Use of national and international guidelines by German urologists-Results of a survey

Objectives: Diagnosis and treatment guidelines (GL) set standards for improving the quality of patient care (QPC). The effect of urological GL has not yet been substantially evaluated. We aimed to assess the acceptance and use of national and international urological GL from a German urologist's perspective. Methods: A link to an online questionnaire on GL use was distributed via email by the German Urological Association. A total of 467 German urologists participated. Differences were analyzed by Fisher's exact and the McNemar test. Results: GL were regarded as helpful by >90% of participants. The mode of guideline distribution preferred by 28.4% was the Internet, while 23.8% favored publication in the journal "Urologe A". For germ cell tumors, 40.5% supported the creation of comprehensive care centers considering them to be more effective in improving the QPC than GL alone. For other tumor entities, particularly prostate cancer, GL development was clearly favored. GL of the AWMF were favored by 86.1% of the participants, those of the EAU by 64%. Conclusions: Most German urologists have a positive attitude towards GL. They mainly use the national GL but are also favorably disposed toward those of the EAU and AUA. GL are subjectively integrated into treatment decisions. These results could serve for improving GL dissemination and implementation strategies. (C) 2010 Elsevier GmbH. All rights reserved.