69 COMPLIANCE WITH RECOMMENDATIONS IN THE METABOLIC EVALUATION OF NEPHROLITHIASIS: A SURVEY OF THE AMERICAN UROLOGICAL ASSOCIATION

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness1 Apr 201169 COMPLIANCE WITH RECOMMENDATIONS IN THE METABOLIC EVALUATION OF NEPHROLITHIASIS: A SURVEY OF THE AMERICAN UROLOGICAL ASSOCIATION Davis P. Viprakasit, Nicole L. Miller, S. Duke Herrell, and David F. Penson Davis P. ViprakasitDavis P. Viprakasit Nashville, TN More articles by this author , Nicole L. MillerNicole L. Miller Nashville, TN More articles by this author , S. Duke HerrellS. Duke Herrell Nashville, TN More articles by this author , and David F. PensonDavid F. Penson Nashville, TN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.133AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We surveyed American Urological Association (AUA) members in order to determine compliance with published guidelines regarding the metabolic evaluation of kidney stone disease, particularly 24-hour urine studies, stone analysis and laboratory testing. We also identified provider characteristics associated with compliance. METHODS In April 2010, members were solicited to complete an online survey. Respondents were asked about demographics, general utilization of 24-hour testing and were presented with 5 case scenarios regarding evaluation of index patients with initial and recurrent stone disease. RESULTS 1,307 (10.2% of 12,815) urologists completed the survey. The majority of respondents were from the United States (64.3%) although 68 other countries were represented. The majority (87.7%) of urologists frequently utilized 24-hour evaluations. In relation to published guidelines, urologists were compliant with guidelines recommendations on 24-hour studies 82–85% of the time, depending upon the particular scenario. However, testing for first-time stone formers with risk factors for recurrent disease as recommended by guidelines was only performed by 54%. Routine stone analysis was performed by 76–85% of urologists. Additionally, 70–81% ordered the guideline-recommended laboratory testing of serum calcium, uric acid, creatinine and urinalysis. On univariate analysis (p≤0.01), younger physicians, those more recently completing training and urologists practicing in the United States were associated with higher compliance with guidelines. CONCLUSIONS Compliance with published guidelines regarding the utilization of metabolic evaluations for recurrent nephrolithiasis is relatively high overall. However, a minority of urologists do not routinely order testing as described by guideline recommendations. Younger provider age, recent completion of training and US practice were associated with higher compliance rates. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e30 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Davis P. Viprakasit Nashville, TN More articles by this author Nicole L. Miller Nashville, TN More articles by this author S. Duke Herrell Nashville, TN More articles by this author David F. Penson Nashville, TN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...