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Ranking Important Factors for Using Postoperative Chemotherapy in Nonmuscle Invasive Bladder Cancer: Conjoint Analysis Results From the Michigan Urological Surgery Improvement Collaborative (MUSIC).
- Source :
-
The Journal of urology [J Urol] 2022 Feb; Vol. 207 (2), pp. 293-301. Date of Electronic Publication: 2021 Sep 23. - Publication Year :
- 2022
-
Abstract
- Purpose: National and international guidelines recommend the use of 1 dose of intravesical chemotherapy immediately following surgery for nonmuscle invasive bladder cancer, which is performed infrequently on a population level. We sought to understand the importance of potential environmental and clinical dimensions involved in the decision to offer this therapy.<br />Materials and Methods: Urologists from the Michigan Urological Surgery Improvement Collaborative (MUSIC) rated 8 distinct clinical vignettes involving patients with nonmuscle invasive bladder cancer. A ratings-based conjoint analysis method was used to evaluate the clinical vignette responses. Each vignette included 4 clinical dimensions and 2 environmental dimensions, with each dimension consisting of 2 possible attributes. The relative importance of each attribute was derived from the regression model and ranked in order.<br />Results: A total of 58 urologists answered the clinical vignettes which represents >75% of MUSIC sites. The median age of urologists was 53, most were male, and median years in practice was 20 years post residency. An environmental attribute, having a recovery room protocol for instilling and disposing of the chemotherapy, ranked as the most influential attribute for giving postoperative chemotherapy (utility=8.6). The clinical attribute yielding the strongest preference for giving chemotherapy was tumor grade (utility=4.9). These preferences varied by different subgroups of urologists, particularly regarding the type of practice a urologist was in.<br />Conclusions: This study demonstrates that urologists have clear preferences for when they offer postoperative immediate chemotherapy. Factors beyond just clinical variables play a role in this decision making process such as the structure of the recovery room.
- Subjects :
- Administration, Intravesical
Adult
Chemotherapy, Adjuvant statistics & numerical data
Female
Humans
Male
Michigan
Middle Aged
Neoplasm Invasiveness
Practice Guidelines as Topic
Practice Patterns, Physicians' statistics & numerical data
Surveys and Questionnaires statistics & numerical data
Urinary Bladder pathology
Urinary Bladder surgery
Urinary Bladder Neoplasms pathology
Urologists standards
Urologists statistics & numerical data
Urology statistics & numerical data
Chemotherapy, Adjuvant standards
Cystectomy
Practice Patterns, Physicians' standards
Urinary Bladder Neoplasms therapy
Urology standards
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3792
- Volume :
- 207
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 34551594
- Full Text :
- https://doi.org/10.1097/JU.0000000000002233