BJU International最新文献

{"title":"Evaluating interactions of patients with large language models for medical information.","authors":"Nicolas Carl, Sarah Haggenmüller, Christoph Wies, Lisa Nguyen, Jana Theres Winterstein, Martin Joachim Hetz, Maurin Helen Mangold, Friedrich Otto Hartung, Britta Grüne, Tim Holland-Letz, Maurice Stephan Michel, Titus Josef Brinker, Frederik Wessels","doi":"10.1111/bju.16676","DOIUrl":"https://doi.org/10.1111/bju.16676","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the interaction of real-world patients with a chatbot in a clinical setting, investigating key aspects of medical information provided by large language models (LLMs).</p><p><strong>Patients and methods: </strong>The study enrolled 300 patients seeking urological counselling between February and July 2024. First, participants voluntarily conversed with a Generative Pre-trained Transformer 4 (GPT-4) powered chatbot to ask questions related to their medical situation. In the following survey, patients rated the perceived utility, completeness, and understandability of the information provided during the simulated conversation as well as user-friendliness. Finally, patients were asked which, in their experience, best answered their questions: LLMs, urologists, or search engines.</p><p><strong>Results: </strong>A total of 292 patients completed the study. The majority of patients perceived the chatbot as providing useful, complete, and understandable information, as well as being user-friendly. However, the ability of human urologists to answer medical questions in an understandable way was rated higher than of LLMs. Interestingly, 53% of participants rated the question-answering ability of LLMs higher than search engines. Age was not associated with preferences. Limitations include social desirability and sampling biases.</p><p><strong>Discussion: </strong>This study highlights the potential of LLMs to enhance patient education and communication in clinical settings, with patients valuing their user-friendliness and comprehensiveness for medical information. By addressing preliminary questions, LLMs could potentially relieve time constraints on healthcare providers, enabling medical personnel to focus on complex inquiries and patient care.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case of the month from University Hospital Bern, Switzerland: bladder tumour with extreme leucocytosis","authors":"Amir Naiem, Gallus Beatus Ineichen, Antonio Rodriguez Calero, George N. Thalmann","doi":"10.1111/bju.16668","DOIUrl":"https://doi.org/10.1111/bju.16668","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"12 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143435663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Chen et al","authors":"Patrick Juliebø-Jones, Vineet Gauhar, Ali Talyshinskii, Christian Arvei Moen, Ingunn Roth, Lazaros Tzelves, Christian Beisland, Bhaskar K Somani","doi":"10.1111/bju.16683","DOIUrl":"https://doi.org/10.1111/bju.16683","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143435664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing privacy and professionalism: commentary on surgical image sharing on social media","authors":"Yin-Shen Chen, Lien-Chung Wei","doi":"10.1111/bju.16682","DOIUrl":"https://doi.org/10.1111/bju.16682","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"11 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143435665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage low-dose vs high-dose brachytherapy for radio-recurrent prostate cancer","authors":"Shaoqin Xie, Jianjiang Liu, Bin Shen, Huali Xu, Jiajing Ni","doi":"10.1111/bju.16639","DOIUrl":"https://doi.org/10.1111/bju.16639","url":null,"abstract":"To summarise the efficacy and toxicity of salvage low-dose-rate brachytherapy (LDR-BT) and compare these findings with the published data on salvage high-dose-rate brachytherapy (HDR-BT).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"8 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of vent designs in flexible and navigable suction ureteric access sheaths","authors":"Richard Menzies-Wilson,&nbsp;Jessica Williams,&nbsp;Candace Rhodes,&nbsp;Alycia Abbott,&nbsp;Thijs Ruiken,&nbsp;Benjamin Turney","doi":"10.1111/bju.16660","DOIUrl":"10.1111/bju.16660","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the different vent designs in three commercially available flexible and navigable suction (FANS) access sheaths—ClearPetra® (Well lead, Guangzhou, China), Elephant II (YIGAOMedical, Hangzhou, China) and Tuohy-Borst FANS access sheath (Seplou, Zhejiang, China)—and quantify the effects these differing designs have on the control of suction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted benchtop experiments to quantify the effect of pressure vent design on suction pressure control. Suction experiments were conducted both in an atmospheric beaker and in a phantom kidney model. With an indwelling 9.5-F LithoVue™ (Boston Scientific, Marlborough, MA, USA) ureteroscope, constant suction was applied to the access sheath's suction port. The vents were incrementally closed and corresponding flow rates calculated as a proxy for suction pressure. A mathematical model was developed to predict the impact of pressure control vent design on suction pressure control, flow rates and intrarenal pressure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For both the ClearPetra and Elephant II suction access sheaths, opening the length of the vent has an exponential reduction in suction pressure. Negligible suction is exerted on the renal pelvis with ≥3 mm of vent open. The Seplou suction access sheath has a Tuohy-Borst pressure vent, which allows finer control of suction pressures. The mathematical model showed strong agreement with experimental data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Commercially available FANS access sheaths are similar in most aspects but have differing vent designs. With the vents open no suction is exerted on the renal collecting system. However, because the flexible access sheath intrarenal end is within the renal pelvis, outflow resistance is low and the pelvis will deflate, giving the impression of suction. We have developed a mathematical model that predicts flow at different suction pressures and with different degrees of the pressure vents open. This allows simulations across multidimensional parameter spaces and the resulting quantitative predictions can be exploited to assess the implications of FANS access sheath and ureteroscope design.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 5","pages":"835-840"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of female and male prostate glands","authors":"Britt Haller,&nbsp;James Brock,&nbsp;Eric Chung,&nbsp;Helen E. O’Connell","doi":"10.1111/bju.16646","DOIUrl":"10.1111/bju.16646","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"582-583"},"PeriodicalIF":3.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining partial gland ablation for localised prostate cancer: the FALCON project","authors":"Lara Rodriguez-Sanchez, Xavier Cathelineau, Theo M. de Reijke, Phillip Stricker, Mark Emberton, Anna Lantz, Bernardino Miñana López, Jose Luis Dominguez-Escrig, Fernando J. Bianco, Georg Salomon, Aiman Haider, Anita Mitra, Alberto Bossi, Eva Compérat, Robert Reiter, Pilar Laguna, Gaelle Fiard, Luca Lunelli, George R. Schade, Peter Ka-Fung Chiu, Petr Macek, Veeru Kasivisvanathan, Jean J.M.C.H. Rosette, Thomas J. Polascik, Ardeshir R. Rastinehad, Alejandro Rodriguez, Rafael Sanchez-Salas","doi":"10.1111/bju.16669","DOIUrl":"https://doi.org/10.1111/bju.16669","url":null,"abstract":"To provide a contemporary statement on focal therapy (FT) for localised prostate cancer (PCa) from an international and diverse group of physicians treating localised PCa, with the aim of overcoming the limitations of previous consensus statements, which were restricted to early adopters, and to offer direction regarding the various aspects of FT application that are currently not well defined.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"25 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendation on the use of protective eyewear in endourological laser procedures","authors":"Tom Lister,&nbsp;Stan Batchelor,&nbsp;Mike Regan,&nbsp;Jason Britton,&nbsp;Hari Ratan,&nbsp;Feras Al-Jaafari,&nbsp;Jake Patterson,&nbsp;British Medical Laser Association and the British Association of Urological Surgeons Endourology Section","doi":"10.1111/bju.16664","DOIUrl":"10.1111/bju.16664","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work examines the current evidence available regarding the risks of eye injury in endourology laser environments with the aim of providing a consensus recommendation on the appropriate use of protective eyewear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A working group was set up consisting of urological surgeons and laser protection advisors. A literature review was conducted to identify articles relevant to endourology practice and the commonly used lasers, and these were reviewed by the working group. Searches of the medical device fault/reporting databases were also undertaken. A consensus was developed and shared with stakeholders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No reports of eye injuries from Ho:YAG, Tm:YAG, or Thulium Fibre Lasers (TFLs) were identified, although reports of skin burns and equipment-related fires were found. Available evidence suggests that ocular risks in endourology from these lasers are minimal and limited to rare cases of reversible corneal damage. Protective eyewear can further reduce this risk. However, Lasers with wavelengths below 1400 nm pose significant ocular risks, including blindness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Personnel working in an endourology environment using Ho:YAG, Tm:YAG, or TFLs face minimal ocular risks when adhering to established safety procedures, and laser-specific eyewear may not always be essential. This requires an understanding of the hazards and risks and is in accordance with the recommendations herein, which should form the basis for relevant local rules. Protective eyewear remains critical when using visible and near-infrared lasers due to the heightened associated ocular risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"577-581"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global comparison of research ethical review protocols: insights from an international research collaborative","authors":"Bing Jie Chow,&nbsp;Alexander Light,&nbsp;Arjun Nathan,&nbsp;Loic Baekelandt,&nbsp;Gautier Marcq,&nbsp;Stefanie Croghan,&nbsp;Fortis Gaba,&nbsp;Francesco Esperto,&nbsp;Luca Orecchia,&nbsp;Carlos Toribio-Vázquez,&nbsp;Juan Gómez Rivas,&nbsp;Adrian Chi-Heng Fung,&nbsp;Kaleab Habtemichael Gebreselassie,&nbsp;Eduardo Felicio,&nbsp;Aria Danurdoro,&nbsp;Nikolaos Pyrgidis,&nbsp;Vukovic Marko,&nbsp;Jan Svihra Jr.,&nbsp;Mohamed Javid,&nbsp;Andrés Salas,&nbsp;Tran Trung Thanh,&nbsp;Cameron Alexander,&nbsp;Nikita Bhatt,&nbsp;Sinan Khadhouri,&nbsp;Veeru Kasivisvanathan,&nbsp;Kevin Byrnes,&nbsp;British Urology Researchers in Surgical Training (BURST) in collaboration with the European Association of Urology Young Academic Urologists Urothelial Carcinoma Working Group","doi":"10.1111/bju.16671","DOIUrl":"10.1111/bju.16671","url":null,"abstract":"&lt;p&gt;Scientific ethical review is a cornerstone of conducting medical research. It aims to ensure human subject research is conducted in a manner that safeguards and respects participants’ rights and well-being. Research ethics committees (RECs) or institutional review boards (IRBs) are responsible for ethical evaluations before approval. This entails assessing potential risks and benefits associated with the research. For effective international research collaboration, researchers must be cognisant of participating countries’ ethical and regulatory requirements. Although these processes may be managed at various levels—local, regional or national; their implementation across countries often remains opaque and varies significantly. The British Urology Researchers in Training (BURST) Research Collaborative houses a network of international representatives to guide prospective study sites within their countries in acquiring ethical approval. We provide an overview of the ethical approval processes across 17 countries, emphasising on approvals for audits, observational studies, and randomised controlled trials (RCTs).&lt;/p&gt;&lt;p&gt;A brief structured questionnaire was sent to all international representatives of BURST (Appendix S1). BURST is an international research group leading major collaborative urological research studies, both interventional and non-interventional, engaging hospitals from multiple countries [&lt;span&gt;1-3&lt;/span&gt;]. The international representatives are from 17 countries (United Kingdom, Ireland, Italy, Spain, Germany, France, Belgium, Portugal, Montenegro, Slovakia, USA, India, Hong Kong, Vietnam, Indonesia, Mexico, and Ethiopia). Additionally, data on ethical approval procedures were collected from the top 15 countries with the highest case contributions to BURST's recent ‘Transurethral REsection and Single instillation intra-vesical chemotherapy Evaluation in bladder Cancer Treatment’ (RESECT) study, which enrolled 19 505 patients across 230 hospitals from 41 countries [&lt;span&gt;3&lt;/span&gt;]. A link to the questionnaire was sent by e-mail to the international representatives in May 2024. The survey encompassed questions relating to local ethical and governance approval application processes, projected timeline, financial implications, challenges, and regulatory guidance.&lt;/p&gt;&lt;p&gt;Of the 24 questionnaires distributed, 18 (75%) were completed and returned by respondents across 17 countries. Table S1 summarises the questionnaire results for each country. All countries confirmed the role and existence of established decision-making committees tasked with overseeing the ethics of human subject research within their countries.&lt;/p&gt;&lt;p&gt;The core of the ethical approval process lies in the clarification and preparation of necessary information for the REC. Applications typically require the study protocol, which defines the research plan, allowing the REC to assess and classify the study. Additional documentation may be requested, including a conflict-of-int","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 5","pages":"717-719"},"PeriodicalIF":3.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16671","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}