To develop performance metrics that objectively define a reference approach to a transurethral resection of bladder tumours (TURBT) procedure, seek consensus on the performance metrics from a group of international experts.
The characterisation of a reference approach to a TURBT procedure was performed by identifying phases and explicitly defined procedure events (i.e., steps, errors, and critical errors). An international panel of experienced urologists (i.e., Delphi panel) was then assembled to scrutinise the metrics using a modified Delphi process. Based on the panel's feedback, the proposed metrics could be edited, supplemented, or deleted. A voting process was conducted to establish the consensus level on the metrics. Consensus was defined as the panel majority (i.e., >80%) agreeing that the metric definitions were accurate and acceptable. The number of metric units before and after the Delphi meeting were presented.
A core metrics group (i.e., characterisation group) deconstructed the TURBT procedure. The reference case was identified as an elective TURBT on a male patient, diagnosed after full diagnostic evaluation with three or fewer bladder tumours of ≤3 cm. The characterisation group identified six procedure phases, 60 procedure steps, 43 errors, and 40 critical errors. The metrics were presented to the Delphi panel which included 15 experts from six countries. After the Delphi, six procedure phases, 63 procedure steps, 47 errors, and 41 critical errors were identified. The Delphi panel achieved a 100% consensus.
Performance metrics to characterise a reference approach to TURBT were developed and an international panel of experts reached 100% consensus on them. This consensus supports their face and content validity. The metrics can now be used for a proficiency-based progression training curriculum for TURBT.
BJU international. 2024 Jun 03 [Epub ahead of print]
Marco Paciotti, Pietro Diana, Andrea Gallioli, Ruben De Groote, Rui Farinha, Vincenzo Ficarra, Richard Gaston, Paolo Gontero, Rodolfo Hurle, Luis Martínez-Piñeiro, Andrea Minervini, Vito Pansadoro, Ben Van Cleynenbreugel, Peter Wiklund, Paolo Casale, Giovanni Lughezzani, Alessandro Uleri, Alexandre Mottrie, Joan Palou, Anthony G Gallagher, Alberto Breda, Nicolò Buffi
Department of Urology, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy., Department of Urology, Fundació Puigvert, Barcelona, Spain., Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium., Urology Department, Lusíadas Hospital, Lisbon, Portugal., Gaetano Barresi Department of Human and Paediatric Pathology, Section of Urology, University of Messina, Messina, Italy., Department of Urology, Clinique Saint Augustin, Bordeaux, France., Department of Urology, University of Turin, Turin, Italy., Department of Urology, La Paz University Hospital and La Paz Hospital Research Institute, Autonomous University of Madrid, Madrid, Spain., Unit of Oncologic Minimally Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, Florence, Italy., Fondazione Vincenzo Pansadoro, Centro di Urologia Laparoscopica e Oncologia Medica, Rome, Italy., Department of Urology, University Hospitals Leuven, Louvain, Belgium., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Development and Regeneration, KU Leuven, Louvain, Belgium.