How Closely Do Urologists Adhere to AUA Guidelines?
How Closely Do Urologists Adhere to AUA Guidelines?
New York, NY, October 16, 2014 /3BL Media/ – Evidence-based guidelines play an increasing role in setting standards for medical practice and quality but are seldom systematically evaluated in the practice setting. Investigators evaluated the rate of physician adherence to the American Urological Association’s (AUA) guidelines on the management of benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) to establish a benchmark for future research. Their findings are published in The Journal of Urology®.
Medical certification bodies, for example, the American Board of Urology, increasingly use guideline-driven content in their examination processes. Despite this increasing emphasis on guidelines, there have been few studies that systematically evaluate physician adherence or patient outcomes.
A team of investigators used electronic medical record-based data extraction techniques to assess how well physicians adhered to the American Urological Association’s BPH/LUTS guidelines over a five-year period.
“Our aim was to establish an adherence benchmark to enlighten further study of barriers to provider adherence and of patient outcomes related to guideline adherence,” explains lead investigator Gregory P. Auffenberg, MD, from the Department of Urology, Northwestern University Feinberg School of Medicine, Chicago.
The study was a retrospective analysis of patient records from the first-time evaluation of nearly 3,500 men 45 years old or older seen for BPH/LUTS by one of twelve urologists at the Northwestern Medical Faculty Foundation from 2008 to 2012. The authors hypothesized that urologists were not uniformly adherent to guidelines.
Provider adherence rates with the nine measures recommended in the guidelines varied by measure from 53.0% to 92.8%. The rate of performance of five not routinely recommended measures was 10.2% or less. This study provides the largest observational analysis of urologist adherence to AUA guidelines on the management of BPH/LUTS, which is not based entirely on administrative data.
“Our investigation includes one of the most robust analyses of physician adherence to AUA guidelines on the management of BPH/LUTS in the published literature, and represents the first published analysis to our knowledge of the rate of performance of measures that are challenging to extract from administrative data (i.e., subjective symptom description, I-PSS, sexual function evaluation, performance of a physical examination and specific examination maneuvers),” says Dr. Auffenberg. “We established a benchmark rate of urologist adherence to the guideline directives. Further investigation will be important to verify this benchmark in different physician populations.
“With an established benchmark, future research can begin to determine if directed interventions can modify adherence rates and subsequently determine whether increased adherence improves patient outcomes. It may allow comparative multi-institutional research by our study group or other groups to determine baseline adherence rates in different practice settings such as academic vs private, rural vs urban, insured vs uninsured, and many others. It will also set the stage for prospective work designed to determine the implications of guideline adherence on cost of care and ultimately in patient outcomes.”
Notes for editors
“Observational Analysis of Provider Adherence to AUA Guidelines on Management of Benign Prostatic Hyperplasia,” by G. B. Auffenberg, C. M. Gonzalez, J. S. Wolf, Jr., J. Q. Clemens, W. Meeks and K. T. McVary. DOI: http://dx.doi.org/10.1016/j.juro.2014.06.016. The Journal of Urology, Volume 192/Issue 5 (November 2014) by Elsevier. This article is openly available at http://www.jurology.com/article/S0022-5347(14)03766-5/fulltext.
Full text of the article is available to credentialed journalists upon request; contact Linda Gruner at +1 212 633 3923 or email@example.com to obtain copies. Journalists wishing to interview the authors should contact Erin White at +1 847 491 4888 or firstname.lastname@example.org or Marla Paul at +1 312 503 8928 or email@example.com.
About the Journal of Urology®
Established in 1917, The Journal of Urology (www.jurology.com) is the official journal of the American Urological Association (www.auanet.org). It is the most widely read and highly cited journal in the field. It brings to its readership all the clinically relevant information needed to stay at the forefront of this dynamic field. This top-ranking journal presents investigative studies on critical areas of research and practice, survey articles providing short condensations of the best and most important urology literature worldwide and practice-oriented reports on interesting clinical observations.
Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.
The company is part of Reed Elsevier Group PLC, a world-leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
+1 212 633 3923