Charlson comorbidity index and success of extracorporeal shock wave lithotripsy.

Introduction/objective: We examined the potential correlation between Charlson comorbidity index (CCI) and stone free rate after extracorporeal shock wave lithotripsy (ESWL).

Materials And Methods: Two hundred twenty-six adult patients were treated with 241 ESWL procedures for a renal or ureteral stone(s) over a 3 year period. Age, race, comorbidities, CCI, stone size and location, number of shocks and power level were determined.

Medical therapy versus surgery and minimally invasive surgical therapies for lower urinary tract symptoms and benign prostatic hyperplasia: what makes better economic sense?

From a clinical standpoint, the emergence of selective pharmacologic therapies and minimally invasive procedural treatments has changed clinical management paradigms for benign prostatic hyperplasia (BPH). Choosing from among the available treatment options can be complex for both patient and physician as factors including clinical outcomes, cost, and reimbursement are weighed and evaluated. Pharmacologic therapies produce modest improvements in objective outcomes measures and subject patients to long-term costs and risks including disease progression and the potential need for subsequent procedural treatment.

A clinical outcomes and cost analysis comparing photoselective vaporization of the prostate to alternative minimally invasive therapies and transurethral prostate resection for the treatment of benign prostatic hyperplasia.

Purpose: We critically evaluated the clinical outcomes and cost characteristics of alternative procedural treatment options for symptomatic benign prostatic hyperplasia.

Materials And Methods: An outcomes and cost analysis was performed for benign prostatic hyperplasia treatments, including photoselective vaporization, microwave thermotherapy, transurethral needle ablation, interstitial laser coagulation and transurethral resection. Clinical outcomes were measured by the percent improvement in American Urological Association/International Prostate Symptom Score, the maximum uroflowmetry rate and quality of life score.

A novel computer based expert decision making model for prostate cancer disease management.

Purpose: We propose a strategic, computer based, prostate cancer decision making model based on the analytic hierarchy process. We developed a model that improves physician-patient joint decision making and enhances the treatment selection process by making this critical decision rational and evidence based.

Materials And Methods: Two groups (patient and physician-expert) completed a clinical study comparing an initial disease management choice with the highest ranked option generated by the computer model.