International consensus panel for transurethral resection of bladder tumours metrics: assessment of face and content validity

Author:

Paciotti Marco1ORCID,Diana Pietro1234ORCID,Gallioli Andrea34ORCID,De Groote Ruben5ORCID,Farinha Rui6ORCID,Ficarra Vincenzo7,Gaston Richard8,Gontero Paolo9,Hurle Rodolfo1,Martínez‐Piñeiro Luis10,Minervini Andrea11ORCID,Pansadoro Vito12,Van Cleynenbreugel Ben1314,Wiklund Peter1516,Casale Paolo1,Lughezzani Giovanni12ORCID,Uleri Alessandro12,Mottrie Alexandre517,Palou Joan34,Gallagher Anthony G.1417,Breda Alberto34,Buffi Nicolò12

Affiliation:

1. Department of Urology IRCCS Humanitas Research Hospital Rozzano Milan Italy

2. Department of Biomedical Sciences Humanitas University Milan Italy

3. Department of Urology Fundació Puigvert Barcelona Spain

4. Department of Surgery Autonomous University of Barcelona Barcelona Spain

5. Department of Urology Onze‐Lieve‐Vrouw Hospital Aalst Belgium

6. Urology Department Lusíadas Hospital Lisbon Portugal

7. Gaetano Barresi Department of Human and Paediatric Pathology, Section of Urology University of Messina Messina Italy

8. Department of Urology Clinique Saint Augustin Bordeaux France

9. Department of Urology University of Turin Turin Italy

10. Department of Urology, La Paz University Hospital and La Paz Hospital Research Institute Autonomous University of Madrid Madrid Spain

11. Unit of Oncologic Minimally Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital University of Florence Florence Italy

12. Fondazione Vincenzo Pansadoro, Centro di Urologia Laparoscopica e Oncologia Medica Rome Italy

13. Department of Urology University Hospitals Leuven Louvain Belgium

14. Department of Development and Regeneration KU Leuven Louvain Belgium

15. Department of Urology Icahn School of Medicine at Mount Sinai New York NY USA

16. Department of Urology Karolinska University Hospital Solna Sweden

17. Orsi Academy Melle Belgium

Abstract

ObjectiveTo 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.MethodsThe 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.ResultsA 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.ConclusionPerformance 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.

Funder

Erasmus+

Publisher

Wiley

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