Seeking clinical consensus on risk assessment in anatomical infravesical obstruction of boys - A Delphi study.

Autor: Leerssen ECM; University of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands; Department of Pediatric Urology, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, the Netherlands. Electronic address: e.c.m.leerssen@umcutrecht.nl., Lindeboom SNS; University of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands., Chrzan R; Department of Pediatric Urology, University Children's Hospital, Kraków-Prokocim, Poland., Abbas TO; Department of Pediatric Urology, Sidra Medicine, Doha, Qatar., Garvelink M; Department of Value Improvement, St. Antonius Hospital, Nieuwegein, the Netherlands; Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, the Netherlands., Schroeder RPJ; University of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands; Department of Pediatric Urology, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of pediatric urology [J Pediatr Urol] 2024 Dec; Vol. 20 (6), pp. 1142-1151. Date of Electronic Publication: 2024 Aug 02.
DOI: 10.1016/j.jpurol.2024.07.026
Abstrakt: Introduction: Infravesical obstruction (IO) is a common urological condition in young boys. Patients may present with various signs and symptoms at different ages, with severity depending to a large extent on the degree of obstruction. Consensus concerning accurate and objective modalities to diagnose IO and to differentiate between an anatomical or functional cause is still lacking.
Objective: This study aimed to reach consensus on the diagnostic determinants that are important to assess the likelihood of anatomical IO in boys and differentiate between an anatomical or functional cause.
Study Design: A Delphi method was used to establish a list of diagnostic determinants that can be utilized in order to diagnose anatomical IO in boys. An international and interdisciplinary panel of experts was recruited to reach consensus using three sequential rounds of electronic questionnaires. Data were collected using the online survey platform Qualtrics. Rounds one and two were used to define diagnostic determinants. Round three was used to stratify key determinants according to age.
Results: All rounds received a response rate of 100%. In round one, consensus was achieved on 44 of a total 79 items. In round two, consensus was achieved on 19 of a total 51 items. Round three identified a variation in key determinants per age group.
Discussion: To create an effective tool for assessing IO in boys, key determinants identified in this study will need to be validated in a prospective clinical trial. Due to a large number of determinants and sections, this will not be a trivial task. In addition, since a Delphi study is based on expert opinion, any consensus achieved remains subjective. Diagnostic determinants identified in this study will need to be validated using prospective clinical data. Artificial Intelligence provides techniques for uncovering complex associations that cannot easily be reduced to equations. It may therefore play a pivotal role in the future development of robust IO risk assessment tools.
Conclusion: An international group of experts agreed that a risk assessment tool for IO in boys would be beneficial for both clinical practice and research purposes. Using a Delphi study methodology, consensus was reached on a set of diagnostic determinants that were considered important to assess the likelihood of IO and differentiate between an anatomical or functional cause. This study paves the way for further research on IO in boys. Eventually this could lead to an accurate and standardized assessment tool for IO.
Competing Interests: Conflict of interest The authors declare that they have no known competing financial interest or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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