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BJUI Compass and open access

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There is no doubt that the publishing landscape is rapidly changing around us. The BJUI is a world leading surgical journal, serving 10 international organisations, with 90 years of history (1929–2019). So why are we launching, BJUI Compass an online, open access (OA) journal, now?

In September 2018, cOAlition S, a predominantly European consortium of research funders, launched Plan S. In its current form, this plan requires that from 2021, scientific publications from research funded by public grants through funders who have signed up to cOAlition S must be published in full OA journals or platforms. This is a model whereby publication of science is paid for by authors, or their funders, rather than by readers to whom access is free [1]. The Wellcome Trust, one of the largest funders of research in the UK, is a major supporter of Plan S and has its own OA policy for 2021 [2].

However, the practical implementation of Plan S continues to be a subject of debate. In other parts of the world, there is increasing interest in OA but the approach to implementation is likely to vary considerably. Our own publisher, Wiley, in readiness for Plan S, announced an agreement with Projekt DEAL, a representative of nearly 700 academic institutions in Germany [3]. Most academic institutions in Germany under this project can publish articles in OA or hybrid journals published by Wiley, including BJUI, a hybrid journal. These initiatives in OA are another factor in the increasing debate about scientific impact, bibliometrics beyond the impact factor, and translating research for public benefit rather than purely the career progression of academics [4].

Dr John W. Davis (@jdhdavis)

 

In keeping with our continued theme of the highest quality, clinically relevant papers, in this issue of the BJUI we present two MRI‐based prostate cancer papers, showing that while we could avoid biopsies in many men without missing significant disease [5], in African‐American men on active monitoring, the cancers can be upgraded more frequently and careful follow‐up is thus warranted [6].

by Prokar Dasgupta and John W. Davis

 

References

  1. cOAlition S. Plan S: Making full and immediate Open Access a reality. Available at: https://www.coalition-s.org/. Accessed October 2019
  2. Wellcome. Open access policy 2021. Available at: https://wellcome.ac.uk/funding/guidance/open-access-policy. Accessed October 2019
  3. Wiley. Wiley and Projekt DEAL partner to enhance the future of scholarly research and publishing in Germany. Available at: https://newsroom.wiley.com/press-release/all-corporate-news/wiley-and-projekt-deal-partner-enhance-future-scholarly-research-an. Accessed October 2019
  4. Hicks D, Wouters P, Waltman L, de Rijcke S, Rafols I. Bibliometrics: The Leiden Manifesto for research metrics. Nature 2015; 520: 429– 31
  5. Venderink W, van Luijtelaar A, van der Leest M et al. Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men. BJU Int 2019; 124: 775– 84
  6. Bloom JB, Lebastchi AH, Gold SA et al. Use of multiparametric magnetic resonance imaging and fusion‐guided biopsies to properly select and follow African‐American men on active surveillance. BJU Int 2019; 124: 768– 74

 

Residents’ podcast: Artificial intelligence applications in urology

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Maria Uloko is a Urology Resident at the University of Minnesota Hospital. In this podcast she is joined by Dr Christopher Weight, an Associate Professor in the Department of Urology at the University of Minnesota. They are discussing a recent BJUI Article of the month:

Current status of artificial intelligence applications in urology and their potential to influence clinical practice

Read the full article

Abstract

Objective

To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome prediction in urologic diseases and evaluate its advantages over traditional models and methods.

Materials and methods

A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta‐Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms “urology”, “artificial intelligence”, “machine learning” were included and categorized by the application of AI in urology. Review articles, editorial comments, articles with no full‐text access, and nonurologic studies were excluded.

Results

Initial search yielded 231 articles, but after excluding duplicates and following full‐text review and examination of article references, only 111 articles were included in the final analysis. AI applications in urology include: utilizing radiomic imaging or ultrasonic echo data to improve or automate cancer detection or outcome prediction, utilizing digitized tissue specimen images to automate detection of cancer on pathology slides, and combining patient clinical data, biomarkers, or gene expression to assist disease diagnosis or outcome prediction. Some studies employed AI to plan brachytherapy and radiation treatments while others used video-based or robotic automated performance metrics to objectively evaluate surgical skill. Compared to conventional statistical analysis, 71.8% of studies concluded that AI is superior in diagnosis and outcome prediction.

Conclusion

AI has been widely adopted in urology. Compared to conventional statistics AI approaches are more accurate in prediction and more explorative for analyzing large data cohorts. With an increasing library of patient data accessible to clinicians, AI may help facilitate evidence‐based and individualized patient care.

More podcasts

BJUI Podcasts now available on iTunes, subscribe here https://itunes.apple.com/gb/podcast/bju-international/id1309570262

 

Dr Weight specializes in the surgical treatment of urologic cancers including prostate, bladder, kidney, adrenal, testis and penile cancer. He performs open, endoscopic, laparoscopic, robotic (da Vinci) and retroperineoscopic surgery.

Dr Weight completed his residency training at Cleveland Clinic where he received several awards including the George and Grace Crile Traveling Fellowship Award, the Society of Laparoendoscopic Surgeons Resident Achievement Award and the ASCO Genitourinary Cancer Symposium Merit Award. Dr. Weight then completed a fellowship in Urologic Oncology at Mayo Clinic, where he also completed a Masters degree in Clinical and Translational Research from Mayo Graduate School and was awarded the Mayo Fellows Association Humanitarian Award.

Dr Weight believes that medical research is a key component to offering excellent patient care. His research is focused on improving patient outcomes and the use of artificial intelligence in different urologic applications. He is an author of more than 45 peer-reviewed publications and book chapters and has been invited to speak at regional, national and international conferences. 

November 2019 – About the cover

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November’s Article of the Month was written by researchers primarily from New York City, USA: Guideline of Guidelines: Testosterone Replacement Therapy for Testosterone Deficiency

The cover image shows the statue of Atlas located within the Rockefeller Center. This “city within a city” was conceived by John D. Rockefeller Jr. and was built during the 1930s, providing valuable jobs during the Great Depression. The first buildings were opened in 1933 providing a center of art, style and entertainment.

The statue of Atlas – a half man/half god giant from Greek mythology – was built in 1937 by Lee Laurie and Rene Paul Chambellan. It is 45 feet (14 metres) tall and weighs 7 tonnes.

 

 

 

BJUI at the Indonesian Urological Association Annual Scientific Meeting

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The Indonesian Urological Association Annual Scientific meeting was held at The Golden Tulip Hotel, Banjarmasin – 3-5 October 2019.

 

The main conference was preceded by pre-congress workshops at the University of Indonesia Medical Education and Research Institute (IMERI) in Jakarta.

Masterclass with Consultant Urologist Mr Brian Chaplin

Furthermore, the BJUI held a plenary lecture entitled: High Risk Non-Muscle-Invasive Bladder Cancer : The Promise of New Therapies by Consultant Urologist Miss Jo Cresswell, also from the South Tees Hospitals NHS Foundation trust in the UK.

[caption id=”attachment_40134″ align=”aligncenter” width=”243′ label=’ Promoting knowledge: Miss Jo Cresswell at the Masterclass

The conference also featured the increasingly popular 10 and 5 Km Uroruns and a Urowalk starting at 6 and 7am on the Saturday morning.

 

Residents’ podcast: NICE guidelines – renal and ureteric stones

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Nikita Bhatt is a Specialist Trainee in Urology in the East of England Deanery and a BURST Committee member @BURSTUrology

NICE Guideline – Renal and ureteric stones: assessment and management

Read the full article

Context

Renal and ureteric stones usually present as an acute episode with severe pain, although some stones are picked up incidentally during imaging or may present as a history of infection. The initial diagnosis is made by taking a clinical history and examination and carrying out imaging; initial management is with painkillers and treatment of any infection.

Ongoing treatment of renal and ureteric stones depends on the site of the stone and size of the stone (less than 10 mm, 10 to 20 mm, greater than 20 mm; staghorn stones). Options for treatment range from observation with pain relief to surgical intervention. Open surgery is performed very infrequently; most surgical stone management is minimally invasive and the interventions include shockwave lithotripsy (SWL), ureteroscopy (URS) and percutaneous stone removal (surgery). As well as the site and size of the stone, treatment also depends on local facilities and expertise. Most centres have access to SWL, but many use a mobile machine on a sessional basis rather than a fixed‐site machine, which has easier access during the working week. The use of a mobile machine may affect options for emergency treatment, but may also add to waiting times for non‐emergency treatment.

Although URS for renal and ureteric stones is increasing (there has been a 49% increase from 12,062 treatments in 2009/10, to 18,066 in 2014/15 [Hospital Episode Statistics data]), there is a trend towards day‐case/ambulatory care, with this increasing by 10% to 31,000 cases a year between 2010 and 2015. The total number of bed‐days used for renal stone disease has fallen by 15% since 2009/10. However, waiting times for treatment are increasing and this means that patient satisfaction is likely to be lower.

Because the incidence of renal and ureteric stones and the rate of intervention are increasing, there is a need to reduce recurrences through patient education and lifestyle changes. Assessing dietary factors and changing lifestyle have been shown to reduce the number of episodes in people with renal stone disease.

Adults, children and young people using services, their families and carers, and the public will be able to use the guideline to find out more about what NICE recommends, and help them make decisions. These recommendations apply to all settings in which NHS‐commissioned care is provided.

 

 

Table 2.Surgical treatment (including SWL) of ureteric stones in adults, children and young people Abbreviations: PCNL, percutaneous nephrolithotomy; SWL, shockwave lithotripsy; URS, ureteroscopy.

 

More podcasts

BJUI Podcasts now available on iTunes, subscribe here https://itunes.apple.com/gb/podcast/bju-international/id1309570262

 

 

A taster week in urology and renal transplant in the UK

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A taster week is a training opportunity offered to UK doctors in their first two years of clinical practice to try a new specialty. They are an important learning experience for doctors at this stage, who will have experienced working in six different specialties at most. While taster weeks are only five days long, they offer a unique insight into a new specialty, as well as the chance to network with registrars and consultants.

During medical school I was interested in transplantation, as I found the combination between surgery and immunology interesting. This led me to complete a Master of Research in Transplantation while at medical school. During this degree, I looked at urinary tract infection in transplant patients and this started my interest in urology.

In the UK, the majority of trainees enter the field of transplantation following training in General Surgery. In clinical practice, it is good to have urologists with an active interest in Renal Transplantation for the betterment of these patients but there are few centres where this can be learnt. However, the Freeman Hospital in Newcastle, UK offers a one to two-year fellowship in renal transplantation which can be completed at the end of urology training. I contacted one of the urology and renal transplant surgeons and organised a week’s visit to the Freeman Hospital.

 

During my taster week I had the opportunity to shadow a urology and renal transplant surgeon. I joined urology and transplant ward rounds, including a renal transplant grand round, and I also attended a transplant nephrology clinic where I saw the long-term management of patients who had received kidney transplants.  I observed theatre lists in both urology and transplant and saw the wide variety of operations that urology and transplant surgeons are involved in, such as renal access surgery for dialysis and robotic partial nephrectomy for renal cancer.

I also had a chance to attend multi-disciplinary team meetings about new transplant recipients as well as an x-ray imaging meeting concerning live kidney donors.

Speaking to urology and renal transplant surgeons was an invaluable experience and helped me plan the next steps in my career as well as solidify it as a preferred career choice.

The highlight of my taster week was attending regional surgical teaching. I spent a day in one of the few world-class cadaveric training laboratories in the UK and learnt how to perform an orchidopexy for testicular torsion and vascular anastomosis; two operations that are no doubt necessary for a urology and renal transplant surgeon.

I am very glad I completed a taster week in urology and renal transplantation. It allowed me to experience the variety of work involved in this niche specialty. It was an experience that would have only been available much later in my career otherwise, which would be at a point too late for a career change.

by Matthew Byrne

 

Matthew Byrne recently completed two years as an Academic Foundation Doctor in Cambridge, UK. He graduated MBBS from Newcastle where he also completed a Master of Research in Transplantation. He is now a Urology Clinical Fellow in Cambridge, UK.

 

 

October 2019 – About the cover

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The Article of the Month for October was written by researchers primarily from Los Angeles, California, USA: Current status of artificial intelligence applications in urology and their potential to influence clinical practice

The cover image shows the Griffith Observatory, with the surrounding view of LA. The observatory is “Southern California’s gateway to the cosmos”. It is named after its creator and funder Griffith J. Griffith who wanted a free public observatory – it is now a world-leader in public astronomy and has received over 80 million visitors in its nearly 90-year history. It is also one of the best vantage points from which to view the Hollywood sign.

 

Video: Current status of artificial intelligence applications in urology

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Current status of artificial intelligence applications in urology and their potential to influence clinical practice

Read the full article

Abstract

Objective

To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome prediction in urologic diseases and evaluate its advantages over traditional models and methods.

Materials and methods

A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta‐Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms “urology”, “artificial intelligence”, “machine learning” were included and categorized by the application of AI in urology. Review articles, editorial comments, articles with no full‐text access, and non-urologic studies were excluded.

Results

Initial search yielded 231 articles, but after excluding duplicates and following full‐text review and examination of article references, only 111 articles were included in the final analysis. AI applications in urology include: utilizing radiomic imaging or ultrasonic echo data to improve or automate cancer detection or outcome prediction, utilizing digitized tissue specimen images to automate detection of cancer on pathology slides, and combining patient clinical data, biomarkers, or gene expression to assist disease diagnosis or outcome prediction. Some studies employed AI to plan brachytherapy and radiation treatments while others used video based or robotic automated performance metrics to objectively evaluate surgical skill. Compared to conventional statistical analysis, 71.8% of studies concluded that AI is superior in diagnosis and outcome prediction.

Conclusion

AI has been widely adopted in urology. Compared to conventional statistics AI approaches are more accurate in prediction and more explorative for analyzing large data cohorts. With an increasing library of patient data accessible to clinicians, AI may help facilitate evidence‐based and individualized patient care.

View more videos

Visual abstract: Current status of artificial intelligence applications in urology and their potential to influence clinical practice

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