Evidence map›Paper›PMID 31017086›Full record

SynthesisEuropean urology oncology2019

Systematic Review of Factors Associated with the Utilization of Radical Cystectomy for Bladder Cancer.

Stephen B Williams, Hogan K Hudgins, Mohamed D Ray-Zack, Karim Chamie, Marc C Smaldone, Stephen A Boorjian, Siamak Daneshmand, Peter C Black, Ashish M Kamat, Peter J Goebell and 11 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European urology oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Stephen B WilliamsDivision of Urology, The University of Texas Medical Branch, Galveston, TX, USA. Electronic address: stbwilli@utmb.edu.
Hogan K HudginsDivision of Urology, The University of Texas Medical Branch, Galveston, TX, USA.
Mohamed D Ray-ZackDivision of Urology, The University of Texas Medical Branch, Galveston, TX, USA.
Karim ChamieDepartment of Urology, University of California Los Angeles, Los Angeles, CA, USA.
Marc C SmaldoneDepartment of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA.
Stephen A BoorjianDepartment of Urology, Mayo Clinic, Rochester, MN, USA.
Siamak DaneshmandUSC Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Peter C BlackDepartment of Urologic Science, University of British Columbia, Vancouver, Canada.
Ashish M KamatDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Peter J GoebellDepartment of Urology, Friedrich-Alexander University, Erlangen, Germany.
Roland SeilerDepartment of Urology University Hospital Bern, Bern, Switzerland.
Bernd Schmitz-DragerDepartment of Urology, Friedrich-Alexander University, Erlangen, Germany.
Roman NawrothDepartment of Urology, Technical University of Munich, Munich, Germany.
Jacques BaillargeonDepartment of Medicine, Division of Epidemiology, Sealy Center on Aging, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
Zachary KlaassenDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Centre, Toronto, Canada.
Girish S KulkarniDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Centre, Toronto, Canada.
Simon P KimUrology Institute, Center for Health Care Quality and Outcomes, University Hospitals Case Western Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Eugene K LeeDepartment of Urology, The University of Kansas Medical Center, Kansas City, KS, USA.
Jeffrey M HolzbeierleinDepartment of Urology, The University of Kansas Medical Center, Kansas City, KS, USA.
Brent K HollenbeckDepartment of Urology, The University of Michigan, Ann Arbor, MI, USA.
John L GoreDepartment of Urology, The University of Washington, Seattle, WA, USA.

Funding

UTMB Clinical and Translational Science AwardUL1TR001439 · NCATS · UNIVERSITY OF TEXAS MED BR GALVESTON · PI URBAN, RANDALL J · 2015 to 2024
$40.0M
NCATS NIH HHS UL1 TR001439NCI NIH HHS L30 CA253020
6 · The paper itself

Abstract

contextDespite established guidelines for the treatment of muscle-invasive bladder cancer, it has been reported that radical cystectomy (RC) is markedly underused, especially among patients of advanced age and those with higher comorbidity burden and lower access to care. Understanding the interactions between patient, provider, and hospital factors may inform targeted interventions to optimize RC utilization.

objectiveTo systematically review the literature regarding factors associated with RC utilization. EVIDENCE ACQUISITION: A systematic search was conducted using Ovid and Medline according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies between 1970 and 2017 reporting on RC utilization. Prospective and retrospective studies were included. EVIDENCE SYNTHESIS: There are no published randomized control trials on RC utilization. Variations in study quality and design precluded a formal statistical meta-analysis. RC receipt significantly depended on patient, provider, and hospital factors. Patient factors associated with lower RC use included advanced age, African American and Hispanic race/ethnicity, higher comorbidity burden, unmarried marital status, higher tumor stage and grade, and lower socioeconomic status. Provider factors associated with underutilization included lower surgeon volume and a metropolitan location. Finally, hospital factors associated with lower RC use included low hospital volume, nonacademic affiliation, and hospital location in the Midwest.

conclusionsRC is reportedly underutilized. We found that age, race, marital status, socioeconomic factors, cancer severity, comorbidity burden, surgeon volume, and facility type and location significantly determined RC receipt. Improved understanding of the varying contributions of the risk factors according to patient, provider, and hospital determinants may assist in developing targeted interventions to improve RC utilization. PATIENT SUMMARY: In this review we explored the clinical evidence for factors predicting the utilization of radical cystectomy for muscle-invasive bladder cancer. Many factors related to the patient, provider, and hospital determine whether patients receive this guideline-recommended treatment. However, there remains a lack of understanding on characterization and targeted interventions according to these levels, which may improve use.

Indexed as

CystectomyHumansProcedures and Techniques UtilizationProspective StudiesRetrospective StudiesRisk AssessmentUrinary Bladder NeoplasmsPredictorsRadical cystectomyUseUtilization

Identifiers

PMID31017086
PMCPMC10039463

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.