Mp35-06 Picture Perfect Diagnoses: Evaluating Urologists' Tumor Identification Skills: The Prospective Tumor Grading Visual Accuracy (Trivia) Study

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II (MP35)1 May 2024MP35-06 PICTURE PERFECT DIAGNOSES: EVALUATING UROLOGISTS' TUMOR IDENTIFICATION SKILLS: THE PROSPECTIVE TUMOR GRADING VISUAL ACCURACY (TRIVIA) STUDY Valentina Grajales, Roberto Contieri, Wei Shen Tan, David G. Tuke, Leyla Akhverdiyeva, Hyunsoo Hwang, Amanda Myers, and Ashish M. Kamat Valentina GrajalesValentina Grajales , Roberto ContieriRoberto Contieri , Wei Shen TanWei Shen Tan , David G. TukeDavid G. Tuke , Leyla AkhverdiyevaLeyla Akhverdiyeva , Hyunsoo HwangHyunsoo Hwang , Amanda MyersAmanda Myers , and Ashish M. KamatAshish M. Kamat View All Author Informationhttps://doi.org/10.1097/01.JU.0001009372.61513.54.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Endoscopic evaluation and resection is the critical first step in the diagnosis and management of bladder tumors. Clinical decisions are made based on the appearance of tumors during cystoscopy and are based solely on the expertise of the urologist. Our objective was to assess the accuracy of urologists with varying experience and training in identifying the correct pathology of a tumor using endoscopic photographs. METHODS: We performed a prospective study whereby a survey (TRIVIA study) with endoscopic photographs of bladder tumors was circulated via the following organizations: Bladder Cancer Advocacy Network (BCAN), Society of Urologic Oncology (SUO), Endourological Society, British Association of Urological Surgeons (BAUS), and in Europe: Section of Oncological Urology (ESOU) and Young Academic Urologists (YAU) groups. The survey presented participants with an endoscopic photograph of a tumor (examples in Fig 1) and asked them to predict histopathologic characteristics. The answers were then correlated with the actual pathology of each tumor regarding grade and stage. Thirteen tumors were used: 2 benign lesions, 5 LgTa, 1 HgTa, 3 Hg/T1-T2, 1 HgT1 + CIS, and 1 pure CIS lesion. Providers' characteristics were summarized using descriptive statistics. Comparisons between continuous and categorical variables were conducted using the Wilcoxon rank-sum test and Fisher's exact test, respectively. All statistical analyses were two-sided. Statistical significance was set at p value=0.05. RESULTS: A total of 521 respondents participated in the study. Overall, there was a high accuracy rate for identifying benign versus malignant lesions: accuracy ranged from 0.85-0.89 across the groups with a sensitivity of 0.95-0.97. Accuracy for identifying correct grade was 0.59 to 0.66 with a sensitivity of 0.70-0.78, and for stage was 0.84-0.91 with a sensitivity of 0.26-0.41. CONCLUSIONS: The TRIVIA study revealed a high level of accuracy among endoscopists in diagnosing malignancy and determining the pathologic stage of bladder tumors. However, the accuracy for assessing pathologic grade was lower, which can impact important clinical decisions eg the need for perioperative chemotherapy and selection of patients for active surveillance/office fulguration. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e582 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Valentina Grajales More articles by this author Roberto Contieri More articles by this author Wei Shen Tan More articles by this author David G. Tuke More articles by this author Leyla Akhverdiyeva More articles by this author Hyunsoo Hwang More articles by this author Amanda Myers More articles by this author Ashish M. Kamat More articles by this author Expand All Advertisement PDF downloadLoading ...