MP45-10 PERSPECTIVES ON THE ROLE OF BIOPSY FOR MANAGEMENT OF T1 RENAL MASSES: RESULTS FROM TWO QUALITY IMPROVEMENT COLLABORATIVES (2021)

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance I (MP45)1 Sep 2021MP45-10 PERSPECTIVES ON THE ROLE OF BIOPSY FOR MANAGEMENT OF T1 RENAL MASSES: RESULTS FROM TWO QUALITY IMPROVEMENT COLLABORATIVES Zachary J. Prebay, Amit Patel, Anna Johnson, Claudette Fonshell, Jay Raman, Serge Ginzburg, Robert Uzzo, Craig Rogers, Brian R. Lane, and for the Michigan Urological Surgery Improvement Collaborative Zachary J. PrebayZachary J. Prebay More articles by this author , Amit PatelAmit Patel More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Claudette FonshellClaudette Fonshell More articles by this author , Jay RamanJay Raman More articles by this author , Serge GinzburgSerge Ginzburg More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Craig RogersCraig Rogers More articles by this author , Brian R. LaneBrian R. Lane More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002066.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal mass biopsy (RMB) has the potential to reduce unnecessary treatment by informing care, however, its utilization varies widely amongst providers and institutions. To better understand perspectives on RMB across multiple practice settings, a survey was distributed to urologists in the Michigan Urological Surgery Improvement Collaborative (MUSIC) and the Pennsylvania Urologic Regional Collaborative (PURC). METHODS: MUSIC and PURC are two large statewide quality improvement collaboratives representing a “real-world” collection of urologists from a variety of academic- and community-based settings. A 13-item survey was distributed to all providers regarding RMB utilization. The survey assessed current RMB utilization, patient- or tumor-specific factors that are important when deciding to recommend RMB, adverse events, changes in management, and simulated patient scenarios. Responses are reported using descriptive statistics. RESULTS: The survey generated 54 responses, with the majority indicating they never use RMB or use it <25% of the time for cT1a (59%) and cT1b (85%) tumors. The three most important patient-specific factors on decision to RMB were possible metastasis (94%), patient comorbidity (89%) and patient age (81%). The three most important tumor-specific factors were presence of bilateral tumors (81%), tumor size (70%) and perceived difficulty of performing nephron-sparing surgery (67%). Regarding barriers and outcomes, 10 (19%) indicated there were barriers to RMB in their practice, 23 (43%) reported experience with a complication or poor outcome, and 43 (80%) reported experience where RMB affected management. When presented with simulated patients, few urologists (9-20%) would recommend RMB in younger patients with any sized mass and recommendations varied for other simulations based on patient age, comorbidity status and tumor size (Figure 1). CONCLUSIONS: Understanding current perspectives on usage of RMB is important to design future quality improvement efforts. In two statewide collaboratives, most urologists do not regularly use RMB and certain factors in combination appeared to affect recommendations of RMB. Defining patient selection for RMB may be an important step towards the goal of reducing unnecessary treatments. Source of Funding: MUSIC receives funding from Blue Cross Blue Shield of Michigan. PURC is funded by participating urology practices and the Partnership for Patient Care, a quality improvement initiative supported by the Health Care Improvement Foundation, Independence Blue Cross, and southeastern PA hospitals and health systems © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e806-e807 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary J. Prebay More articles by this author Amit Patel More articles by this author Anna Johnson More articles by this author Claudette Fonshell More articles by this author Jay Raman More articles by this author Serge Ginzburg More articles by this author Robert Uzzo More articles by this author Craig Rogers More articles by this author Brian R. Lane More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...