The Impact of American Board of Urology Certification on Postoperative Outcomes for Patients in New York State.

Introduction: Our goal was to determine if board certification status was associated with improved postoperative outcomes for certain urologic oncology operations.

Methods: We performed a retrospective cohort study of patients aged 65 and over having radical prostatectomy (RP), radical cystectomy (RC), and radical or partial nephrectomy (RPN) by surgeons with New York State licenses from 2015 to 2021 using the Medicare limited dataset. Our primary exposure was surgeon American Board of Urology certification determined by the New York State Physician Profile.

Disposable versus Reusable Cystoscopes: A Micro-Costing Value Analysis in High-Volume and Low-Volume Urology Practices.

Introduction: Disposable single-use cystoscopes have become increasingly available, demonstrating comparable quality to reusable cystoscopes while eliminating the need for reprocessing and repairs. However, high costs remain a concern. To clarify the role for these scopes, we performed a cost analysis comparison between the single-use Ambu® aScope™ 4 cystoscope and reusable Olympus® CYF-VHR and V2 cystoscopes in 2 clinical settings: a high-volume multi-provider practice and low-volume single-provider practice.

An Interoperable Similarity-based Cohort Identification Method Using the OMOP Common Data Model version 5.0.

Cohort identification for clinical studies tends to be laborious, time-consuming, and expensive. Developing automated or semi-automated methods for cohort identification is one of the "holy grails" in the field of biomedical informatics. We propose a high-throughput similarity-based cohort identification algorithm by applying numerical abstractions on Electronic Health Records (EHR) data.

EliIE: An open-source information extraction system for clinical trial eligibility criteria.

Objective: To develop an open-source information extraction system called Eligibility Criteria Information Extraction (EliIE) for parsing and formalizing free-text clinical research eligibility criteria (EC) following Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) version 5.0.

Materials And Methods: EliIE parses EC in 4 steps: (1) clinical entity and attribute recognition, (2) negation detection, (3) relation extraction, and (4) concept normalization and output structuring.

A multi-site cognitive task analysis for biomedical query mediation.

Objective: To apply cognitive task analyses of the Biomedical query mediation (BQM) processes for EHR data retrieval at multiple sites towards the development of a generic BQM process model.

Materials And Methods: We conducted semi-structured interviews with eleven data analysts from five academic institutions and one government agency, and performed cognitive task analyses on their BQM processes. A coding schema was developed through iterative refinement and used to annotate the interview transcripts.

A data-driven concept schema for defining clinical research data needs.

Objectives: The Patient, Intervention, Control/Comparison, and Outcome (PICO) framework is an effective technique for framing a clinical question. We aim to develop the counterpart of PICO to structure clinical research data needs.

Methods: We use a data-driven approach to abstracting key concepts representing clinical research data needs by adapting and extending an expert-derived framework originally developed for defining cancer research data needs.

Facilitating biomedical researchers' interrogation of electronic health record data: Ideas from outside of biomedical informatics.

Electronic health records (EHR) are a vital data resource for research uses, including cohort identification, phenotyping, pharmacovigilance, and public health surveillance. To realize the promise of EHR data for accelerating clinical research, it is imperative to enable efficient and autonomous EHR data interrogation by end users such as biomedical researchers. This paper surveys state-of-art approaches and key methodological considerations to this purpose.

Use of Self-Service Query Tools Varies by Experience and Research Knowledge.

The lack of understanding of user experience with self-service query tools is a barrier to designing effective query tools and is what propelled this study. User actions were documented and transformed into networks of actions for qualitative analysis. Proficient use of self-service query tools requires significant technical experience.

Delay from biopsy to radical prostatectomy influences the rate of adverse pathologic outcomes.

Background: We sought to determine maximum wait times between biopsy diagnosis and surgery for localized prostate cancer, beyond which the rate of adverse pathologic outcomes is increased.

Methods: We retrospectively reviewed 4,610 patients undergoing radical prostatectomy between 1990 and 2011. Patients were stratified by biopsy Gleason score and PSA value.

The role of preoperative prostatic urethral biopsy in clinical decision-making at the time of radical cystectomy.

Introduction: Involvement of the prostatic urethra by bladder cancer directly impacts prognosis, risk of urethral recurrence, and timing of radical cystectomy (RC); it also affects the type of urinary diversion chosen. Both cold cup biopsies and transurethral (TUR) loop biopsies have been used to evaluate the status of the prostatic urethra. We report our 20 year experience with preoperative and intro-operative prostatic urethral biopsies in order to determine relative efficacy and associated treatment implications.

Toward a cognitive task analysis for biomedical query mediation.

In many institutions, data analysts use a Biomedical Query Mediation (BQM) process to facilitate data access for medical researchers. However, understanding of the BQM process is limited in the literature. To bridge this gap, we performed the initial steps of a cognitive task analysis using 31 BQM instances conducted between one analyst and 22 researchers in one academic department.

What Is Asked in Clinical Data Request Forms? A Multi-site Thematic Analysis of Forms Towards Better Data Access Support.

Many academic medical centers have aggregated data from multiple clinical systems into centralized repositories. These repositories can then be queried by skilled data analysts who act as intermediaries between the data stores and the research teams. To obtain data, researchers are often expected to complete a data request form.

Characterization of the biomedical query mediation process.

To most medical researchers, databases are obscure black boxes. Query analysts are often indispensable guides aiding researchers to perform mediated data queries. However, this approach does not scale up and is time-consuming and expensive.

An Integrated Model for Patient Care and Clinical Trials (IMPACT) to support clinical research visit scheduling workflow for future learning health systems.

We describe a clinical research visit scheduling system that can potentially coordinate clinical research visits with patient care visits and increase efficiency at clinical sites where clinical and research activities occur simultaneously. Participatory Design methods were applied to support requirements engineering and to create this software called Integrated Model for Patient Care and Clinical Trials (IMPACT). Using a multi-user constraint satisfaction and resource optimization algorithm, IMPACT automatically synthesizes temporal availability of various research resources and recommends the optimal dates and times for pending research visits.

Neoadjuvant chemotherapy in the treatment of muscle invasive bladder cancer with mixed histology.

Introduction: We examined the effects of neoadjuvant chemotherapy (NC) in the treatment of muscle invasive urothelial carcinoma of the bladder in those with mixed histology (MH) versus those with pure urothelial carcinoma (UC).

Materials And Methods: Between 2000-2012, 195 patients were identified with clinical stage T2-T4, N0-Nx, M0-Mx UCB who had either NC (+/- radical cystectomy) (n = 63) or radical cystectomy (RC) alone (n = 132). Tumors were classified as either pure UC or MH.

A centralized research data repository enhances retrospective outcomes research capacity: a case report.

This paper describes our considerations and methods for implementing an open-source centralized research data repository (CRDR) and reports its impact on retrospective outcomes research capacity in the urology department at Columbia University. We performed retrospective pretest and post-test analyses of user acceptance, workflow efficiency, and publication quantity and quality (measured by journal impact factor) before and after the implementation. The CRDR transformed the research workflow and enabled a new research model.

Socioeconomic and clinical factors influence the interval between positive prostate biopsy and radical prostatectomy.

Objective: To examine socioeconomic and clinical factors that may predict a longer interval between prostate biopsy and radical prostatectomy (RP).

Methods: The Columbia University Urologic Oncology Database was queried for patients who underwent RP from 1990-2010. Time to surgery (TTS) was defined as the period between the most recent positive prostate biopsy and date of surgery.

Partial nephrectomy online: a preliminary evaluation of the quality of health information on the Internet.

Unlabelled: What's known on the subject? and What does the study add? Patients are highly likely to access the Internet for health information, and studies have reported that inaccurate or low-quality information may alter patients' expectations and negatively impact informed decision-making. In a unique collaboration with the Health On the Internet (HON) Foundation, we evaluated the top 20 search results for the urology search term 'partial nephrectomy,' and identified the highest and lowest scoring criteria to increase awareness of areas of concern and improvement.

Objective: To further evaluate the quality of information available on the Internet with regard to the management of localized renal cancer, we evaluated websites providing information on 'partial nephrectomy' in conjunction with the Health On the Internet (HON) Foundation.

The impact of perioperative blood transfusion on survival following radical cystectomy for urothelial carcinoma.

Introduction: Perioperative blood transfusion (PBT) has been shown to contribute to cancer progression and mortality. This study sought to determine the impact of PBT during radical cystectomy on cancer-specific survival (CSS) and overall survival (OS).

Materials And Methods: The Columbia University Urologic Oncology Database was reviewed for patients who underwent a RC from 1989 to 2010 (n = 638).

Pathological confirmation of nerve-sparing types performed during robot-assisted radical prostatectomy (RARP).

Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Incremental nerve-sparing techniques (NSTs) improve postoperative erectile function after robot-assisted radical prostatectomy (RARP). However, there are no studies to date that histologically confirm the surgeon intended NST. Thus, in the present study, we histologically confirmed that the surgeon performed the nerve preservation as his intended NSTs during RARP.

Comparison of two core biopsy techniques before and after laparoscopic cryoablation of small renal cortical neoplasms.

Introduction: Cryoablation is an acceptable treatment option for small renal cortical neoplasms (RCN). Unlike extirpative interventions, intraoperative needle biopsy is the only pathologic data for ablated tumors. It is imperative that sampled tissue accurately captures pathology.

Comparison of biochemical failure definitions for predicting local cancer recurrence following cryoablation of the prostate.

Background: Various definitions of biochemical failure (BF) have been used to predict cancer recurrence following prostate cryoablation. However to date, none of these definitions have been validated for this use. We have reviewed several definitions of BF to determine their accuracy in predicting biopsy-proven local recurrence following prostate cryoablation.

Immediate radical cystectomy vs conservative management for high grade cT1 bladder cancer: is there a survival difference?

Objective: To determine whether a survival difference exists between patients with high grade (HG) cT1 urothelial cell carcinoma (UCC) receiving immediate radical cystectomy (IRC) as opposed to those choosing bladder-sparing therapy.

Patients And Methods: Between January 1990 and August 2010, 349 patients were retrospectively identified with a diagnosis of HG cT1 UCC of the bladder. Patients were divided into two groups: those who underwent IRC and those treated with conservative management (CM), consisting of transurethral resection of the bladder tumour (TURBT) and intravesical therapy.