Page 8 - CUA2018 Abstracts - Miscellaneous/Other

Poster session 2: Education/Practice Management

(AM). The primary objective is to identify factors associated with improved MP–2.15
treatment effectiveness measured by patient–reported outcomes (PROs). Evaluation of the leader and communicator CanMEDS roles of
In this preliminary analysis, we describe differences between treatment graduating Canadian urology residents
groups in several patient baseline (BL) characteristics, including PROs. Naji Touma , Gregory Hosier 1
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Methods: Patients inluded adults with OAB symptoms ≥3 month initiating 1 Urology, Queen’s University, Kingston, ON, Canada
a new course of mirabegron or AM in routine clinical practice. PROs were Introduction: The Leader and Communicator roles are two of the seven
mesured using OAB–q–short form (symptom bother and health–related roles identified by the Royal College as part of the framework of abilities
quality of life [HRQoL] scores) and Patient Perception of Bladder Condition that are essential to graduating fellows. However, aside from the role
(PPBC) questionnaires, both completed within seven days of enrolment. of medical expert, it is somewhat difficult to formally assess the other
Results: Overall, 1514 patients (613 mirabegron, 901 AM) were enrolled; CanMEDS roles.
mean age was 62.2 years, 87.2% were white, and 73.5% were women. Methods: Chief residents (n=36) were evaluated with two surveys at the
The proportion of women initiating mirabegron treatment was lower than time of a weekend course. The response rate was 100%. Both surveys
those initiating AM (69.2 vs. 76.5%). Mirabegron patients, compared with were validated on 5000 business students. One survey evaluates the
AM patients, had a longer time since diagnosis (49.3 vs. 41.0 months) and personal management skills with 84 questions scored on a Likert scale,
were more likely to be diagnosed by a urologist (49.3 vs. 39.1%) than and the other evaluates the residents’ communication skills with 20 ques-
other healthcare professionals. Fewer mirabegron than AM patients had tions scored on a Likert scale, as well as some case scenarios evaluating
wet OAB (71.1 vs. 79.8%), stress/mixed incontinence (72.0 vs. 85.0%), their communication style. The same surveys were administered through
and were currently using pads (47.1 vs. 55.8%). More mirabegron vs AM email to the residents’ program directors (PDs) in a blinded fashion to
patients had received OAB medication in the past 12 months (29.0 vs. see if PDs agreed with the residents’ self– assessment. The response rate
18.8%). BL PRO data within the first seven days were missing for 45–46% for PDs was 50%
of mirabegron and 33% of AM patients. Among those completing BL Results: Graduating urology residents tend to score slightly higher (mean
PROs, mirabegron patients reported lower PPBC scores, indicating fewer score 93.2) on communication skills compared to business students (mean
problems (36.8 vs. 41.1% reported severe or many severe problems), score 90.91). They do, however, score lower on management skills (mean
lower symptom bother score (59.0 vs. 63.0), and higher total HRQoL score 385.3 for urology residents vs. 394.55 for business students). There
score (49.7 vs. 43.4) compared with AM patients was no difference in the residents’ self–assessment of their own commu-
Conclusions: Important BL demographic, clinical, and HRQoL differences nication and management skills and the evaluation of PDs of the their
exist between mirabegron– and AM–treated OAB patients. residents’ skills.
Conclusions: This objective way of evaluating the Leader and
MP–2.14 Communicator CanMEDS roles reveals that graduating urology residents
Direct to cystoscopy: A prospective quality assessment of patient score better than business students in communication, but lower in man-
preference and current outcomes agement skills. It would appear that the residents’ self–assessments do
Mark Assmus , Ryan McLarty , Shubha De 1 not differ much from their PDs’ evaluation.
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1 Surgery, Division of Urology, University of Alberta, Edmonton, AB,
Canada UP–2.1
Introduction: Cystourethroscopy is one of the most common procedures Artificial intelligence in manuscript analysis: Using machine
performed by urologists in both office and operative settings. With the learning to automate the peer–review process
recent centralization of cystoscopy at our centre, we looked to assess our Luke Witherspoon , Isar Nejadgholi , Najmeh Taleb , Renaud Bougueng ,
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current delivery model, to determine whether new patients prefer their Samuel Witherspoon , Christopher Morash 1
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initial visit to be in cystoscopy, or in the clinic, followed by a cystoscopy 1 Urology, The Ottawa Hospital, Ottawa, ON, Canada; IMSRV Data Labs,
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appointment later. Ottawa, ON, Canada
Methods: We administered 500 prospective questionnaires to adults Introduction: The peer–review process is an integral part of the scientific
undergoing cystoscopy by 14 urologists at our centre. These results were method, however, with rising numbers of publications, providing quality,
compared to patient demographics and a chart review for indications/ timely peer–review has become difficult. There has been limited research
disposition related to their cystoscopy. Our primary objective was to assess into the use of artificial intelligence (AI) to improve this process, and
which patients prefer to be seen directly to cystoscopy (DTC) vs. a clinic the work that has been done is limited to privately developed systems
appointment (CA) before cystoscopy. used by publishers. Using machine learning, we present a system for
Results: A total of 500 surveys were analyzed, with 333/500 (67%) automated peer–review.
patients being male. Mean age was 66 years (21–93), with 34% being Methods: In partnership with IMSRV Data Labs, urological journal articles
under 60 years. Thirty–eight percent (n=192) were undergoing their first were ingested into our AI engine and then broken into component parts
cystoscopy, with 82% preferring DTC. There was no difference in age, and separated by heading, paragraph, sentence, word, and character
gender, or first–time–cystoscopy when comparing those who preferred in a hierarchical model (tokenization) (Fig. 1; available at https://cua.
DTC to CA. The vast majority (98%) felt they understood their indication guide/). The tokens were fed to the semantic model and word embed-
for cystoscopy, however, 5% misunderstood why they were being scoped; dings (vectors) are created for each tokenized sentence. The sentences
84% (n=420) felt their results were adequately disclosed. Clinically sig- are then evaluated against a historical dataset to predict a probability of
nificant abnormalities were detected in 22% of patients, who felt their receiving different classes of peer–reviewed feedback. This allows our
results were not discussed. When asked about abnormal results, only 56% AI engine to compare each aspect of a manuscript to the entirety of
of patients’ answers correlated to their urologist’s diagnoses. Thirty–seven the scientific communities published data on the subject. We can then
percent of patients who indicated ‘no followup was required,’ actually predict the probability of acceptance in the journal relying upon several
had followup (imaging, office visits, surgery, etc.). human specified features.
Conclusions: By evaluating patient understanding and preferences sur- Results: Our prototype AI engine continues development to improve
rounding cystoscopy, we have identified many opportunities for improve- accuracy and feedback. Continuing in the prototype phase, we are able
ment. The majority of patients do not take issue with their initial encoun- to compare ingested articles against a wide array of previously published
ter being an invasive procedure, however, communication needs to be urological and other scientific journals to aid in providing a score of
addressed. Future efforts will be directed towards post–procedural engage- originality. Based on this score we aim to estimate chances of acceptance.
ment to improve patient comprehension. Ongoing work continues in assessment of different quality indicators of a
manuscript, such as scientific method and statistical analysis.
CUAJ • June 2018 • Volume 12(6Suppl2) S77