Defining the Publication Source of High Quality Evidence in Urology: An Analysis of EvidenceUpdates.

To determine the publication sources of Urology articles within EvidenceUpdates, a second-order peer review system of the medical literature designed to identify high quality articles to support up-to-date and evidence-based clinical decisions.

Using administrator-level access, all EvidenceUpdates citations from 2003 to 2014 were downloaded from the topics Surgery-Urology and Oncology-Genitourinary. Data fields accessed included PUBMED unique reference identifier, study title, abstract, journal and date of publication, as well as clinical relevance and newsworthiness ratings as determined by discipline-specific physician raters. The citations were then coded by clinical topic (oncology, voiding dysfunction, ED/infertility, infection/inflammation, stones/endourology/laparoscopy, trauma/reconstruction, transplant, or other), journal category (general medical journal, oncology journal, urology journal, non-urology specialty journal, Cochrane review, or other), and study design (randomized controlled trial, systematic review, observational study, or other). Articles that were perceived to be misclassified and/or of no direct interest to urologists were excluded. Descriptive statistics using proportions and 95% confidence intervals as well as means and standard deviations were used to characterize the overall data cohort and to analyze trends over time.

We identified 731 unique citations classified under either Surgery-Urology or Oncology-Genitourinary for analysis after exclusions. Between 2005 and 2014, the most common topics were oncology (48. 6%, 355 articles) and voiding dysfunction (21. 8%, 159 articles). Within the topic of oncology, prostate cancer contributed over half the studies (54. 6%; n=194). The most common study types were randomized controlled trials (42. 3%, 309 articles) and systematic reviews (39. 6%, 290 articles). Systematic reviews had a nearly four-fold relative increase within less than a decade. The largest proportion of studies relevant to urology were published in general oncology journals (20. 0%; n=146), followed by the Cochrane Library (19. 3%, n=141) and general medical journals (17. 2%; n=126). Urology-specific journals contributed to only approximately one-tenth of EvidenceUpdates alerts (9. 4%; n=69), with the highest contribution occurring during the 2013/2014 period. With respect to clinical relevance and newsworthiness scores (each graded on scales of 1-7), urology journals scored the highest in clinical relevance 5. 9 ±0. 75 and general medical journals scored highest for newsworthiness at 5. 3 ± 0. 94. On average, randomized controlled trials scored highest both for clinical relevance and newsworthiness with mean scores of 5. 71 ± 0. 81 and 5. 22 ± 0. 91, respectively.

A large number of high quality, clinically relevant, and newsworthy peer-reviewed urology publications are published outside of traditional urology journals. This requires urologists to implement well-defined strategies to stay abreast of current best evidence. This article is protected by copyright. All rights reserved.

BJU international. 2015 Dec 14 [Epub ahead of print]

Vikram M Narayan, Kristin Chrouser, R Brian Haynes, Rick Parrish, Philipp Dahm

Minneapolis Veterans Healthcare System and University of Minnesota, Department of Urology, Minneapolis, MN. , Minneapolis Veterans Healthcare System and University of Minnesota, Department of Urology, Minneapolis, MN. , McMaster University, Hamilton, ON. , McMaster University, Hamilton, ON. , Minneapolis Veterans Healthcare System and University of Minnesota, Department of Urology, Minneapolis, MN.