MP28-04 VALIDATION OF A SURGICAL DECISION AID FOR PATIENTS WITH NEPHROLITHIASIS: SHOCKWAVE LITHOTRIPSY VERSUS URETEROSCOPY

Abstract

You have accessJournal of UrologyCME1 May 2022MP28-04 VALIDATION OF A SURGICAL DECISION AID FOR PATIENTS WITH NEPHROLITHIASIS: SHOCKWAVE LITHOTRIPSY VERSUS URETEROSCOPY John Michael DiBianco, Stephanie Daignault-Newton, Bronson Conrado, Sarah T. Hawley, Giulia Lane, Khurshid R. Ghani, Casey A. Dauw, and for the Michigan Urological Surgery Improvement Collaborative John Michael DiBiancoJohn Michael DiBianco More articles by this author , Stephanie Daignault-NewtonStephanie Daignault-Newton More articles by this author , Bronson ConradoBronson Conrado More articles by this author , Sarah T. HawleySarah T. Hawley More articles by this author , Giulia LaneGiulia Lane More articles by this author , Khurshid R. GhaniKhurshid R. Ghani More articles by this author , Casey A. DauwCasey A. Dauw More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002571.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Shared decision making is recommended for patients with symptomatic nephrolithiasis to assist the deciding between ureteroscopy (URS) or shockwave lithotripsy (SWL). The practice of shared decision making remains low in this population. We aimed to develop a surgical decision aid (SDA) to facilitate treatment decision making for patients with nephrolithiasis. METHODS: The scope of the SDA was identified through discussions with patients, patient advocates and urologists in the Michigan Urological Surgery Improvement Collaborative (MUSIC). A steering committee consisted of patient advocates, MUSIC coordinating center, decision making content experts, biostatisticians and MUSIC urologists. Content domains were assessed through best available evidence and expert opinion. For content validation we conducted anonymous survey of 35 MUSIC urologists. Content Validity Ratios (CVR), numeric value indicating degree of expert validity, were calculated. Face validation interviews were conducted with patient advocates. RESULTS: A prototype using descriptive plain language and pictorial information was designed for nephrolithiasis patients who are candidates for SWL or URS. Page 1 addressed patient education and page 2 informed urologists of patient treatment goals. Six content domains were chosen: anesthesia type, effectiveness, number of procedures, risk, pain and recovery. 91.4% and 85.7% of urologists indicated that Page 1 and Page 2 accomplished their goals, respectively (Table 1). Anesthesia type was the only domain to receive a lower than acceptable CVR. Patient advocates reported high levels of face validation (Table 2). CONCLUSIONS: We developed a SWL vs URS treatment choice SDA with promising content and face validity. Agreement and contradiction between content and face validation regarding relevance of anesthesia type and recovery time indicate further work is required to determine clinical utility and understand its potential ability to improve patient understanding and treatment satisfaction. Source of Funding: Blue Cross Blue Shield of Michigan © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e461 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Michael DiBianco More articles by this author Stephanie Daignault-Newton More articles by this author Bronson Conrado More articles by this author Sarah T. Hawley More articles by this author Giulia Lane More articles by this author Khurshid R. Ghani More articles by this author Casey A. Dauw More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF DownloadLoading ...