Patient’s preferences: an unmet need by current urolithiasis guidelines: a systematic review

Pauchard, Felipe; Ventimiglia, Eugenio; Traxer, Olivier

doi:10.1007/s00345-023-04678-4

Cited by 2 publications

References 26 publications

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Patient Risk–Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair

Hung,

Yang,

Wallace

et al. 2024

JAHA

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Background Transcatheter edge‐to‐edge repair (TEER) of mitral regurgitation is less invasive than surgery but has greater 5‐year mortality and reintervention risks, and leads to smaller improvements in physical functioning. The study objective was to quantify patient preferences for risk–benefit trade‐offs associated with TEER and surgery. Methods and Results A discrete choice experiment survey was administered to patients with mitral regurgitation. Attributes included procedure type; 30‐day mortality risk; 5‐year mortality risk and physical functioning for 5 years; number of hospitalizations in the next 5 years; and risk of additional surgery in the next 5 years. A mixed‐logit regression model was fit to estimate preference weights. Two hundred one individuals completed the survey: 63% were female and mean age was 74 years. On average, respondents preferred TEER over surgery. To undergo a less invasive procedure (ie, TEER), respondents would accept up to a 13.3% (95% CI, 8.7%–18.5%) increase in reintervention risk above a baseline of 10%, 4.6 (95% CI, 3.1–6.2) more hospitalizations above a baseline of 1, a 10.7% (95% CI, 6.5%–14.5%) increase in 5‐year mortality risk above a baseline of 20%, or more limited physical functioning representing nearly 1 New York Heart Association class (0.7 [95% CI, 0.4–1.1]) over 5 years. Conclusions Patients in general preferred TEER over surgery. When holding constant all other factors, a functional improvement from New York Heart Association class III to class I maintained over 5 years would be needed, on average, for patients to prefer surgery over TEER.

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Patient Risk–Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair

Hung,

Yang,

Wallace

et al. 2024

JAHA

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An In Vitro Study Evaluating The Intrarenal Pressure During RIRS of Suction Ureteral Access Sheath Versus Traditional Sheath

Liu,

Zhang,

Chai

et al. 2024

Preprint

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Introduction: Flexible ureteroscopy (fURS) is widely recognized as an effective treatment for ureteral or renal stones. The used of flexible urinary endoscopy provides an effective treatment for ureteral stones, and the development of vacuum suction ureteral access sheaths has significantly improved the stone clearance rate. Our experimental aim is to prove the effectiveness of negative suction ureteral access sheath on decreasing intraluminal pressure in various settings, utilizing by stimulating an in vitroflexible ureteroscope model. Methods: An 8.6Fr disposable flexible ureteroscope was used to measure intraluminal pressure through a manufactured silicone urinary model using 3D printing technology. We conducted on three settings use of ureteral access sheaths (UAS), which are (1) conventional UAS, (2) negative pressure suction sheath with an open vent, and (3) negative pressure suction sheath with a fully closed vent. Intrarenal pressure and irrigation flow rate were recorded on various sizes of UAS under irrigation pressures ranging from 10 to 240 mmHg. Results: Under different infusion pressure conditions, the negative pressure sheath with an opened vent demonstrated marginally lower intraluminal ureteral pressure than the traditional sheath, but this difference was not statistically significant (P = 0.56). In contrast, when employing the closed vent method, the negative pressure aspiration sheath shwed a notably significantly distinct intraluminal pressure change from the traditional sheath and its opened vent mode (P < 0.01). Additionally, The choice of ureteral sheath size profoundly impacted intraluminal pressure; larger sheath sizes were associated with more reduced pressure levels under the same infusion pressure (P < 0.01). Conclusions: In ureteroscopy procedures, the intraluminal pressure in the ureter increases with the rise in irrigation pressure. However, applying negative pressure with a closed vent can effectively reduce the intraluminal pressure.

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Patient’s preferences: an unmet need by current urolithiasis guidelines: a systematic review

Cited by 2 publications

References 26 publications

Patient Risk–Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair

Patient Risk–Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair

An In Vitro Study Evaluating The Intrarenal Pressure During RIRS of Suction Ureteral Access Sheath Versus Traditional Sheath

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