You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making II (MP19)1 Sep 2021MP19-20 RISK PREDICTION TOOLS IN AN INTUITION-BASED WORLD: A MIXED METHODS STUDY OF UROLOGIC SURGEONS Hung-Jui Tan, Allison Deal, Antonia Bennett, Susan Blalock, Alex Sox-Harris, Daniel Reuland, Arlene Chung, David Gotz, Matthew Nielsen, and Ethan Basch Hung-Jui TanHung-Jui Tan More articles by this author , Allison DealAllison Deal More articles by this author , Antonia BennettAntonia Bennett More articles by this author , Susan BlalockSusan Blalock More articles by this author , Alex Sox-HarrisAlex Sox-Harris More articles by this author , Daniel ReulandDaniel Reuland More articles by this author , Arlene ChungArlene Chung More articles by this author , David GotzDavid Gotz More articles by this author , Matthew NielsenMatthew Nielsen More articles by this author , and Ethan BaschEthan Basch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002004.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A plethora of risk prediction tools (RPTs) have been developed to support surgical decision-making. However, past studies indicate both limited uptake and minimal impact on actual decisions. To promote the design of impactful tools, we sought to understand the current role of RPTs and prevailing attitudes among urologists. METHODS: We conducted a national mixed methods study using a sequential explanatory design. Via the 2019 AUA Census, we surveyed urologists on RPT use, perceived helpfulness, and relative trust and identified associated characteristics through bivariable and multivariable analyses. We then interviewed 25 respondents on their surgical decision-making, risk evaluation, and RPTs. Coding-based thematic analysis was applied and integrated with survey findings. RESULTS: Among a weighted sample of 12,366 practicing urologists, 30.4% (28.2–32.6%) routinely used RPTs and 34.3% (31.9–36.6%) found them to be helpful while 47.0% (44.6–49.5%) more often trusted their own assessment over RPT-generated estimates. On multivariable analysis, more years in practice were negatively associated with RPT use, perceived helpfulness, and relative trust (p<0.001) whereas oncologists reported greater use and more positive attitudes (p<0.001). As illustrated in the joint display, almost all interviewed urologists described relying on their intuition/gestalt to assess surgical risks and benefits. Most employed gist-based approximations and less actively retrieved numerical information, which is where RPTs reside. Challenges to greater RPT use appear both methodological (e.g., translating group statistics to an individual, missing variables) and operational (e.g., ease of use at the point-of-care). In the current state, interviewed urologists found more value in RPTs as a communication aid for patients rather than decision support for their own surgical decision-making. CONCLUSIONS: Despite their wide availability, RPTs are used infrequently and have limited perceived utility among urologists. This likely reflects both the intuitive nature of surgical decision-making and implementation challenges. For RPTs to be used more broadly and affect decision-making, both types of barriers will need to be addressed. Source of Funding: American Cancer Society MRSG-18-193-01-CPPB © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e335-e336 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hung-Jui Tan More articles by this author Allison Deal More articles by this author Antonia Bennett More articles by this author Susan Blalock More articles by this author Alex Sox-Harris More articles by this author Daniel Reuland More articles by this author Arlene Chung More articles by this author David Gotz More articles by this author Matthew Nielsen More articles by this author Ethan Basch More articles by this author Expand All Advertisement Loading ...