasia Prostática surge pela possível partilha, a determinado ponto da sua abordagem, de um trilho que cursa também com a solicitação do PSA. Os resultados de dois grandes ensaios clínicos constituem o maior corpo da evidência actual e deles sobressai que o número de homens que evitaram a morte por câncer prostático após submetidos ao rastreio foi reduzido. Há evidência de que 100-200 em 1000 homens rastreados terão um falso-positivo, a maioria dos quais será biopsada, com possíveis danos psicológicos e orgânicos. O Médico de Família deverá relembrar que não é recomendado que se ofereça esta análise, sem que primeiro discuta, juntamente com o paciente, as questões inerentes ao PSA. AbstractAfter U.S. Preventive Services Task Force published a recommendation against prostate cancer screening, the medical community cannot extricate itself from all specific features associated with the prostate-specific antigen (PSA). The focus given to the guidelines of the Prostatic Hyperplasia happens for the possible sharing of a certain point of its approach with the prostatic cancer case-finding, that is the PSA test. The results of two large clinical trials represent the largest body of evidence and they say the number of men who avoided prostate cancer death after subjected to screening was reduced. There is evidence that 100-200 in 1000 screened men will have a false-positive, most of which will have a biopsy with possible psychological damage and organic. The GP should remember that it is not recommended to provide this test, without first discussing together with the patient, the issues that are inherent to the PSA sample. ResumenDespués de U.S. Preventive Services Task Force publicar una recomendación en contra el screening del cáncer de próstata, la comunidad médica no puede liberarse de todas las particularidades propias de lo antígeno prostático específico (PSA). La atención prestada a las directrices de la Hiperplasia Prostática aparece debido a posibilidad de compartir un cierto punto com el screening, que conduce a la petición del PSA. Los resultados de dos grandes ensayos clínicos representan el mayor cuerpo de evidencia y de ellos sobresale que el número de hombres que evitaron la muerte de cáncer de próstata después de someterse a el screening es reducido. Hay evidencia de que 100-200 en 1000 hombres sometidos a el screening tendrá un falso positivo, mayoría de los cuales será biopsada con posible daño psicológico y orgánico. El médico de família debe recordar que no se recomienda para proporcionar este estudio analítico, sin discutir primero junto con el paciente, los problemas que son inherentes en el PSA.

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