Cuaj-Canadian Urological Association Journal最新文献

{"title":"Podium Session 2: Functional Urology, Pediatric Urology, Other Friday, June 27, 2025 • 16:20-17:20.","authors":"","doi":"10.5489/cuaj.9249","DOIUrl":"10.5489/cuaj.9249","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 6 Suppl 1","pages":"S6-S8"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of marginalization and PSMA-PET in prostate cancer An analysis of the Ontario PSMA-PET Registry for Recurrent Prostate Cancer.","authors":"Vivian S Tan, Ur Metser, Mohammed Rashid, Deanna L Langer, Pamela MacCrostie, Bo Green, Victor Mak, Girish S Kulkarni, Bobby Shayegan, Stephen Pautler, Luke T Lavallée, Antonio Finelli, Laurence Klotz, Marlon Hagerty, Glenn Bauman","doi":"10.5489/cuaj.9034","DOIUrl":"10.5489/cuaj.9034","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) is a new standard for the imaging of high-risk or recurrent prostate cancer. While marginalization disparities exist for prostate cancer, less is known in the context of PSMA-PET. The objective of the study was to determine if marginalization was associated with access, PET positivity, management change, radiation use, and survival of prostate cancer in a universal healthcare system.</p><p><strong>Methods: </strong>Patients enrolled in the Ontario PSMA-PET Registry for Recurrent Prostate Cancer (PREP) between 2018 and 2022 were included. The Ontario Marginalization Index (material resources, racialized/newcomer, age/labor force, household/dwellings) was used. Outcomes included access, PET positivity, management change, radiation use, and survival. Cox proportional hazards and logistic regression models examined the association between marginalization and outcomes. Provincial administrative databases were leveraged to generate a diagnosis and a survivorship cohort of prostate cancer patients who received primary treatment to compare with the PSMA-PET cohort.</p><p><strong>Results: </strong>There were 4034 patients in the PSMA-PET cohort. Patients at higher material marginalization quintiles were under-represented in the PSMA-PET Registry Database. Similar under-representation was noted in the diagnosis (n=123 128) and survival (n=56 753) cohorts. Within the PSMA cohort, marginalization dimensions were not significantly correlated with PET positivity, management change, or radiation use.</p><p><strong>Conclusions: </strong>Marginalization quintiles across PSMA-PET access were similar in distribution to prostate cancer diagnoses and survivor cohorts. We found no association of marginalization with PET positivity, management change, or radiation use among those receiving PSMA-PET.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"193-201"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of artificial intelligence-generated multiple-choice questions for the examination of surgical subspecialty residents Report of feasibility and psychometric analysis.","authors":"Jin Kyu Kim, Michael E Chua, Armando J Lorenzo, Mandy Rickard, Laura Andreacchi, Michael Kim, Douglas Cheung, Yonah Krakowsky, Jason Y Lee","doi":"10.5489/cuaj.9020","DOIUrl":"10.5489/cuaj.9020","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple-choice questions (MCQs) are essential in medical education and widely used by licensing bodies. They are traditionally created with intensive human effort to ensure validity. Recent advances in artificial intelligence (AI), particularly large language models (LLMs), offer the potential to streamline this process. This study aimed to develop and test a GPT-4 model with customized instructions for generating MCQs to assess urology residents.</p><p><strong>Methods: </strong>A GPT-4 model was embedded using guidelines from medical licensing bodies and reference materials specific to urology. This model was tasked with generating MCQs designed to mimic the format and content of the 2023 urology examination outlined by the Royal College of Physicians and Surgeons of Canada (RCPSC). Following generation, a selection of MCQs underwent expert review for validity and suitability.</p><p><strong>Results: </strong>From an initial set of 123 generated MCQs, 60 were chosen for inclusion in an exam administered to 15 urology residents at the University of Toronto. The exam results demonstrated a general increasing performance with level of training cohorts, suggesting the MCQs' ability to effectively discriminate knowledge levels among residents. The majority (33/60) of the questions had discriminatory value that appeared acceptable (discriminatory index 0.2-0.4) or excellent (discriminatory index >0.4).</p><p><strong>Conclusions: </strong>This study highlights AI-driven models like GPT-4 as efficient tools to aid with MCQ generation in medical education assessments. By automating MCQ creation while maintaining quality standards, AI can expedite processes. Future research should focus on refining AI applications in education to optimize assessments and enhance medical training and certification outcomes.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"182-187"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is uptake of AS in low-risk prostate cancer in Ontario linked to guideline publication?","authors":"Matthew R Cooperberg","doi":"10.5489/cuaj.9282","DOIUrl":"10.5489/cuaj.9282","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 6","pages":"165-166"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poster Session 11: Pediatric Urology Sunday, June 29, 2025 • 07:00-08:30.","authors":"","doi":"10.5489/cuaj.9269","DOIUrl":"10.5489/cuaj.9269","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 6 Suppl 1","pages":"S103-S113"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podium Session 1: Endourology, BPH Friday, June 27, 2025 • 13:15-14:15.","authors":"","doi":"10.5489/cuaj.9248","DOIUrl":"10.5489/cuaj.9248","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 6 Suppl 1","pages":"S3-S5"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lidocaine solution vs. lidocaine gel instillation for pain management during intravesical botulinum injections.","authors":"Cristina Negrean, James Ross, Wenhui Yu, Conrad Maciejewski, Humberto R Vigil, Duane Hickling","doi":"10.5489/cuaj.9011","DOIUrl":"10.5489/cuaj.9011","url":null,"abstract":"<p><strong>Introduction: </strong>Most Canadian urologists use lidocaine solution prior to botulinium toxin (BoNT) administration; however, this requires additional time. Our aim was to compare pain scores in patients undergoing office-based BoNT using lidocaine instillation and lidocaine gel vs. lidocaine gel alone.</p><p><strong>Methods: </strong>All patients undergoing office-based intradetrusor BoNT between March 1 and September 1, 2022, were included. Group 1 received intravesical lidocaine solution (20 ml 2% lidocaine solution + 30 ml 0.9% normal saline) instillation for 30 minutes and lidocaine gel. Group 2 received lidocaine gel only. The Verbal Numeric Rating Scale (VNRS) was used to measure pain. Patient demographics were compared with t-test for continuous and Chi-squared for categorical variables. The Mann-Whitney U test was used to compare pain scores.</p><p><strong>Results: </strong>A total of 79 patients were included (mean age 61 years, 74.7% female, 58.2% with overactive bladder, and 30.4% receiving first treatment). Group 1 had 39 patients and group 2 had 40. There was no significant difference in pain scores between groups: group 1 median VNRS 3.0 (interquartile range [IQR] 2.5) vs. group 2 median VNRS 4.0 (IQR 2.0) (p=0.11). No significant differences in pain scores were noted between groups based on sex, indication for treatment, or number of previous BoNT treatments (p>0.05). Post-procedural complications were low. Treatment failure did not occur.</p><p><strong>Conclusions: </strong>Lidocaine gel alone may be an acceptable analgesic alternative while improving availability and efficiency of treatment delivery. Our findings are limited by the retrospective nature of the study and the small sample size.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"189-192"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the methodologic heterogeneity of Canadian Urological Association guidelines Adoption of the GRADE approach (2018-2023).","authors":"Maylynn Ding, Vardhil Gandhi, Daniel A Gonzalez-Padilla, Philipp Dahm","doi":"10.5489/cuaj.8926","DOIUrl":"10.5489/cuaj.8926","url":null,"abstract":"<p><strong>Introduction: </strong>The Canadian Urological Association (CUA) has a longstanding tradition of developing evidence-based guidelines. We conducted this study to assess the heterogeneity of the CUA's guideline methodology for developing recommendations from 2018-2023.</p><p><strong>Methods: </strong>We included guidelines from the CUA website from 2018-2023. Two reviewers working independently and in duplicate abstracted all data points and categorized the reported methodologic approaches for formulating recommendations and rating the evidence. We performed descriptive statistics only.</p><p><strong>Results: </strong>We included 23 guideline documents with a total of 654 recommendations. The median number of recommendations per guideline was 25 (interquartile range 17, 35). Seven guidelines (187 recommendations) used a modified Oxford Center for Evidence-Based Medicine approach for both the strength of recommendations and the levels of evidence, and eight guidelines (177 recommendations) reported the use of GRADE both for the strength of recommendations and the certainty of evidence. Of the remaining eight guidelines, four (154 recommendations) blended the GRADE approach for the strength of recommendations with modified Oxford levels of evidence, and the remaining four combined the American Urological Association's approach to recommendations with Oxford levels of evidence (n=1), GRADE certainty of evidence (n=2), or used GRADE but made no recommendations (n=1).</p><p><strong>Conclusions: </strong>CUA guidelines have been marked by considerable methodologic heterogeneity that may confuse end users. Continued advancement in the CUA's approach to guideline development will facilitate greater collaboration and resource sharing, thereby supporting the CUA's mission of promoting high-quality, evidence-based care.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"173-180"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting wellness in urology residency programs Moving beyond tokenism.","authors":"Rahim Dhalla, Jason Y Lee, Yonah Krakowsky","doi":"10.5489/cuaj.9076","DOIUrl":"10.5489/cuaj.9076","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"208-210"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using real-world, population-level data to assess the uptake of active surveillance for low-grade prostate cancer before and after the release of clinical guidelines.","authors":"Douglas C Cheung, Lisa J Martin, Narhari Timilshina, Maria Komisarenko, Patrick O Richard, Shabbir M H Alibhai, Jonathan Sussman, Nicole Mittmann, Antonio Finelli","doi":"10.5489/cuaj.9019","DOIUrl":"10.5489/cuaj.9019","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical guidelines recommend active surveillance (AS) as the preferred strategy for men with localized grade group (GG) 1 prostate cancer (PCa). We determined if the percentage of GG1 PCa patients in Ontario, Canada, managed by AS changed after the introduction of AS clinical guidelines and assessed adherence to the recommended followup protocol.</p><p><strong>Methods: </strong>Using Ontario administrative databases, we conducted a time series analysis (autoregressive integrated moving average [ARIMA] models) in a population-based cohort of men diagnosed with GG1 PCa (2010-2018). Men were classified as managed by AS if they had repeat (confirmatory) biopsy within two years. Sensitivity analyses (treatment classification variation) and secondary analyses (low-risk GG1 and GG2 PCa) were conducted.</p><p><strong>Results: </strong>We identified 12 236 eligible GG1 PCa patients, of which 7749 (63.3%) were initially managed by AS. Percentage AS increased from 44% in 2010 to 81% in 2018. Interrupted time series analysis estimated an immediate step change of 6.2 percentage points (95% confidence interval [CI] 3.0, 9.4) and a difference in slope of -2.3 percentage points (95% CI -6.9, 2.3) per year. Findings were robust to sensitivity analyses and similar for low-risk PCa. Adherence to monitoring and AS uptake in GG2 patients were not associated with guideline publication. Limitations include lack of treatment intent information in administrative data.</p><p><strong>Conclusions: </strong>The use of AS for low-grade PCa patients in Ontario increased from almost one in two patients in 2010 to four in five patients in 2017/2018. Adoption appeared to reflect the growing acceptance of AS prior to the guidelines, as well as an increase in response to the guideline introduction.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"158-164"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}