602 results on '"Cacciamani, Giovanni E."'
Search Results
202. Impact of radiomics on prostate cancer detection: a systematic review of clinical applications.
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Sugano, Dordaneh, Sanford, Daniel, Abreu, Andre, Duddalwar, Vinay, Gill, Inderbir, and Cacciamani, Giovanni E.
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- 2020
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203. Comment on: "Fusion US/Mri prostate biopsy using a computer aided diagnostic (Cad) system".
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Sholklapper, Tamir, Checcucci, Enrico, Puliatti, Stefano, Taratkin, Mark, Marenco, José, Kowalewski, Karl-Friedrich, Gomez Rivas, Juan, Rivero, Ines, Lebastchi, Amir, Abreu, Andre, and Cacciamani, Giovanni E.
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- 2021
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204. Comment on: "Predictive factors for opioid-free management after robotic radical prostatectomy: the value of a single-port robotic platform".
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Puliatti, Stefano, Piazza, Pietro, Cacciamani, Giovanni E., Gómez Rivas, Juan, Taratkin, Mark, Marenco, José L., Belenchon, Ines Rivero, Kowalewski, Karl-Friedrich, and Checcucci, Enrico
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- 2021
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205. Publishers’ and journals’ instructions to authors on use of generative artificial intelligence in academic and scientific publishing: bibliometric analysis
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Ganjavi, Conner, Eppler, Michael B, Pekcan, Asli, Biedermann, Brett, Abreu, Andre, Collins, Gary S, Gill, Inderbir S, and Cacciamani, Giovanni E
- Abstract
ObjectivesTo determine the extent and content of academic publishers’ and scientific journals’ guidance for authors on the use of generative artificial intelligence (GAI).DesignCross sectional, bibliometric study.SettingWebsites of academic publishers and scientific journals, screened on 19-20 May 2023, with the search updated on 8-9 October 2023.ParticipantsTop 100 largest academic publishers and top 100 highly ranked scientific journals, regardless of subject, language, or country of origin. Publishers were identified by the total number of journals in their portfolio, and journals were identified through the Scimago journal rank using the Hirsch index (H index) as an indicator of journal productivity and impact.Main outcome measuresThe primary outcomes were the content of GAI guidelines listed on the websites of the top 100 academic publishers and scientific journals, and the consistency of guidance between the publishers and their affiliated journals.ResultsAmong the top 100 largest publishers, 24% provided guidance on the use of GAI, of which 15 (63%) were among the top 25 publishers. Among the top 100 highly ranked journals, 87% provided guidance on GAI. Of the publishers and journals with guidelines, the inclusion of GAI as an author was prohibited in 96% and 98%, respectively. Only one journal (1%) explicitly prohibited the use of GAI in the generation of a manuscript, and two (8%) publishers and 19 (22%) journals indicated that their guidelines exclusively applied to the writing process. When disclosing the use of GAI, 75% of publishers and 43% of journals included specific disclosure criteria. Where to disclose the use of GAI varied, including in the methods or acknowledgments, in the cover letter, or in a new section. Variability was also found in how to access GAI guidelines shared between journals and publishers. GAI guidelines in 12 journals directly conflicted with those developed by the publishers. The guidelines developed by top medical journals were broadly similar to those of academic journals.ConclusionsGuidelines by some top publishers and journals on the use of GAI by authors are lacking. Among those that provided guidelines, the allowable uses of GAI and how it should be disclosed varied substantially, with this heterogeneity persisting in some instances among affiliated publishers and journals. Lack of standardization places a burden on authors and could limit the effectiveness of the regulations. As GAI continues to grow in popularity, standardized guidelines to protect the integrity of scientific output are needed.
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- 2024
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206. Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus.
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Cacciamani, Giovanni E., Shakir, A., Tafuri, A., Gill, K., Han, J., Ahmadi, N., Hueber, P. A., Gallucci, M., Simone, G., Campi, R., Vignolini, G., Huang, W. C., Taylor, J., Becher, E., Van Leeuwen, F. W. B., Van Der Poel, H. G., Velet, L. P., Hemal, A. K., Breda, A., and Autorino, R.
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UROLOGICAL surgery , *SURGICAL robots , *INDOCYANINE green , *SENTINEL lymph nodes , *BEST practices , *FLUORESCENCE - Abstract
Purpose: The aim of the present study is to investigate the impact of the near-infrared (NIRF) technology with indocyanine green (ICG) in robotic urologic surgery by performing a systematic literature review and to provide evidence-based expert recommendations on best practices in this field. Methods: All English language publications on NIRF/ICG-guided robotic urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus® and Web of Science™ databases (up to April 2019). Experts in the field provided detailed pictures and intraoperative video-clips of different NIRF/ICG-guided robotic surgeries with recommendations for each procedure. A unique QRcode was generated and linked to each underlying video-clip. This new exclusive feature makes the present the first "dynamic paper" that merges text and figure description with their own video providing readers an innovative, immersive, high-quality and user-friendly experience. Results: Our electronic search identified a total of 576 papers. Of these, 36 studies included in the present systematic review reporting the use of NIRF/ICG in robotic partial nephrectomy (n = 13), robotic radical prostatectomy and lymphadenectomy (n = 7), robotic ureteral re-implantation and reconstruction (n = 5), robotic adrenalectomy (n = 4), robotic radical cystectomy (n = 3), penectomy and robotic inguinal lymphadenectomy (n = 2), robotic simple prostatectomy (n = 1), robotic kidney transplantation (n = 1) and robotic sacrocolpopexy (n = 1). Conclusion: NIRF/ICG technology has now emerged as a safe, feasible and useful tool that may facilitate urologic robotic surgery. It has been shown to improve the identification of key anatomical landmarks and pathological structures for oncological and non-oncological procedures. Level of evidence is predominantly low. Larger series with longer follow-up are needed, especially in assessing the quality of the nodal dissection and the feasibility of the identification of sentinel nodes and the impact of these novel technologies on long-term oncological and functional outcomes. [ABSTRACT FROM AUTHOR]
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- 2020
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207. One-Stop MRI and MRI/transrectal ultrasound fusion-guided biopsy: an expedited pathway for prostate cancer diagnosis.
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Tafuri, Alessandro, Ashrafi, Akbar N., Palmer, Suzanne, Shakir, Aliasger, Cacciamani, Giovanni E., Iwata, Atsuko, Iwata, Tsuyoshi, Cai, Jie, Sali, Akash, Gupta, Chhavi, Medina, Luis G., Stern, Mariana C., Duddalwar, Vinay, Aron, Manju, Gill, Inderbir S., and Abreu, Andre
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ENDORECTAL ultrasonography ,CANCER diagnosis ,SURGICAL complications ,PROSTATE biopsy ,MAGNETIC resonance imaging ,BIOPSY - Abstract
Purpose: To assess the feasibility, safety, and outcomes of an expedited One-Stop prostate cancer (PCa) diagnostic pathway. Patients and methods: We identified 370 consecutive patients who underwent multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound fusion prostate biopsy (MRI/TRUS-PBx) from our institutional review board-approved database. Patients were divided according to diagnostic pathway: One-Stop (n = 74), with mpMRI and same-day PBx, or Standard (n = 296), with mpMRI followed by a second visit for PBx. mpMRIs were performed and interpreted according to Prostate Imaging-Reporting and Data System (PI-RADS v2). Grade group ≥ 2 PCa defined clinically significant PCa (csPCa). Statistical significance was considered when p < 0.05. Results: Age (66 vs 66 years, p = 0.59) and PSA density (0.1 vs 0.1 ng/mL
2 , p = 0.26) were not different between One-Stop vs Standard pathway, respectively. One-Stop patients lived further away from the hospital than Standard patients (163 vs 31 km; p < 0.01), and experienced shorter time from mpMRI to PBx (0 vs 7 days; p < 0.01). The number (p = 0.56) and distribution of PI-RADS lesions (p = 0.67) were not different between the groups. All procedures were completed successfully with similar perioperative complications rate (p = 0.24). For patients with PI-RADS 3–5 lesions, the csPCa detection rate (49% vs 41%, p = 0.55) was similar for One-Stop vs Standard, respectively. The negative predictive value of mpMRI (PI-RADS 1–2) for csPCa was 78% for One-Stop vs 83% for Standard (p = 0.99). On multivariate analysis, age, prostate volume and PI-RADS score (p < 0.01), but not diagnostic pathway, predicted csPCa detection. Conclusion: A One-Stop PCa diagnostic pathway is feasible, safe, and provides similar outcomes in a shorter time compared to the Standard two-visit diagnostic pathway. [ABSTRACT FROM AUTHOR]- Published
- 2020
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208. Radical cystectomy pentafecta: a proposal for standardisation of outcomes reporting following robot‐assisted radical cystectomy.
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Cacciamani, Giovanni E., Winter, Matthew, Medina, Luis G., Ashrafi, Akhbar N., Miranda, Gus, Tafuri, Alessandro, Landsberger, Hannah, Lin‐Brande, Michael, Rajarubendra, Nieroshan, De Castro Abreu, Andre, Berger, Andre, Aron, Monish, Gill, Inderbir S., and Desai, Mihir M.
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CYSTECTOMY , *URINARY diversion , *LOGISTIC regression analysis , *SURGICAL site , *ODDS ratio , *REGRESSION analysis - Abstract
Objective: To propose a standardisable composite method for reporting outcomes of radical cystectomy (RC) that incorporates both perioperative morbidity and oncological adequacy. Patients and methods: From July 2010 to December 2017, 277 consecutive patients who underwent robot‐assisted RC with intracorporeal urinary diversion (UD) for bladder cancer at our Institution were prospectively analysed. Patients who simultaneously demonstrated negative soft tissue surgical margins (STSMs), ≥16 lymph node (LN) yield, absence of major (grade III–IV) complications at 90 days, absence of UD‐related long‐term sequelae and absence of clinical recurrence at ≤12 months, were considered as having achieved the RC‐pentafecta. A multivariable logistic regression model was assessed to measure predictors for achieving RC‐pentafecta. Results and limitations: Since 2010, 270 of 277 patients that had completed at least 12 months of follow‐up were included. Over a mean follow‐up of 22.3 months, ≥16 LN yield, negative STSMs, absence of major complications at 90 days, and absence of UD‐related surgical sequelae and clinical recurrence at ≤12 months were observed in 93.0%, 98.9%, 76.7%, 81.5% and 92.2%, patients, respectively, resulting in a RC‐pentafecta rate of 53.3%. Multivariable logistic regression analysis revealed age (odds ratio [OR] 0.95; P = 0.002), type of UD (OR 2.19; P = 0.01) and pN stage (OR 0.48; P = 0.03) as independent predictors for achieving RC‐pentafecta. Conclusions: We present a RC‐pentafecta as a standardisable composite endpoint that incorporates perioperative morbidity and oncological adequacy as a potential tool to assess quality of RC. This tool may be useful for assessing the learning curve and calculating cost‐effectiveness amongst others but needs to be externally validated in future studies. [ABSTRACT FROM AUTHOR]
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- 2020
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209. Impact of Surgical Factors on Robotic Partial Nephrectomy Outcomes: Comprehensive Systematic Review and Meta-Analysis
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Cacciamani, Giovanni E., primary, Medina, Luis G., additional, Gill, Tania, additional, Abreu, Andre, additional, Sotelo, René, additional, Artibani, Walter, additional, and Gill, Inderbir S., additional
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- 2018
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210. Robotic Management of Rectourethral Fistulas After Focal Treatment for Prostate Cancer
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Medina, Luis G., primary, Cacciamani, Giovanni E., additional, Hernandez, Angelica, additional, Landsberger, Hannah, additional, Doumanian, Leo, additional, Ashrafi, Akbar N., additional, Winter, Matthew, additional, Gill, Inderbir, additional, and Sotelo, Rene, additional
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- 2018
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211. A Larger Perspective Study is Needed When Judging Robotic Radical Nephrectomy
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Cacciamani, Giovanni E., primary, Desai, Mihir M., additional, and Gill, Inderbir S., additional
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- 2018
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212. Determinant factors for chronic kidney disease after partial nephrectomy
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Martín, Oscar D., primary, Bravo, Heilen, additional, Arias, Marcos, additional, Dallos, Diego, additional, Quiroz, Yesica, additional, Medina, Luis G., additional, Cacciamani, Giovanni E., additional, and Carlini, Raul G., additional
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- 2018
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213. Impact of Preoperative Patient Characteristics and Flow Rate on Failure, Early Complications, and Voiding Dysfunction After a Transobturator Tape Procedure: A Multicentre Study
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Cocci, Andrea, primary, Cacciamani, Giovanni E., additional, Russo, Giorgio Ivan, additional, Cerruto, Maria Angela, additional, Milanesi, Martina, additional, Medina, Luis G., additional, Cimino, Sebastiano, additional, Artibani, Walter, additional, Morgia, Giuseppe, additional, Carini, Marco, additional, and Li Marzi, Vincenzo, additional
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- 2017
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214. Consulting “Dr. Google” for Prostate Cancer Treatment Options: A Contemporary Worldwide Trend Analysis
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Cacciamani, Giovanni E., Bassi, Silvia, Sebben, Marco, Marcer, Anna, Russo, Giorgio I., Cocci, Andrea, Dell’Oglio, Paolo, Medina, Luis G., Nassiri, Nima, Tafuri, Alessandro, Abreu, Andre, Porcaro, Antonio B., Briganti, Alberto, Montorsi, Francesco, Gill, Inderbir S., and Artibani, Walter
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In the era of digital data, the Internet has become the primary source from which individuals draw healthcare information.
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- 2020
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215. ROBOTIC INTRACORPOREAL ILEAL CONDUIT: TECHNICAL ASPECTS.
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Medina, Luis G., Baccaglini, Willy, Hernández, Angélica, Rajarubendra, Nieroshan, Winter, Matthew, Ashrafi, Akbar N., Tafuri, Alessandro, Cacciamani, Giovanni E., and Sotelo, Rene
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- 2019
216. PRISMA AI reporting guidelines for systematic reviews and meta-analyses on AI in healthcare
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Cacciamani, Giovanni E., Chu, Timothy N., Sanford, Daniel I., Abreu, Andre, Duddalwar, Vinay, Oberai, Assad, Kuo, C.-C. Jay, Liu, Xiaoxuan, Denniston, Alastair K., Vasey, Baptiste, McCulloch, Peter, Wolff, Robert F., Mallett, Sue, Mongan, John, Kahn, Charles E., Sounderajah, Viknesh, Darzi, Ara, Dahm, Philipp, Moons, Karel G. M., Topol, Eric, Collins, Gary S., Moher, David, Gill, Inderbir S., and Hung, Andrew J.
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- 2023
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217. ChatGPT: standard reporting guidelines for responsible use.
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Cacciamani, Giovanni E., Gill, Inderbir S., and Collins, Gary S.
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Letter to the Editor [ABSTRACT FROM AUTHOR]
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- 2023
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218. Can We Avoid a Systematic Biopsy in Men with PI-RADS 5? Reply.
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Tafuri, Alessandro, Atsuko Iwata, Shakir, Aliasger, Tsuyoshi Iwata, Gupta, Chhavi, Sali, Akash, Sugano, Dordaneh, Mahdi, Abtahi Seyed, Cacciamani, Giovanni E., Kaneko, Masatomo, Cai, Jie, Ukimura, Osamu, Duddalwar, Vinay, Aron, Manju, Gill, Inderbir S., Palmer, Suzanne L., and Abreu, Andre Luis
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MEDICAL personnel ,PROSTATE cancer ,BIOPSY ,MAGNETIC resonance imaging ,PROSTATE-specific antigen ,CANCER hormone therapy - Published
- 2022
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219. Need to define hostile surgical sites to enhance surgical planning and outcomes.
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Eppler, Michael B., Gill, Inderbir, and Cacciamani, Giovanni E.
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SURGICAL site - Published
- 2023
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220. The Novel Green Learning Artificial Intelligence for Prostate Cancer Imaging: a Balanced Alternative to Deep Learning and Radiomics
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Kaneko, Masatomo, Magoulianitis, Vasileios, Ramacciotti, Lorenzo Storino, Raman, Alex, Paralkar, Divyangi, Chen, Andrew, Chu, Timothy N., Yang, Yijing, Xue, Jintang, Yang, Jiaxin, Liu, Jinyuan, Jadvar, Donya S., Gill, Karanvir, Cacciamani, Giovanni E., Nikias, Chrysostomos L., Duddalwar, Vinay, Kuo, C.-C.Jay, Gill, Inderbir S., and Abreu, Andre Luis
- Abstract
The application of artificial intelligence (AI) on prostate magnetic resonance imaging (MRI) has shown promising results. A number of AI systems have been developed to automatically analyze prostate MRI for segmentation, cancer detection, and region of interest characterization, thereby assisting clinicians in their decision-making process. Deep learning, the current trend in imaging AI, has limitations including the lack of transparency “black box“, large data processing, and excessive energy consumption. In this narrative review, we provide an overview of the recent advances in AI for prostate cancer diagnosis and introduce our next-generation AI model, Green Learning, as a promising solution.
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- 2023
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221. Reporting standards for the use of large language model-linked chatbots for health advice
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Huo, Bright, Cacciamani, Giovanni E., Collins, Gary S., McKechnie, Tyler, Lee, Yung, and Guyatt, Gordon
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- 2023
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222. Comprehensive Assessment of MRI-based Artificial Intelligence Frameworks Performance in the Detection, Segmentation, and Classification of Prostate Lesions Using Open-Source Databases
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Ramacciotti, Lorenzo Storino, Hershenhouse, Jacob S., Moktar, Daniel, Paralkar, Divyangi, Kaneko, Masatomo, Eppler, Michael, Gill, Karanvir, Mogoulianitis, Vasileios, Duddalwar, Vinay, Abreu, Andre L., Gill, Inderbir, and Cacciamani, Giovanni E.
- Abstract
Numerous MRI-based artificial intelligence (AI) frameworks have been designed for prostate cancer lesion detection, segmentation, and classification via MRI as a result of intrareader and interreader variability that is inherent to traditional interpretation. Open-source data sets have been released with the intention of providing freely available MRIs for the testing of diverse AI frameworks in automated or semiautomated tasks. Here, an in-depth assessment of the performance of MRI-based AI frameworks for detecting, segmenting, and classifying prostate lesions using open-source databases was performed. Among 17 data sets, 12 were specific to prostate cancer detection/classification, with 52 studies meeting the inclusion criteria.
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- 2023
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223. Artificial Intelligence Applications in Urology.
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Cacciamani, Giovanni E., Gill, Inderbir S., and Hung, Andrew J.
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ARTIFICIAL intelligence , *MEDICAL personnel , *CYSTOSCOPY , *MAGNETIC resonance imaging , *PHYSICIANS , *UROLOGY , *BLADDER cancer , *PROSTATE cancer - Published
- 2021
224. Robotic Approach to Vena Cava Thrombectomy for Level ll-lll Tumor Thrombi.
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Cacciamani, Giovanni E. and Gill, Inderbir S.
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VENAE cavae , *BLADDER cancer , *ROBOTICS , *KIDNEY pelvis - Published
- 2018
225. Open versus Robot-Assisted Radical Cystectomy for the Treatment of pT4a Bladder Cancer: Comparison of Perioperative Outcomes.
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Perri, Davide, Rocco, Bernardo, Sighinolfi, Maria Chiara, Bove, Pierluigi, Pastore, Antonio L., Volpe, Alessandro, Minervini, Andrea, Antonelli, Alessandro, Zaramella, Stefano, Galfano, Antonio, Cacciamani, Giovanni E., Celia, Antonio, Dalpiaz, Orietta, Crivellaro, Simone, Greco, Francesco, Pini, Giovannalberto, Porreca, Angelo, Pacchetti, Andrea, Calcagnile, Tommaso, and Berti, Lorenzo
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CYSTECTOMY , *SURGICAL robots , *SURGERY , *PATIENTS , *TREATMENT effectiveness , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *MINIMALLY invasive procedures , *EVALUATION of medical care , *OPERATIVE surgery , *LONGITUDINAL method , *MEDICAL records , *ACQUISITION of data , *TUMOR classification , *COMPARATIVE studies , *LENGTH of stay in hospitals , *PERIOPERATIVE care ,BLADDER tumors - Abstract
Simple Summary: Bladder cancer is the second most common genitourinary malignancy. Robotic-assisted radical cystectomy has demonstrated comparable efficacy in treating bladder cancer to open radical cystectomy. Due to the features of the procedure itself and the often weak general health status of patients, radical cystectomy is related to a significant incidence of complications. During the last decades, robotic surgery has spread in bladder cancer treatment in order to take advantage of the benefits of minimally invasive surgery. However, the majority of evidence in the literature comes from cT2-T3 muscle-invasive bladder cancer. The management of patients with cT4 stage represents a relevant surgical challenge. The aim of the present study is to compare intra- and postoperative outcomes of robot-assisted and open radical cystectomy in the treatment of patients with a pT4a MIBC in a pathological report. We compared the perioperative outcomes of open (ORC) vs. robot-assisted (RARC) radical cystectomy in the treatment of pT4a MIBC. In total, 212 patients underwent ORC (102 patients, Group A) vs. RARC (110 patients, Group B) for pT4a bladder cancer. Patients were prospectively followed and retrospectively reviewed. We assessed operative time, estimated blood loss (EBL), intraoperative and postoperative complications, length of stay, transfusion rate, and oncological outcomes. Preoperative features were comparable. The mean operative time was 232.8 vs. 189.2 min (p = 0.04), and mean EBL was 832.8 vs. 523.7 mL in Group A vs. B (p = 0.04). An intraoperative transfusion was performed in 32 (31.4%) vs. 11 (10.0%) cases during ORC vs. RARC (p = 0.03). The intraoperative complications rate was comparable. The mean length of stay was shorter after RARC (12.6 vs. 7.2 days, p = 0.02). Postoperative transfusions were performed in 36 (35.3%) vs. 13 (11.8%) cases (p = 0.03), and postoperative complications occurred in 37 (36.3%) vs. 29 (26.4%) patients in Groups A vs. B (p = 0.05). The positive surgical margin (PSM) rate was lower after RARC. No differences were recorded according to the oncological outcomes. ORC and RARC are feasible treatments for the management of pT4a bladder tumors. Minimally invasive surgery provides shorter operative time, bleeding, transfusion rate, postoperative complications, length of stay, and PSM rate. [ABSTRACT FROM AUTHOR]
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- 2024
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226. Impact of Pelvic Lymph Node Dissection and Its Extent on Perioperative Morbidity in Patients Undergoing Radical Prostatectomy for Prostate Cancer: A Comprehensive Systematic Review and Meta-analysis
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Cacciamani, Giovanni E., Maas, Marissa, Nassiri, Nima, Ortega, David, Gill, Karanvir, Dell’Oglio, Paolo, Thalmann, George N., Heidenreich, Axel, Eastham, James A., Evans, Christopher P., Karnes, R. Jeffrey, De Castro Abreu, Andre L., Briganti, Alberto, Artibani, Walter, Gill, Inderbir, and Montorsi, Francesco
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Pelvic lymph node dissection (PLND) yields the most accurate staging in patients undergoing radical prostatectomy (RP) for prostate cancer (PCa), although it can be associated with morbidity.
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- 2021
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227. Programmed Death 1 and Programmed Death Ligand 1 Inhibitors in Advanced and Recurrent Urothelial Carcinoma: Meta-analysis of Single-Agent Studies
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Tafuri, Alessandro, Smith, David D., Cacciamani, Giovanni E., Cole, Sarah, Shakir, Aliasger, Sadeghi, Sarmad, Vogelzang, Nicholas J., Quinn, David, Gill, Parkash S., and Gill, Inderbir S.
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We performed a systematic review and meta-analysis on the response rates of patients with treatment-refractory urothelial carcinoma treated with programmed cell death 1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors. We reviewed the literature for prospective studies evaluating PD-1/PD-L1 inhibitors in refractory urothelial carcinoma patients, which formed the basis for US Food and Drug Administration approval of 5 different antagonistic antibodies targeting PD-1 or PD-L1 (atezolizumab, durvalumab, avelumab, nivolumab, and pembrolizumab). We considered studies examining PD-1/PD-L1–treated patients, which we identified using the following key terms in the Pubmed, Scopus, Web of Science, ClinicalTrial.gov, and Cochrane Library databases. Eligible studies had ≥ 20 patients each and reported response rates, duration of response, and overall survival (OS). We performed fixed and random-effects meta-analyses to model the point estimates for objective response rate and complete response. The median progression-free survival (PFS) and OS for studies reporting these statistics were evaluated. We found 10 eligible studies that met our inclusion criteria, providing extractable numerators and denominators for response rates, PFS, and OS for 1934 patients with metastatic urothelial carcinoma. The objective response rate was 18% (95% confidence interval, 15-22) for second-line or later therapies. The random-effects estimate for complete response was 4% (95% confidence interval, 3-5), including all disease locations and all PD-1 and PD-L1 inhibitors. Median OS and PFS were < 13 months and 3 months, respectively, across all studies, irrespective of PD-L1 expression. We found that the estimated response rates of agents included in this meta-analysis seem to be more favorable than other salvage therapies.
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- 2020
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228. Gender disparities among publications within international sexual medicine urology journals and the impact of blinding in the review process.
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Burg, Madeleine L, Kohli, Priya, Ha, Nhi, Mora Jr, Richard, Kurup, Trisha, Sidhu, Hannah, Rodman, Jack, Cacciamani, Giovanni E, and Samplaski, Mary K
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GENDER inequality , *SEX discrimination , *CITATION analysis , *MEDICAL writing , *GENDER identity - Abstract
Background: While female urologists are known to publish at less frequency than their male peers, The Journal of Sexual Medicine was reported to have among the highest growth in female authorship from 2002 to 2020 in urology journals. Aim: We sought to assess the frequency of female authorship in sexual medicine journals worldwide and the factors that affect this, including the blinded/unblinded review process. Methods: Eleven sexual medicine journals were assessed for geographic location, peer review method, and SCImago Journal Rank citation index (a metric of citation frequency and prestige). Journals were grouped into top, middle, and bottom quartiles based on metric score. Web of Science was used to access the publications' first, second, last, and corresponding authors from the past 5 years. An internet search or Gender-API.com was used to determine the gender identities of authors. Univariate and multivariable logistic regression models were performed. Outcomes: Outcomes included the likelihood of female authorship (first, second, last, and corresponding) based on journal location and ranking, the clustering of female authors, the journal's peer review process, and the frequency of female editorial board members. Results: Overall, 8938 publications were identified. Women represented 30.7%, 31.3%, 21.3%, and 18.7% of the first, second, last, and corresponding authors, respectively; gender was unable to be assessed for 2.6%, 17.2%, 7.3%, and 2.7%. On univariate analysis, journals from North America, in the top quartile, and with a double-blind review process were more likely to have female authors (P <.001). On multivariate analysis, articles were more likely to have a female first author if they had a double-blind peer review process (odds ratio [OR], 1.20; 95% CI, 1.02-1.40), a female second author (OR, 2.54; 95% CI, 2.26-2.85), or a female corresponding author (OR, 7.80; 95% CI, 6.69-9.10). Clinical Implications: Gender-concordant mentoring and universal double-blind manuscript review processes may minimize the impact of gender bias and increase female authorship rates, in turn producing more diverse research. Strengths and Limitations: This is the first study assessing female authorship in sexual medicine journals. Limitations include not assessing every author listed on articles and being unable to determine gender identities for some authors. Conclusion: Female authorship rates are higher than reported rates of practicing female urologists but still lower than their male peers. Female authors were more likely to be published in journals with double-blind peer review processes and when publishing with additional female authors. [ABSTRACT FROM AUTHOR]
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- 2024
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229. Criteria for enhancing reporting of perioperative transfusions in surgical and anaesthesiological studies.
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Eppler, Michael B., Ganjavi, Conner, Davis, Ryan, Sayegh, Aref S., Hershenhouse, Jacob S., Mokhtar, Daniel, Knudsen, J. Everett, Tran, John, Bhardwaj, Lokesh, Shin, John J. S., Hemal, Sij, Goldenberg, Mitchell G., Miranda, Gus, Sotelo, Rene, Desai, Mihir, Gill, Inderbir, and Cacciamani, Giovanni E.
- Published
- 2023
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230. Transperineal vs transrectal magnetic resonance and ultrasound image fusion prostate biopsy: a pair-matched comparison.
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Kaneko, Masatomo, Medina, Luis G., Lenon, Maria Sarah L., Hemal, Sij, Sayegh, Aref S., Jadvar, Donya S., Ramacciotti, Lorenzo Storino, Paralkar, Divyangi, Cacciamani, Giovanni E., Lebastchi, Amir H., Salhia, Bodour, Aron, Manju, Hopstone, Michelle, Duddalwar, Vinay, Palmer, Suzanne L., Gill, Inderbir S., and Abreu, Andre Luis
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ENDORECTAL ultrasonography , *PROSTATE biopsy , *MAGNETIC resonance imaging , *IMAGE fusion , *DIGITAL rectal examination , *PROSTATE cancer - Abstract
The objective of this study was to compare transperineal (TP) versus transrectal (TR) magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) fusion prostate biopsy (PBx). Consecutive men who underwent prostate MRI followed by a systematic biopsy. Additional target biopsies were performed from Prostate Imaging Reporting & Data System (PIRADS) 3–5 lesions. Men who underwent TP PBx were matched 1:2 with a synchronous cohort undergoing TR PBx by PSA, Prostate volume (PV) and PIRADS score. Endpoint of the study was the detection of clinically significant prostate cancer (CSPCa; Grade Group ≥ 2). Univariate and multivariable analyses were performed. Results were considered statistically significant if p < 0.05. Overall, 504 patients met the inclusion criteria. A total of 168 TP PBx were pair-matched to 336 TR PBx patients. Baseline demographics and imaging characteristics were similar between the groups. Per patient, the CSPCa detection was 2.1% vs 6.3% (p = 0.4) for PIRADS 1–2, and 59% vs 60% (p = 0.9) for PIRADS 3–5, on TP vs TR PBx, respectively. Per lesion, the CSPCa detection for PIRADS 3 (21% vs 16%; p = 0.4), PIRADS 4 (51% vs 44%; p = 0.8) and PIRADS 5 (76% vs 84%; p = 0.3) was similar for TP vs TR PBx, respectively. However, the TP PBx showed a longer maximum cancer core length (11 vs 9 mm; p = 0.02) and higher cancer core involvement (83% vs 65%; p < 0.001) than TR PBx. Independent predictors for CSPCa detection were age, PSA, PV, abnormal digital rectal examination findings, and PIRADS 3–5. Our study demonstrated transperineal MRI/TRUS fusion PBx provides similar CSPCa detection, with larger prostate cancer core length and percent of core involvement, than transrectal PBx. [ABSTRACT FROM AUTHOR]
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- 2023
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231. Impact of smoking on urologic cancers: a snapshot of current evidence.
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Kumar, Raj, Matulewicz, Richard, Mari, Andrea, Moschini, Marco, Ghodoussipour, Saum, Pradere, Benjamin, Rink, Michael, Autorino, Riccardo, Desai, Mihir M., Gill, Inderbir, and Cacciamani, Giovanni E.
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SMOKING cessation , *SMOKING , *PROSTATE cancer , *BLADDER cancer , *TOBACCO smoke , *DISEASE relapse , *LYMPHATIC metastasis - Abstract
Purpose: The purpose of this paper is to present evidence regarding the associations between smoking and the following urologic cancers: prostate, bladder, renal, and upper tract urothelial cancer (UTUC). Methods: This is a narrative review. PubMed was queried for evidence-based analyses and trials regarding the associations between smoking and prostate, bladder, renal, and UTUC tumors from inception to September 1, 2022. Emphasis was placed on articles referenced in national guidelines and protocols. Results: Prostate—multiple studies associate smoking with higher Gleason score, higher tumor stage, and extracapsular invasion. Though smoking has not yet been linked to tumorigenesis, there is evidence that it plays a role in biochemical recurrence and cancer-specific mortality. Bladder—smoking is strongly associated with bladder cancer, likely due to DNA damage from the release of carcinogenic compounds. Additionally, smoking has been linked to increased cancer-specific mortality and higher risk of tumor recurrence. Renal—smoking tobacco has been associated with tumorigenesis, higher tumor grade and stage, poorer mortality rates, and a greater risk of tumor recurrence. UTUC—tumorigenesis has been associated with smoking tobacco. Additionally, more advanced disease, higher stage, lymph node metastases, poorer survival outcomes, and tumor recurrence have been linked to smoking. Conclusion: Smoking has been shown to significantly affect most urologic cancers and has been associated with more aggressive disease, poorer outcomes, and tumor recurrence. The role of smoking cessation is still unclear, but appears to provide some protective effect. Urologists have an opportunity to engage in primary prevention by encouraging cessation practices. [ABSTRACT FROM AUTHOR]
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- 2023
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232. Obturator Nerve Injury in Robotic Pelvic Surgery: Scenarios and Management Strategies.
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La Riva, Anibal, Sayegh, Aref S., Perez, Laura C., Poncel, Jaime, Medina, Luis G., Adamic, Brittany, Powers, Ryan, Cacciamani, Giovanni E., Aron, Monish, Gill, Inderbir, and Sotelo, Rene
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NERVOUS system injuries , *SURGICAL robots , *UROLOGICAL surgery , *LYMPHADENECTOMY , *GYNECOLOGIC surgery , *NERVE endings , *PELVIC pain - Abstract
The obturator nerve can be damaged during urological or gynecological surgeries. Obturator nerve injury is a preventable complication for which there are different management options, depending on the type of nerve injury. Obturator nerve injury (ONI) is an uncommon complication of pelvic surgery, usually reported in 0.2–5.7% of cases undergoing surgical treatment of urological and gynecological malignancies involving pelvic lymph node dissection (PLND). To describe how an ONI may occur during robotic pelvic surgery and the corresponding management strategies. We retrospectively analyzed video content on intraoperative ONI provided by robotic surgeons from high-volume centers. ONI was identified during PLND and managed according to the type of nerve injury. The management approach varies with the type of injury. Crush injury frequently occurs at an advanced stage of PLND. For a crush injury to the obturator nerve caused by a clip, management only requires its safe removal. Three situations can occur if the nerve is transected: (1) transection with feasible approximation and tension-free nerve anastomosis; (2) transection with challenging approximation requiring certain strategies for proper nerve anastomosis; and (3) transection with a hidden proximal nerve ending that may initially appear intact, but is clearly injured when revealed by further dissection. Each case has different management strategies with a common aim of prompt repair of the anatomic disruption to restore proper nerve conduction. ONI is a preventable complication that requires proper identification of the anatomy and high-risk areas when performing pelvic lymph node dissection. Prompt intraoperative recognition and repair using the management strategies described offer patients the best chance of recovery without sequelae. We describe the different ways in which the obturator nerve in the pelvic area can be damaged during urological or gynecological surgeries. This is a preventable complication and we describe how it can be avoided and different management options, depending on the type of nerve injury. [ABSTRACT FROM AUTHOR]
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- 2023
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233. Minimally Invasive Management of Rectourethral Fistulae.
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Medina, Luis G., Sayegh, Aref S., La Riva, Anibal, Perez, Laura C., Ortega, David G., Rangel, Enanyeli, Hernandez, Angelica B., Lizana, Maria A., Sanchez, Alexis, Polotti, Charles F., Cacciamani, Giovanni E., and Sotelo, Rene
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MINIMALLY invasive procedures , *FISTULA , *LENGTH of stay in hospitals , *SURGICAL complications , *CYSTOSCOPY , *DEMOGRAPHIC characteristics , *URINARY fistula , *RETROSPECTIVE studies , *URETHRA diseases , *LAPAROSCOPY , *ANAL fistula - Abstract
Objective: To report our experience and outcomes in minimally invasive management of rectourethral fistula (RUF).Methods: From 2004 to 2021, 15 patients who underwent minimally invasive RUF repair by a single surgeon at 2 international institutions were retrospectively reviewed. Baseline demographic characteristics, perioperative, and postoperative data were collected. Complications were reported using the modified Clavien-Dindo Classification System and the European Association of Urology Complication Panel Assesment and Recommendations. Success was defined as complete resolution of fistula-related symptoms at 12-month follow-up along with confirmation of fistula closure by imaging or cystoscopy. Categorical variables were presented as frequencies and percentages whereas continuous variables were reported as median and quartiles.Results: Fifteen male patients with a median age of 71 (64-79.2) years were treated. Four cases (26.6%) occurred postsurgery, 8 cases (53.3%) occurred after energy treatments, and 3 cases (20%) after surgery combined with an energy treatment modality. A robotic and laparoscopic approach was performed in 9 (60%) and 6 (40%) patients, respectively. No intraoperative complications were reported. Median operative time was 264 (217.5-341) minutes, estimated blood loss was 175 (137.5-200) mL, and the length of hospital stay was 4 days. Nine postoperative complications were reported. All patients were followed-up for 12 months with no recurrence reported. All patients reached our criteria for successful RUF repair.Conclusions: Minimally invasive surgery could represent an efficient way to manage RUF in selected patients. More studies and treatment standardization are needed to assess the role of minimally invasive surgery in the management of RUF. [ABSTRACT FROM AUTHOR]- Published
- 2022
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234. Reply to Rui-Cheng Wu, Deng-Xiong Li, and De-Chao Feng's Letter to the Editor re: Michael Eppler, Conner Ganjavi, Lorenzo Storino Ramacciotti, et al. Awareness and Use of ChatGPT and Large Language Models: A Prospective Cross-sectional Global Survey in Urology. Eur Urol. 2024;85:146–53
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Eppler, Michael, Ganjavi, Conner, Abreu, Andre, Gill, Inderbir, and Cacciamani, Giovanni E.
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LANGUAGE models , *CHATGPT , *AWARENESS - Published
- 2024
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235. Contemporary Trends of Systemic Neoadjuvant and Adjuvant Intravesical Chemotherapy in Patients With Upper Tract Urothelial Carcinomas Undergoing Minimally Invasive or Open Radical Nephroureterectomy: Analysis of US Claims on Perioperative Outcomes and Health Care Costs
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Del Giudice, Francesco, van Uem, Stefanie, Shufeng Li, Vilson, Fernandino L., Sciarra, Alessandro, Salciccia, Stefano, Busetto, Gian Maria, Maggi, Martina, Tiberia, Letizia, Viscuso, Pietro, Canale, Vittorio, Panebianco, Valeria, Pecoraro, Martina, Ferro, Matteo, Moschini, Marco, Krajewski, Wojciech, D'Andrea, David, Cacciamani, Giovanni E., Mari, Andrea, and Soria, Francesco
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MEDICAL care costs , *TRANSITIONAL cell carcinoma , *NEOADJUVANT chemotherapy , *TREATMENT effectiveness , *SURGICAL complications - Abstract
Most of the radical interventions have shifted towards more minimally invasive approaches such as laparoscopic or robotic assisted surgeries to treat UTUC. While these paradigm shifts have led to reduction of morbidity and perioperative health-care related costs over the past 15 years, our patient cohort did not receive NAC and PIC. Introduction: New evidence indicates that minimally invasive surgery (MIS) (laparoscopic or robotic-assisted [LNU, RANU]) reaches oncologic equivalence compared with Open Radical Nephroureterectomy (ORNU) for high-risk uppertract urothelial carcinoma (UTUC). Recently, European Association of Urology (EAU) Guidelines suggested implementing neoadjuvant chemotherapy (NAC) to standard treatment to improve oncologic outcomes of high-risk UTUC. We aimed (1) To explore contemporary trends of MIS for RNU in the United States and to compare perioperative outcomes and costs with that of ORNU. (2) To determine the trends of NAC and postoperative intravesical chemotherapy (PIC) administration for high-risk UTUC and to assess their contribution to perioperative outcomes and costs. Patients and Methods: The Optum Clinformatics Data Mart de-identified database was queried from 2003 to 2018 to retrospectively examine patients who had undergone LNU/RANU or ORNU with or without NAC and PIC. We evaluated temporal adoption trends, complications, and health care cost analyses. We obtained descriptive statistics and utilized multivariable regression modeling to assess outcomes. Results: A total of n = 492 ORNU and n = 1618 LNU/RANU procedures were reviewed. The MIS approach was associated with a statistically significant lower risk of intraoperative complications (adjusted Odds Ratio [aOR], 0.48, 95% CI:0.24-0.96), risk of hospitalization costs (aOR: 0.62, 95% CI:0.49-0.78), and shorter hospital stay (aOR: 0.20, 95% CI:0.15-0.26) when compared to ORNU. Overall, adoption of NAC and PIC accounted for only n = 81 and n < 37 cases respectively. The implementation of NAC and higher number of cycles were associated with an increased probability of any complication rate (aOR: 2.06, 95% CI:1.26-3.36) and hospital costs (aOR: 2.12, 95% CI:1.33-3.38). Conclusion: MIS has become the approach of choice for RNU in the US. Although recommended by guidelines, neither NAC nor postoperative bladder instillation of chemotherapy has been routinely incorporated into the clinical practice of patients with UTUC. [ABSTRACT FROM AUTHOR]
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- 2022
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236. Impact of the Implementation of the EAU Guidelines Recommendation on Reporting and Grading of Complications in Patients Undergoing Robot-assisted Radical Cystectomy: A Systematic Review.
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Dell'Oglio, Paolo, Andras, Iulia, Ortega, David, Galfano, Antonio, Artibani, Walter, Autorino, Riccardo, Mazzone, Elio, Crisan, Nicolae, Bocciardi, Aldo Massimo, Sanchez-Salas, Rafael, Gill, Inderbir, Wiklund, Peter, Desai, Mihir, Mitropoulos, Dionysios, Mottrie, Alexandre, and Cacciamani, Giovanni E.
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SURGICAL robots , *OPERATIVE surgery , *CYSTECTOMY , *SCIENCE databases , *WEB databases - Abstract
In 2012, the European Association of Urology (EAU) Ad Hoc Panel proposed a standardised methodology on reporting and grading complications after urological surgical procedures. The aim of the current study was to assess the impact of this implementation on complications reporting for patients undergoing robot-assisted radical cystectomy (RARC). A systematic review of all English-language original articles published on RARC until March 2020 was performed using PubMed, Scopus, and Web of Science databases. The study selection process followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) criteria. The quality of reporting and grading complication was evaluated according to the EAU recommendations. Our analysis failed to observe a statistically significant improvement in reporting outcomes after the EAU guidelines recommendations except for three of the 14 criteria proposed (ie, follow-up duration, utilisation of a severity grade system, and risk factors included in the analyses). A lower statistically significant adherence to outcome reporting in terms of inclusion of readmissions and causes (p = 0.02), was observed. In this study, we evaluated the impact of the proposed European Association of Urology (EAU) standardised reporting tool for urological complications, in patients treated with robot-assisted radical cystectomy. A low adherence to EAU guidelines recommendations for complications reporting was observed. We failed to observe a significant improvement in reporting robot-assisted radical cystectomy outcomes after the 2012 European Association of Urology (EAU) guidelines recommendations on reporting and grading complications after urological surgical procedures. There is an impending need to widely adopt the standardised predefined 14-item criteria proposed by the EAU Guidelines Panel to avoid underestimating the rate of complications and to improve patient counselling. [ABSTRACT FROM AUTHOR]
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- 2021
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237. A Double-Blind, Placebo-Controlled Parallel Group Study to Evaluate the Effect of a Single Oral Dose of 5-HT1A Antagonist GSK958108 on Ejaculation Latency Time in Male Patients Suffering From Premature Ejaculation.
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Migliorini, Filippo, Tafuri, Alessandro, Bettica, Paolo, Ziviani, Luigi, Lund, Jesper, Poggesi, Italo, Marcer, Anna, Cacciamani, Giovanni E., Lorenzo-Gomez, Maria Fernanda, Porcaro, Antonio B., Antonelli, Alessandro, and Milleri, Stefano
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PREMATURE ejaculation , *EJACULATION , *DRUG side effects , *SUFFERING - Abstract
Premature ejaculation (PE) is a common male neurobiological sexual disorder, related to a disturbance in central serotonin (5-hydroxytryptamine or 5-HT) neurotransmission. To assess the efficacy of a single oral dose of 5HT 1A receptor antagonist GSK958108 on ejaculation latency time (ELT) in male subjects suffering from PE. A total of 35 male subjects were enrolled in a Phase 1 double-blind, placebo-controlled, parallel group masturbation-model study. All subjects completed the study. No subject was withdrawn from the study. There were no major protocol deviations reported during the study. The primary outcome of the study was to evaluate the effect of a single oral dose of 5HT 1A receptor antagonist GSK958108 on ELT as measured in the masturbation model; additionally, we investigated drug's safety and tolerability. In the 3 mg GSK958108 treatment group, the ELT was estimated to be 16% longer (1.542 vs 1.328, 95% CI: -16% to +61%) than if the subjects had taken placebo. In the 7 mg GSK958108 treatment group, the ELT was estimated to be 77% longer (2.346 vs 1.328, 95% CI: +28% to +144%) than in the placebo group. The systemic exposure to GSK958108 increased with dosage between 3 mg and 7 mg. A significant trend toward an increase of ELT was observed with increasing plasma concentrations of GSK958108. A total of 4 patients all treated with 7 mg dose experienced minor drug related adverse events (5 adverse events in 4 patients): somnolence (n = 3), headache (n = 1), tinnitus (n = 1). In the current double-blind, placebo-controlled parallel group study the 5HT 1A receptor antagonist GSK958108 was tested in 3 mg and 7 mg doses for PE treatment in humans. It was shown that GSK958108 significantly delayed ejaculation showing a new and safe alternative in PE treatment. The present study showed innovative results suggesting an important role of 5HT 1A receptor antagonist in the PE treatment. However, the use of masturbation model and the small population are the main limitations of this investigation. 5HT 1A receptor antagonist GSK958108 3 mg per day and 7 mg per day was found to be well-tolerated, safe and effective for the treatment of PE subjects and demonstrated a strong association between 5HT1A receptors and ejaculation control in humans (NCT00861484). Migliorini F, Tafuri A, Bettica P, et al. A Double-Blind, Placebo-Controlled Parallel Group Study to Evaluate the Effect of a Single Oral Dose of 5-HT1A Antagonist GSK958108 on Ejaculation Latency Time in Male Patients Suffering From Premature Ejaculation. J Sex Med 2021;18:63–71. [ABSTRACT FROM AUTHOR]
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- 2021
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238. Robotic Renal Artery Aneurysm Repair.
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Abreu, Andre Luis, Medina, Luis G., Chopra, Sameer, Gill, Karanvir, Cacciamani, Giovanni E., Azhar, Raed A., Ashrafi, Akbar, Winter, Matthew, Fay, Carlos, Weaver, Fred, Duddalwar, Vinay, Desai, Mihir, Sotelo, Rene, and Gill, Inderbir S.
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RENAL artery , *NEPHRECTOMY , *BLOOD loss estimation , *ROBOTICS , *ANEURYSMS , *PATIENT selection - Abstract
Renal artery aneurysm (RAA) is a rare condition, traditionally managed with endovascular or open surgical techniques. To report our experience with robotic RAA repair. Nine consecutive patients underwent intracorporeal robotic surgery for 10 RAAs. Two patients underwent concomitant robotic partial nephrectomy. One patient had RAA in a solitary kidney. Median RAA diameter was 2.2 (1.8–3) cm. Intracorporeal transarterial hypothermic renal perfusion was performed in five patients. Robotic techniques included tailored aneurysmectomy and repair (n = 5), excision with end-to-end anastomosis (n = 2), aneurysmectomy with branch reimplantation (n = 1), prosthetic interposition graft repair (n = 1), and simple nephrectomy (n = 1; this patient's data were excluded from analysis). Demographics, RAA characteristics, intraoperative techniques, perioperative outcomes, and follow up data were analyzed. Aneurysms were diagnosed by computed tomography, angiography, or incidentally during the performance of a partial nephrectomy. All cases were performed robotically, without conversion to open surgery. Median (range) operative time was 3.8 (3–6) h, warm ischemia time 26 (19–32) min, hypothermic renal perfusion time 34 (29–69) min, and estimated blood loss 100 (25–400) ml. No intraoperative blood transfusion was required. Median hospital stay was 3 (2–6) d. One patient had a Clavien-Dindo grade II complication. At median follow-up of 16 (2–67) mo, all patients had preserved renal function. Follow-up imaging confirmed normal caliber reconstructed renal arteries with globally perfused kidneys, except for two kidneys with small segmental infarcts due to an intentionally ligated small polar vessel. Limitations include the small number of patients and the retrospective nature of the study. Robotic repair of complex RAAs is feasible. Surgical expertise, patient selection, and RAA-specific vascular reconstruction are critical for success. Greater experience is needed to evaluate the proper place of robotic repair of RAAs. We report intracorporeal robotic repair for complex renal artery aneurysms. This robotic operation is feasible and safe, and replicates open principles. However, it requires considerable experience and expertise. We report our experience with nine consecutive patients who underwent robotic aneurysm repair. Techniques after the excision included tailored repair, end-to-end anastomosis, branch reimplantation, and graft interposition. This technique is feasible. However, surgical expertise and proper patient selection are critical. [ABSTRACT FROM AUTHOR]
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- 2020
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239. Management of the incidental adrenal mass, continued surveillance versus surgical excision: analysis of US claims data on contemporary socio-demographic predictors and perioperative outcomes
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Francesco DEL GIUDICE, Wansuk KIM, Shufeng LI, Ettore DE BERARDINIS, Alessandro SCIARRA, Stefano SALCICCIA, Matteo FERRO, Riccardo AUTORINO, Savio D. PANDOLFO, Felice CROCETTO, Antonio GALFANO, Paolo DELL’OGLIO, Giovanni E. CACCIAMANI, Benjamin PRADERE, Ekaterina LAUKHTINA, David D’ANDREA, Federico BELLADELLI, Wojciech KRAJEWSKI, Andrea MARI, Andrea MINERVINI, Andrea GALLIOLI, Daniele AMPARORE, Enrico CHECCUCCI, Cristian FIORI, Francesco PORPIGLIA, Luca MORGANTINI, Simone CRIVELLARO, Benjamin I. CHUNG, Del Giudice, Francesco, Kim, Wansuk, Li, Shufeng, DE Berardinis, Ettore, Sciarra, Alessandro, Salciccia, Stefano, Ferro, Matteo, Autorino, Riccardo, Pandolfo, Savio D, Crocetto, Felice, Galfano, Antonio, Dell'Oglio, Paolo, Cacciamani, Giovanni E, Pradere, Benjamin, Laukhtina, Ekaterina, D'Andrea, David, Belladelli, Federico, Krajewski, Wojciech, Mari, Andrea, Minervini, Andrea, Gallioli, Andrea, Amparore, Daniele, Checcucci, Enrico, Fiori, Cristian, Porpiglia, Francesco, Morgantini, Luca, Crivellaro, Simone, and Chung, Benjamin I
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Nephrology ,Epidemiology ,Urology ,Watchful waiting ,General surgery ,Minimally invasive surgical procedure - Abstract
Background: Incidentally diagnosed adrenal masses represent an entity that can result in either long term follow-up, surgical excision, or both. Understanding when and which adrenal masses are ultimately excised surgically is not well understood. We sought to understand the ultimate fate of these incidentalomas using a large population-based dataset. Methods: The primary outcome of the study was determining the trend in adoption of surveillance vs. surgical excision according to socio-demographic, economic, and pathologic indices, and also provider specialty. Secondary outcomes were the assessment of perioperative complications, operative time, surgical approach, hospital stay, and provider specialty (general surgery vs. urology) among the cohort that underwent excision. Results: Out of a total of N.=91,560 adrenal masses, ultimately N.=3375 (3.83%) of these underwent surgical excision. In the surgical excision cohort, the incidence of aldosteronoma, functional adenoma/Cushing's disease, and adrenocortical carcinoma was higher than in the surveillance cohort. Those patients who were older, female, and with higher Charlson Comorbidity indexes (CCI) were less likely to undergo surgical resection. Factors that predicted for an increased probability of resection included obtaining more CT/MRI scans as well as general surgeons as primary physician providers. Over the study period, the vast majority of surgeries were performed by surgeons other than urologists (12.9%) and open and laparoscopic approaches dominated, with the robotic-assisted approach accounting for a minority of the surgical cases (23.9%). The minimally invasive surgery (MIS) approach independently predicted for both lower rates of complications and shorter hospital stay. Conclusions: In the US, adrenal incidentalomas are more likely to undergo surveillance rather than surgical resection. In our study, surgery is mainly offered for functional or malignant disease and the receipt of surgery can vary by physician specialty. A MIS approach independently predicted for both lower rates of complications and shorter hospital stay.
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- 2023
240. Robotic assisted simple prostatectomy versus other treatment modalities for large benign prostatic hyperplasia: a systematic review and meta-analysis of over 6500 cases
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Savio Domenico Pandolfo, Francesco Del Giudice, Benjamin I. Chung, Celeste Manfredi, Marco De Sio, Rocco Damiano, Edward E. Cherullo, Cosimo De Nunzio, Giovanni E. Cacciamani, Luca Cindolo, Francesco Porpiglia, Vincenzo Mirone, Ciro Imbimbo, Riccardo Autorino, Fabio Crocerossa, Domenico Pandolfo, Savio, Del Giudice, Francesco, Chung, Benjamin I., Manfredi, Celeste, DE SIO, Marco, Damiano, Rocco, Cherullo, Edward E., De Nunzio, Cosimo, Cacciamani, Giovanni E., Cindolo, Luca, Porpiglia, Francesco, Mirone, Vincenzo, Imbimbo, Ciro, Autorino, Riccardo, and Crocerossa, Fabio
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turp ,Cancer Research ,benign prostatic hyperplasia ,simple prostatectomy ,Oncology ,Urology - Abstract
Background Current guidelines recommend simple prostatectomy or endoscopic enucleation of the prostate (EEP) as treatment of choice for bladder prostatic obstruction (BPO) caused by large prostate glands. We aimed to provide a wide-ranging analysis of the currently available evidence, comparing safety and effectiveness of robot-assisted simple prostatectomy (RASP) versus open simple prostatectomy (OSP), laparoscopic simple prostatectomy (LSP), and laser EEP. Methods A systematic search was performed across MEDLINE, EMBASE, and Web of Science databases for retrospective and prospective studies comparing RASP to OSP or LSP or laser EEP (HoLEP/ThuLEP). Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations were followed to design the search strategies, selection criteria, and evidence report. A meta-analysis evaluated perioperative safety and effectiveness outcomes. The weighted mean difference and risk ratio were used to compare continuous and dichotomous variables, respectively. Quality was assessed using the Newcastle-Ottawa scale and the Cochrane Collaboration's tool for RCT article assessing risk of bias. Results 15 studies, including 6659 patients, were selected for meta-analysis: 13 observational studies, 1 non-randomized prospective study, and 1 randomized controlled trial. RASP was associated with statistically significant longer operative time (OT) and lower postoperative complication rate, length of stay (LOS), estimated blood loss (EBL), and transfusion rate (TR) compared to OSP. LSP showed longer LOS and lower postoperative SHIM score, with no difference in OT, EBL, and complications. Compared to laser EEP, RASP presented longer LOS and catheterization time and higher TR. ThuLEP presented shorter OT than RASP. No difference were found in functional outcomes between groups both subjectively (IPSS, QoL) and objectively (Qmax, PVR). Conclusion RASP has become a size-independent treatment for the management of BPO caused by a large prostate gland. It can duplicate the functional outcomes of OSP while offering a better safety profile. When compared to LSP, the latter still stands as a valid lower-cost option, but it requires solid laparoscopic skill sets and therefore it is unlikely to spread on larger scale. When compared to laser EEP, RASP offers a shorter learning curve, but it still suffers from longer catheterization time and LOS.
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- 2022
241. Contemporary trends in the surgical management of urinary incontinence after radical prostatectomy in the United States
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Francesco Del Giudice, Jianlin Huang, Shufeng Li, Simon Sorensen, Ekene Enemchukwu, Martina Maggi, Stefano Salciccia, Matteo Ferro, Felice Crocetto, Savio Domenico Pandolfo, Riccardo Autorino, Wojciech Krajewski, Simone Crivellaro, Giovanni E. Cacciamani, Eugenio Bologna, Vincenzo Asero, Carlo Scornajenghi, Marco Moschini, David D’Andrea, David R. Brown, Benjamin I. Chung, Del Giudice, Francesco, Huang, Jianlin, Li, Shufeng, Sorensen, Simon, Enemchukwu, Ekene, Maggi, Martina, Salciccia, Stefano, Ferro, Matteo, Crocetto, Felice, Pandolfo, Savio Domenico, Autorino, Riccardo, Krajewski, Wojciech, Crivellaro, Simone, Cacciamani, Giovanni E, Bologna, Eugenio, Asero, Vincenzo, Scornajenghi, Carlo, Moschini, Marco, D'Andrea, David, Brown, David R, and Chung, Benjamin I
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Cancer Research ,Oncology ,Urology - Abstract
Purpose: To identify trends, costs, and predictors in the use of different surgical procedures for post-radical prostatectomy incontinence (PPI). Materials and methods: We identified 21,589 men who were diagnosed with localized prostate cancer (PCa) and treated with radical prostatectomy (RP) from 2003 to 2017. The primary outcome was the incontinence procedure performances. Optum's de-identified Clinformatics® Data Mart Database was queried to define the cohort of interest. The average costs of the different incontinence procedures were obtained and compared. Also, demographic, and clinical predictors of incontinence surgery were evaluated by multivariable regression analysis. Results: Of the 21,589 men with localized PCa treated with RP, 740 (3.43%) underwent at least one incontinence procedure during a median of 5 years of follow-up. In total, there were 844 unique incontinence procedures. Male slings were the most common procedure (47.5%), had an intermediate cost compared to the other treatment options, and was the first-choice treatment for the majority of patients (50%). The use of an artificial urinary sphincter (AUS) was the second most common (35.3%), but also was the most expensive treatment and was first-choice-treatment for 32.3% of patients. On multivariable analysis, metabolic syndrome related disorders, adjuvant/salvage radiation therapy as well as a history of neurological comorbidities were independently associated with an increased likelihood of incontinence surgery. Conclusions: The receipt of male slings increased and then subsequently decreased, while AUS utilization was stable, and the use of urethral bulking agents was uncommon. From a cost standpoint, AUS was the most expensive option. Finally, patient's comorbidity history and RP related factors were found to influence the choice for primary or subsequent PPI interventions.
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- 2022
242. Impact of the COVID-19 pandemic on urology residency training in Italy
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Francesco Porpiglia, Enrico Checcucci, Carlo Trombetta, Giovanni Cacciamani, Giovanni Liguori, Francesco Claps, Riccardo Campi, Marco Carini, Cristian Fiori, Sergio Serni, Daniele Amparore, Francesco Esperto, Amparore, Daniele, Claps, Francesco, Cacciamani, Giovanni E, Esperto, Francesco, Fiori, Cristian, Liguori, Giovanni, Serni, Sergio, Trombetta, Carlo, Carini, Marco, Porpiglia, Francesco, Checcucci, Enrico, and Campi, Riccardo
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medicine.medical_specialty ,Telemedicine ,Coronavirus disease 2019 (COVID-19) ,education ,Pneumonia, Viral ,030232 urology & nephrology ,MEDLINE ,Urology ,covid 19 ,residents ,training ,urology ,Urologic Surgical Procedure ,Education, Distance ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Smart learning ,Pandemic ,Medicine ,Humans ,resident ,Pandemics ,business.industry ,Internship and Residency ,COVID-19 ,Outpatient visits ,Italy ,Nephrology ,030220 oncology & carcinogenesis ,General Surgery ,Urologic Surgical Procedures ,business ,Coronavirus Infections ,Residency training - Abstract
In the global emergency scenario caused by COVID-19 pandemic, the Urology residents' training might be critically affected. To provide insights on this issue, a 25-item online Survey was sent to all Italian residents one month after the first case of COVID-19 in Italy, to evaluate their routine involvement in "clinical" (on-call duty, outpatient visits, diagnostic procedures) and "surgical" (endoscopic, open and minimally invasive surgery) training activities before and during the COVID-19 period. Overall, 351 of 577 (60.8%) residents completed the Survey. Before the COVID-19 pandemic, the proportion of residents routinely involved in "clinical" and "surgical" activities ranged from 79.8% to 87.2% and from 49.3% to 73.5%, respectively. In the COVID-19 period, the proportion of residents experiencing a severe reduction (>40%) or complete suppression (>80%) of training exposure ranged between 41.1% and 81.2% for "clinical" activities while between 44.2% and 62.1% for "surgical" activities. This reduction was even more pronounced for residents attending the final year of training. Our study is the first to provide real-life data on how Urology residency training can be impaired during an emergency period. To address this challenge, strategies aiming to increase the use of telemedicine, "smart learning" programs and tele-mentoring of surgical procedures, are warranted.
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- 2020
243. A framework for human evaluation of large language models in healthcare derived from literature review.
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Tam TYC, Sivarajkumar S, Kapoor S, Stolyar AV, Polanska K, McCarthy KR, Osterhoudt H, Wu X, Visweswaran S, Fu S, Mathur P, Cacciamani GE, Sun C, Peng Y, and Wang Y
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With generative artificial intelligence (GenAI), particularly large language models (LLMs), continuing to make inroads in healthcare, assessing LLMs with human evaluations is essential to assuring safety and effectiveness. This study reviews existing literature on human evaluation methodologies for LLMs in healthcare across various medical specialties and addresses factors such as evaluation dimensions, sample types and sizes, selection, and recruitment of evaluators, frameworks and metrics, evaluation process, and statistical analysis type. Our literature review of 142 studies shows gaps in reliability, generalizability, and applicability of current human evaluation practices. To overcome such significant obstacles to healthcare LLM developments and deployments, we propose QUEST, a comprehensive and practical framework for human evaluation of LLMs covering three phases of workflow: Planning, Implementation and Adjudication, and Scoring and Review. QUEST is designed with five proposed evaluation principles: Quality of Information, Understanding and Reasoning, Expression Style and Persona, Safety and Harm, and Trust and Confidence., (© 2024. The Author(s).)
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- 2024
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244. ChatGPT and large language models (LLMs) awareness and use. A prospective cross-sectional survey of U.S. medical students.
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Ganjavi C, Eppler M, O'Brien D, Ramacciotti LS, Ghauri MS, Anderson I, Choi J, Dwyer D, Stephens C, Shi V, Ebert M, Derby M, Yazdi B, and Cacciamani GE
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Generative-AI (GAI) models like ChatGPT are becoming widely discussed and utilized tools in medical education. For example, it can be used to assist with studying for exams, shown capable of passing the USMLE board exams. However, there have been concerns expressed regarding its fair and ethical use. We designed an electronic survey for students across North American medical colleges to gauge their views on and current use of ChatGPT and similar technologies in May, 2023. Overall, 415 students from at least 28 medical schools completed the questionnaire and 96% of respondents had heard of ChatGPT and 52% had used it for medical school coursework. The most common use in pre-clerkship and clerkship phase was asking for explanations of medical concepts and assisting with diagnosis/treatment plans, respectively. The most common use in academic research was for proof reading and grammar edits. Respondents recognized the potential limitations of ChatGPT, including inaccurate responses, patient privacy, and plagiarism. Students recognized the importance of regulations to ensure proper use of this novel technology. Understanding the views of students is essential to crafting workable instructional courses, guidelines, and regulations that ensure the safe, productive use of generative-AI in medical school., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ganjavi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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245. Early Adjuvant Chemotherapy Improves Survival in Muscle Invasive Bladder Cancer: A Systematic Review and Meta-analysis.
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Kronstedt S, Saffati G, Hinojosa-Gonzalez DE, Doppalapudi SK, Boyle J, Chua K, Jang TL, Cacciamani GE, and Ghodoussipour S
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Objective: To evaluate whether earlier administration of adjuvant chemotherapy (AC) can significantly augment survival rates in muscle-invasive bladder cancer., Methods: We systematically searched PubMed, Cochrane Central, Scopus, and Web of Science library databases for original articles that looked at timing to AC after radical cystectomy. Heterogeneity was assessed using Higgins I2%, with values over 50% considered heterogeneous and analyzed with a random effects model; otherwise, a fixed effects model was used. Studies were stratified based on the cutoff time used for administering AC. Two primary cutoffs were employed: 45 days and 90 days. Immediate AC was defined as chemotherapy administered before the predefined cutoff, while delayed AC was defined as chemotherapy administered after this cutoff. Comparisons were made between immediate versus delayed., Results: A total of 5 studies were included. Overall survival (OS) was reported in all of the studies. The meta-analysis showed that immediate AC significantly improved OS, with a hazard ratio (HR) of 1.20 [1.06, 1.36], P=.004. When stratifying by the timing of therapy, starting chemotherapy within 45 days resulted in a greater improvement in survival (HR 1.27 [1.02, 1.59], P=.03) compared to starting within 90 days (HR 1.17 [1.00, 1.36], P=.04)., Conclusion: The findings of this systematic review and meta-analysis emphasize that the timing of AC post-radical cystectomy significantly influences survival outcomes in patients with MIBC. The benefits of early AC initiation underscore its potential in mitigating disease progression and improving long-term survival rates., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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246. Transperineal versus Transrectal MRI/TRUS fusion-guided prostate biopsy in a large, ethnically diverse, and multiracial cohort.
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Ramacciotti LS, Strauss D, Cei F, Kaneko M, Mokhtar D, Cai J, Jadvar D, Cacciamani GE, Aron M, Halteh PB, Duddalwar V, Gill I, and Abreu AL
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- Humans, Male, Middle Aged, Aged, Perineum, Magnetic Resonance Imaging, Interventional methods, Neoplasm Grading, Multiparametric Magnetic Resonance Imaging methods, Reproducibility of Results, Prostatic Neoplasms pathology, Prostatic Neoplasms diagnostic imaging, Image-Guided Biopsy methods, Ultrasonography, Interventional methods, Prostate pathology, Prostate diagnostic imaging
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Purpose: To compare transperineal (TP) vs transrectal (TR) magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) fusion-guided prostate biopsy (PBx) in a large, ethnically diverse and multiracial cohort., Materials and Methods: Consecutive patients who underwent multiparametric (mp) MRI followed by TP or TR TRUS-fusion guided PBx, were identified from a prospective database (IRB #HS-13-00663). All patients underwent mpMRI followed by 12-14 core systematic PBx. A minimum of two additional target-biopsy cores were taken per PIRADS≥3 lesion. The endpoint was the detection of clinically significant prostate cancer (CSPCa; Grade Group, GG≥2). Statistical significance was defined as p<0.05., Results: A total of 1491 patients met inclusion criteria, with 480 undergoing TP and 1011 TR PBx. Overall, 11% of patients were Asians, 5% African Americans, 14% Hispanic, 14% Others, and 56% White, similar between TP and TR (p=0.4). For PIRADS 3-5, the TP PBx CSPCa detection was significantly higher (61% vs 54%, p=0.03) than TR PBx, but not for PIRADS 1-2 (13% vs 13%, p=1.0). After adjusting for confounders on multivariable analysis, Black race, but not the PBx approach (TP vs TR), was an independent predictor of CSPCa detection. The median maximum cancer core length (11 vs 8mm; p<0.001) and percent (80% vs 60%; p<0.001) were greater for TP PBx even after adjusting for confounders., Conclusions: In a large and diverse cohort, Black race, but not the biopsy approach, was an independent predictor for CSPCa detection. TP and TR PBx yielded similar CSPCa detection rates; however the TP PBx was histologically more informative., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)
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- 2024
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247. The learning curve for transperineal MRI/TRUS fusion prostate biopsy: A prospective evaluation of a stepwise approach.
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Ramacciotti LS, Kaneko M, Strauss D, Hershenhouse JS, Rodler S, Cai J, Liang G, Aron M, Duddalwar V, Cacciamani GE, Gill I, and Abreu AL
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Objective: To evaluate the learning curve of a transperineal (TP) magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) fusion prostate biopsy (PBx)., Materials and Methods: Consecutive patients undergoing MRI followed by TP PBx from May/2017 to January/2023, were prospectively enrolled (IRB# HS-13-00663). All participants underwent MRI followed by 12 to 14 core systematic PBx (SB), with at least 2 additional targeted biopsy (TB) cores per PIRADS ≥3. The biopsies were performed transperineally using an organ tracking image-fusion system. The cohort was divided into chronological quintiles. An inflection point analysis was performed to determine proficiency. Operative time was defined from insertion to removal of the TRUS probe from the patient's rectum. Grade Group ≥2 defined clinically significant prostate cancer (CSPCa). Statistically significant if P < 0.05., Results: A total of 370 patients were included and divided into quintiles of 74 patients. MRI findings and PIRADS distribution were similar between quintiles (P = 0.08). The CSPCa detection with SB+TB was consistent across quintiles: PIRADS 1 and 2 (range, 0%-18%; P = 0.25); PIRADS 3 to 5 (range, 46%-70%; P = 0.12). The CSPCa detection on PIRADS 3 to 5 TB alone, for quintiles 1 to 5, was respectively 44%, 58%, 66%, 41%, and 53% (P = 0.08). The median operative time significantly decreased for PIRADS 1 and 2 (33 min to 13 min; P < 0.01) and PIRADS 3 to 5 (48 min to 19 min; P < 0.01), reaching a plateau after 156 cases. Complications were not significantly different across quintiles (range, 0-5.4%; P = 0.3)., Conclusions: The CSPCa detection remained consistently satisfactory throughout the learning curve of the Transperineal MRI/TRUS fusion prostate biopsy. However, the operative time significantly decreased with proficiency achieved after 156 cases., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Receives consultancy fees from Merck, MSD, and Novartis and has equity in Rocketlane Medical Ventures GmbH - Severin Rodler; Has equity interest in OneLine Health and Karkinos - Inderbir Gill; Is a consultant for Koelis, a speaker for EDAP, and a proctor for Sonablate - Andre Luis Abreu; Other authors do not have any competing interests. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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248. Generative AI Platform for Automating Social Media Posts From Urology Journal Articles: A Cross-Sectional Study and Randomized Assessment.
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Ramacciotti LS, Cei F, Hershenhouse JS, Mokhtar D, Rodler S, Gill K, Strauss D, Medina LG, Cai J, Abreu AL, Desai MM, Sotelo R, Gill IS, and Cacciamani GE
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Purpose: This cross-sectional study assessed a generative-AI platform to automate the creation of accurate, appropriate, and compelling social-media (SoMe) posts from urological journal articles., Materials and Methods: One hundred SoMe-posts from the top 3 journals in urology X (Twitter) profiles were collected from Aug-2022 to Oct-2023 A freeware GPT-tool was developed to auto-generate SoMe posts, which included title-summarization, key findings, pertinent emojis, hashtags, and DOI links to the article. Three physicians independently evaluated GPT-generated posts for achieving tetrafecta of accuracy and appropriateness criteria. Fifteen scenarios were created from 5 randomly selected posts from each journal. Each scenario contained both the original and the GPT-generated post for the same article. Five questions were formulated to investigate the posts' likability, shareability, engagement, understandability, and comprehensiveness. The paired posts were then randomized and presented to blinded academic authors and general public through Amazon Mechanical Turk (AMT) responders for preference evaluation., Results: Median (IQR) time for post auto-generation was 10.2 seconds (8.5-12.5). Of the 150 rated GPT-generated posts, 115 (76.6%) met the correctness tetrafecta: 144 (96%) accurately summarized the title, 147 (98%) accurately presented the articles' main findings, 131 (87.3%) appropriately used emojis and hashtags 138 (92%). A total of 258 academic urologists and 493 AMT responders answered the surveys, wherein the GPT-generated posts consistently outperformed the original journals' posts for both academicians and AMT responders ( P < .05)., Conclusions: Generative-AI can automate the creation of SoMe posts from urology journal abstracts that are both accurate and preferable by the academic community and general public.
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- 2024
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249. Readability Assessment of Patient Education Materials on Uro-oncological Diseases Using Automated Measures.
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Rodler S, Maruccia S, Abreu A, Murphy D, Canes D, Loeb S, Malik RD, Bagrodia A, and Cacciamani GE
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Background and Objective: Readability of patient education materials is of utmost importance to ensure understandability and dissemination of health care information in uro-oncology. We aimed to investigate the readability of the official patient education materials of the European Association of Urology (EAU) and American Urology Association (AUA)., Methods: Patient education materials for prostate, bladder, kidney, testicular, penile, and urethral cancers were retrieved from the respective organizations. Readability was assessed via the WebFX online tool for Flesch Kincaid Reading Ease Score (FRES) and for reading grade levels by Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GFS), Smog Index (SI), Coleman Liau Index (CLI), and Automated Readability Index (ARI). Layperson readability was defined as a FRES of ≥70 and with the other readability indexes <7 according to European Union recommendations. This study assessed only objective readability and no other metrics such as understandability., Key Findings and Limitations: Most patient education materials failed to meet the recommended threshold for laypersons. The mean readability for EAU patient education material was as follows: FRES 50.9 (standard error [SE]: 3.0), and FKGL, GFS, SI, CLI, and ARI all with scores ≥7. The mean readability for AUA patient material was as follows: FRES 64.0 (SE: 1.4), with all of FKGL, GFS, SI, and ARI scoring ≥7 readability. Only 13 out of 70 (18.6%) patient education materials' paragraphs met the readability requirements. The mean readability for bladder cancer patient education materials was the lowest, with a FRES of 36.7 (SE: 4.1)., Conclusions and Clinical Implications: Patient education materials from leading urological associations reveal readability levels beyond the recommended thresholds for laypersons and may not be understood easily by patients. There is a future need for more patient-friendly reading materials., Patient Summary: This study checked whether health information about different cancers was easy to read. Most of it was too hard for patients to understand., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2024
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250. The long but necessary road to responsible use of large language models in healthcare research.
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Kwong JCC, Wang SCY, Nickel GC, Cacciamani GE, and Kvedar JC
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- 2024
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