Chad Ellimoottil

A primer on clinical trial design

A well-designed and executed clinical trial is the gold standard of evidence-based medicine. It is important for readers to understand the rationale for the study design, identify common pitfalls, and scrutinize limitations. Herein, we present a brief overview of types of designs used for clinical trials and discuss the use of appropriate end points, the selection of study participants, randomization, sample size calculation, blinding, and analysis of data. Finally, we emphasize the importance of accurate and transparent reporting. Our goal is to provide a primer for practicing urologists to enhance their understanding of the clinical trial literature.

Cost Analysis of Metallic Stents for Chronic Ureteral Obstruction: A Multicenter Study

Introduction: Metallic and polymer ureteral stents are used to manage chronic ureteral obstruction. In general, metallic stents are more costly than polymer stents but they are changed less frequently. We examined the overall costs of using these stent types at 2 institutions. Methods: We identified all patients in whom a metallic stent was placed at 2 academic institutions between July 2007 and July 2013. We calculated the average time to stent exchange or failure and the overall cost of metallic and polymer stent use. Costs included those associated with materials, operating room services, anesthesia and other expenses. Results: We identified 86 patients in whom a total of 230 metallic stents were placed. Time to stent failure or exchange of a metallic stent was 7.4 months. The per unit cost of a polymer stent and a metallic stent was

What is the impact of a clinically related readmission measure on the assessment of hospital performance

121 and

Real-world Impact of Minimally Invasive Versus Open Radical Cystectomy on Perioperative Outcomes and Spending

887, respectively. The average annual cost of unilateral and bilateral metallic stents was

PD14-01 VARIATION IN 90-DAY EPISODE PAYMENTS FOR UROLOGICAL CANCER SURGERY: IMPLICATIONS FOR BUNDLED PAYMENT PROGRAMS

7,859.43 and

Alternative payment models and urology

9,296.37, respectively. For a unilateral polymer stent that was changed every 3 months the yearly cost was

MP51-05 THE IMPACT OF VIDEO VISITS ON MEASURES OF CLINICAL EFFICIENCY AND REIMBURSEMENT

16,342. For bilateral polymer stents that were changed every 3 months the cost was

MP76-04 ACCOUNTABLE CARE ORGANIZATIONS AND THE COST AND QUALITY OF UROLOGICAL CANCER CARE AT THE END OF LIFE

16,826 per year. If unilateral and bilateral polymer stents were changed every 6 months, the costs were

Engaging telehealth to drive value-based urology

8,171 and

Association Between Hospital Participation in Medicare Shared Savings Program Accountable Care Organizations and Readmission Following Major Surgery

8,413, respectively. Conclusions: Our findings suggest that because metallic stents are changed less frequently than polymer stents, the annual expense associated with treating patients with chronic ureteral obstruction can be decreased by using metallic stents.