[Non-muscle-invasive bladder cancer: Information transfer from the clinic to the doctor's office : Results of a questionnaire study and presentation of a software solution]

Urologe A. 2017 Feb;56(2):194-201. doi: 10.1007/s00120-016-0234-y.
[Article in German]

Abstract

Background and objectives: The adjuvant treatment of non-muscle-invasive bladder cancer (NMIBC) is based on the individual risk profile (RP) and its sufficient transfer from the clinic to the doctor's office. The objectives of our study were to verify the importance and degree of transfer of RP and recommendation for risk-adapted adjuvant treatment (RAAT) in patients with NMIBC as well as to develop appropriate tools for this purpose, if necessary.

Materials and methods: An email-based survey distributed to urologists in Brandenburg, Berlin, Bavaria and Lower Saxony explored the questions mentioned above. In addition, a tool for risk stratification and information transfer for patients with NMIBC was developed and validated.

Results: From a total of 134 questionnaires analyzed, 55 were from clinic urologists (CUs) and 79 were from ambulant urologists (AUs). Although 9 out of 10 urologists considered the RP of importance, only 29 % of CUs and 24 % of AUs (p = 0.553) confirmed that the RP was always mentioned in medical reports. The recommendation for RAAT was confirmed from 62 % of CUs and 20 % of AUs (p < 0.001). A recommendation for RAAT in the medical report was requested by 86 % of AUs. The risk calculator presented here - to our knowledge the first with integration of the 2004 WHO grading - is delivered in all mathematically possible constellations a RP, according to guideline recommendations.

Conclusion: Urologists in the clinic and doctor's office both attach considerable importance to the determination and transfer of RP and the recommendation for RAAT. There was evidence to suggest an overestimation of the quality of medical reports by the CU. The risk calculator provides an easy and cost-neutral option to improve risk stratification and information transfer from the clinic to the doctor's office.

Keywords: Guideline; NMIBC; Questionnaire; Risk stratification; Undertreatment.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data*
  • Ambulatory Care Facilities / statistics & numerical data*
  • Documentation / statistics & numerical data
  • Electronic Health Records / statistics & numerical data*
  • Female
  • Germany / epidemiology
  • Humans
  • Information Dissemination
  • Male
  • Medical Record Linkage / methods*
  • Middle Aged
  • Muscle, Smooth / pathology
  • Neoplasm Invasiveness
  • Risk Assessment / statistics & numerical data*
  • Surveys and Questionnaires
  • Urinary Bladder Neoplasms / epidemiology*