Researchers, clinicians, policy makers and patients have difficulty synthesizing the vast amount of information required to evaluate the risks and benefits of treatments in benign urological diseases. Our goal is to conduct and disseminate comprehensive high quality systematic reviews to evaluate the effects of interventions in four urological conditions: benign prostatic hyperplasia (BPH), erectile/sexual dysfunction, urinary incontinence and urolithiasis. These have been selected because they represent common conditions that: 1) have high clinical and resource impact; 2) span a broad spectrum of patients and health care providers; 3) have pilot data indicating a large and rapidly growing body of RCT/CCT data amenable to meta-analysis; 4) have key controversial clinical questions. By using strategies that limit bias, systematic reviews utilize the results of primary investigations to identify best evidence. Systematic reviews and quantitative meta-analyses evaluate the magnitude and consistency of benefits and harms, explore differences across outcomes or patient groups, and identify gaps in knowledge where additional research is needed. These integrative reports provide the essential evidence for development of guidelines, economic evaluations, and future research. The few reviews in urology are rarely comprehensive or performed according to quality criteria. We will utilize an existing group of investigators and support staff experienced in systematic reviews, meta-analysis, health services delivery, information retrieval and dissemination, and economic/decision analysis. All are located in Minneapolis, MN. A comprehensive systematic review and meta-analysis will be conducted each year. Each review will focus on evidence available and required to evaluate a series of key clinical questions unique for the urological condition. Medical Advisory Panel members will be recruited to provide condition and methodological expertise. Quality assurance, decision and economic analyses will adhere to the Quality of Reporting of Meta-analyses and Economic Evaluation Guidelines for Systematic Reviews. We will establish and update and electronic registry of existing trials and reviews. The completed evidence report will provide a comprehensive single, source document that summarizes and evaluates the effectiveness and adverse effects of interventions for each of these high priority conditions. This will provide rapid dissemination, enhances implementation, and identifies new areas requiring additional research.
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