Virtual "Matchmaking": Stakeholder Perspectives on the Future of the Urology Residency Match.

Objective: To examine stakeholder perspectives regarding the lack of in-person externships and transition to a virtual urology residency interview format. The unprecedented disruption from the COVID-19 pandemic forced an abrupt pivot to a "virtual" Urology Match for the 2021 cycle. We aim for our study to inform ongoing deliberations on the future of the Urology Match.

Association of the hospital readmission reduction program with readmission and mortality outcomes after coronary artery bypass graft surgery.

The Affordable Care Act established the Hospital Readmissions Reduction Program (HRRP) to reduce payments to hospitals with excessive readmissions in an effort to link payment to the quality of hospital care. Prior studies demonstrating an association of HRRP implementation with increased mortality after heart failure discharges have prompted concern for potential unintended adverse consequences of the HRRP. We examined the impact of these policies on coronary artery bypass graft (CABG) surgery outcomes using the Nationwide Readmissions Database and found that, in line with previously observed readmission trends for CABG, readmission rates continued to decline in the era of the HRRP, but that this did not come at the expense of increased mortality.

Prehabilitation Exercise Before Urologic Cancer Surgery: A Systematic and Interdisciplinary Review.

Context: The Consensus on Therapeutic Exercise Training (CONTENT) scale assesses the therapeutic validity of exercise programs. To date, prehabilitation exercise programs for heath optimization before urologic cancer surgeries have not been assessed for therapeutic validity or efficacy.

Objective: To systematically assess prehabilitation exercise programs before urologic cancer surgery for therapeutic validity and efficacy, informing discussion of best practices for future intervention.

Is There An Association Between Bundled Payments and "Cherry Picking" and "Lemon Dropping" in Orthopaedic Surgery? A Systematic Review.

Background: The goal of bundled payments-lump monetary sums designed to cover the full set of services needed to provide care for a condition or medical event-is to provide a reimbursement structure that incentivizes improved value for patients. There is concern that such a payment mechanism may lead to patient screening and denying or providing orthopaedic care to patients based on the number and severity of comorbid conditions present associated with complications after surgery. Currently, however, there is no clear consensus about whether such an association exists.

Radical prostatectomy versus external beam radiation therapy for high-grade, clinically localized prostate cancer: Emulation of a target clinical trial.

Purpose: The comparative effectiveness of surgery and radiation therapy for high-grade, clinically localized prostate cancer remains a seminal, open question in urologic oncology, with no randomized controlled trials to inform management. We therefore emulated a hypothetical target clinical trial of radical prostatectomy (RP) versus external beam radiotherapy (EBRT) for high-grade, clinically localized prostate cancer.

Materials And Methods: We conducted observational analyses using the National Cancer Database from 2006-2015 to emulate a target clinical trial in men 55-69 years with cT1-3cN0cM0, PSA<20 ng/mL, Gleason 8 to 10 prostate adenocarcinoma treated with RP or 75 to 81 Gy EBRT with androgen deprivation therapy (EBRT+ADT).

Management of Clinically Regional Node-Positive Urothelial Carcinoma of the Bladder.

Purpose Of Review: Clinically regional node-positive (cN+) urothelial carcinoma of the bladder requires a multi-modal management approach amidst growing recognition that it represents a spectrum of disease. Herein, we review the contemporary evidence for the natural history, evaluation, and management of clinically regional node-positive urothelial carcinoma of the bladder, highlighting recent changes in lymph node staging.

Recent Findings: Despite advances in techniques, cross-sectional imaging remains relatively insensitive for the detection of lymph node metastases.

Systematic Review of Time to Definitive Treatment for Intermediate Risk and High Risk Prostate Cancer: Are Delays Associated with Worse Outcomes?

Purpose: Prostate cancer is most commonly an indolent disease, especially when detected at a localized stage. Unlike other tumors that may benefit from timely receipt of definitive therapy, it is generally accepted that treatment delays for localized prostate cancer are acceptable, especially for low risk prostate cancer. Since treatment delay for intermediate risk and high risk disease is more controversial, we sought to determine if delays for these disease states negatively impacted oncological outcomes.

Value-Based Healthcare in Urology: A Collaborative Review.

Context: In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and remunerated.

Objective: To systematically review the literature regarding the implementation and impact of value-based healthcare in urology.

Evidence Acquisition: A systematic review was performed to identify studies that described the implementation of one or more elements of value-based healthcare in urologic settings and in which the associated change in healthcare value had been measured.

Clinical applications of artificial intelligence in urologic oncology.

Purpose Of Review: This review aims to shed light on recent applications of artificial intelligence in urologic oncology.

Recent Findings: Artificial intelligence algorithms harness the wealth of patient data to assist in diagnosing, staging, treating, and monitoring genitourinary malignancies. Successful applications of artificial intelligence in urologic oncology include interpreting diagnostic imaging, pathology, and genomic annotations.