Adherence to First-Line Intravesical Bacillus Calmette-Guérin Therapy in the Context of Guideline Recommendations for US Patients With High-Risk Non-muscle Invasive Bladder Cancer.

Bacillus Calmette-Guérin (BCG) can reduce recurrence and delay progression among patients with high-risk non-muscle invasive bladder cancer (NMIBC), but is associated with a substantial emotional, physical, and social burden. This study evaluated the adequacy of first-line intravesical BCG treatment among high-risk NMIBC patients in the United States, including the subgroup with carcinoma in situ (CIS) of the bladder. Adults with high-risk NMIBC treated with BCG were selected from de-identified MarketScan® Commercial, Medicare, and Medicaid Databases (1/1/2010-2/28/2021).

Feasibility of Pay for Performance and Transparency Interventions on the Selection and Quality of Observational Management for Patients With Low-Risk Prostate Cancer in the Community Practice.

Introduction: Practice-level strategies to improve the use of conservative management for low-risk prostate cancer have not been rigorously evaluated. We examined the feasibility of implementation and preliminary outcomes of a pay-for-performance (P4P) and a transparency intervention at the practice level.

Methods: We conducted a pilot study within a Southern California urology practice network.

Time Trends and Variation in the Use of Active Surveillance for Management of Low-risk Prostate Cancer in the US.

Importance: Active surveillance (AS) is endorsed by clinical guidelines as the preferred management strategy for low-risk prostate cancer, but its use in contemporary clinical practice remains incompletely defined.

Objective: To characterize trends over time and practice- and practitioner-level variation in the use of AS in a large, national disease registry.

Design, Setting, And Participants: This retrospective analysis of a prospective cohort study included men with low-risk prostate cancer, defined as prostate-specific antigen (PSA) less than 10 ng/mL, Gleason grade group 1, and clinical stage T1c or T2a, newly diagnosed between January 1, 2014, and June 1, 2021.

Use of Monitoring Tests Among Patients With Localized Prostate Cancer Managed With Observation.

Purpose: It is unknown whether compliance with recommended monitoring tests during observation of localized prostate cancer has changed over time.

Materials And Methods: We performed a retrospective cohort study of Medicare beneficiaries diagnosed with low- or intermediate-risk prostate cancer in 2004-2016 who were initially managed with observation for a minimum of 12 months. The primary objective was to examine rates of PSA testing, prostate biopsy, and prostate MRI.

Change in prostate cancer presentation coinciding with USPSTF screening recommendations at a community-based urology practice.

Objective: The benefits of prostate-specific antigen (PSA)-based prostate cancer screening are controversial. We sought to determine the change in prostate cancer presentation coinciding with the release of the United States Preventative Services Task Force recommendations against screening in a high-volume community-based urology practice.

Methods: Characteristics of men presenting for an elevated PSA at a community urology practice from August 2011 to August 2015 were queried from a prospectively collected database.

Preprinted standardized orders promote venous thromboembolism prophylaxis compared with traditional handwritten orders: an endorsement of standardized evidence-based practice.

The objective was to determine if a standardized process of care--namely, standardized evidence-based medical orders (SEBMOs)--improves physician compliance with venous thromboembolism (VTE) prophylaxis. A total of 61 physicians received information about VTE prophylaxis after introduction of an admission SEBMO. Hospitalists received enhanced presentations about SEBMOs and their value in VTE prevention; specialists did not.