New treatment modalities for benign prostatic hyperplasia (BPH) have considerably altered the decision making process in daily clinical practice.
Guidelines provide a framework for treatment choice but leave much room for physician personal opinions.
We identified and quantified determinants of treatment choice for BPH among urologists focusing on urologist treatment preferences.
The study population consisted of 670 consecutive patients with BPH 50 years old or older newly referred to 1 of 39 urologists in a stratified sample of 13 hospitals throughout The Netherlands.
Data on patient characteristics were retrieved from patient questionnaires (symptomatology, bothersomeness, sexual function), medical records (diagnostic outcomes, co-morbidity) and urologist questionnaire (initial treatment choice and main considerations for this decision).
Urologist treatment preferences were inventoried using a mailed questionnaire.
Polychotomous logistic regression analysis was used to study the impact of patient characteristics and urologist preferences on treatment choice.
Among the patient characteristics maximum flow rate, residual urine and prostate volume were strongly associated with the probability of surgery and watchful waiting.
However, the influence of urologist preferences on actual decisions was also significant.
Adjusted for case mix the differences in low and high preferences revealed a 2. (...)
Mots-clés Pascal : Adénome, Prostate, Hyperplasie, Indication, Traitement, Critère décision, Modalité traitement, Etude statistique, Homme, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie, Tumeur bénigne, Chirurgie, Economie santé
Mots-clés Pascal anglais : Adenoma, Prostate, Hyperplasia, Indication, Treatment, Decision criterion, Application method, Statistical study, Human, Urinary system disease, Male genital diseases, Prostate disease, Benign neoplasm, Surgery, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0050134
Code Inist : 002B14D02. Création : 31/05/1999.