FROM THE SCIENCE & QUALITY COUNCIL Science & Quality Update

By: David Penson, MD, MPH, MMHC | Posted on: 01 May 2022

AUA staff and physician leadership work diligently to produce material of the highest quality on various topics of importance to the field of urology. Our primary goal is always to produce materials that help urologists in their daily practice. In an effort to ensure that AUA documents continue to be of value to our members in this way, AUA staff and associated Science & Quality (S&Q) Council leadership initiated an extensive review of the current AUA document taxonomy system.

Taxonomy Review

The AUA Taxonomy Review, which focused on usefulness, relevance and significance to the field of urology, identified 7 types of documents of varying focus and content overlap. Upon reflection, it was clear that there was a need for simplification and consolidation of the current system to enable members to more easily find relevant clinical guidance that they could use every day. After further consideration of membership needs, the following 4 categories were proposed and approved by the AUA Board of Directors to encompass all future AUA documents:

  1. Clinical Practice Guidelines (CPGs): Evidence-based guidance based on systematic review of available scientific evidence supplemented by clinical consensus when gaps in the evidence exist.
  2. Clinical Consensus Statements (CCSs): Statements of clinical interest based on expert opinion that may be supported by literature when available.
  3. Quality Improvement Issue Briefs (QIIBs): Qualitative assessments based on expert opinion and supported by literature when available on topics specific to quality or patient safety in urology.
  4. AUA Position/Policy Statements (PPSs): Presentations of AUA positions, philosophy and/or policies on topics of interest in the urology specialty.
“Upon reflection, it was clear that there was a need for simplification and consolidation of the current system to enable members to more easily find relevant clinical guidance that they could use every day.”

This simplified taxonomy maintains elements of the previous system (ie CPGs, PPSs) while consolidating a number of previous documents (ie Best Practice Statements, White Papers, Technology Assessments, Standard Operating Procedures, Consensus Statements) as either CCSs or QIIBs, depending on content and focus.

Taxonomy Implementation

As AUA begins the transition to this new taxonomy system, all existing documents will be reviewed and either reclassified under the new 4-class taxonomy or retired should they not meet newly established guidance criteria.

Updated procedures for the development of these documents will be implemented and promoted to the membership in the coming months. CPGs and PPSs are well-established, high-value products for AUA members; as such, their development processes will remain largely unchanged. New procedures will be drafted to guide creation of CCSs and QIIBs in line with the highest standards of development for these types of documents.

AUA staff and physician leadership is confident that this new streamlined taxonomy will provide members with a more simplified means of accessing pertinent information while also showcasing the importance and unique benefits of each document type. As always, the AUA welcomes topic nominations for consideration for future document development and encourages members to visit www.auanet.org/guidelines for updates on opportunities to further engage in S&Q activities.

Closing Reflections

For the past 4 years, I have had the honor and privilege to serve as the Chair of the S&Q Council. In this role I’ve worked with my fellow S&Q Committee members to provide strategic oversight to shape and execute the science, quality and data components of the AUA’s mission to promote the highest standards of urological clinical care. I am proud of the work we accomplished as a team, including AUA staff and S&Q component committees.

During my tenure, we released 17 new Guidelines and maintained the Guidelines program as one of the top member benefits, providing evidence-based recommendations on a broad spectrum of topics important to urologists. We made impactful updates to conflict of interest policies, increased the diversity of our panels and implemented updated systematic review procedures in keeping with the highest standards of Guideline development to ensure Guidelines remain the high-quality products our members have come to trust. We revitalized the Quality & Measurement Program, most notably including the launch of E-QIPS (Engage with Quality Improvement and Patient Safety), a forum for the dissemination of community-sourced content to cultivate quality improvement and patient safety projects. Further, we developed a long-term framework to guide future measure development and maintenance, and formed the MEP (Measure Evaluation Panel) to provide ongoing guidance in these efforts. On the data front, we continued to grow the AQUA (AUA Quality) Registry, which now covers more than 7 million patients, and maintained status as a QCDR (Qualified Clinical Data Registry). The Census also realized significant growth since its 2014 launch and now serves as a valuable tool for clinicians, policymakers and patients in the collection of meaningful data to bridge knowledge gaps in urology.

“Updated procedures for the development of these documents will be implemented and promoted to the membership in the coming months. CPGs and PPSs are well-established, high-value products for AUA members; as such, their development processes will remain largely unchanged.”

As my tenure as Chair of the S&Q Council comes to a close, I wish my colleague, Dr. Matthew Nielsen, the best as he steps into the role, and I look forward to the continued growth and success of the program under his leadership.

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