title: Quality assessment of partial nephrectomy complications reporting using EAU standardised quality criteria.
abstract: BACKGROUND
  A standardised system to report outcomes and complications of urologic procedures has recently been proposed by an ad hoc European Association of Urology (EAU) Guidelines panel. To date, no studies have used these criteria to evaluate the quality of reports of outcomes and complications after partial nephrectomy (PN).
  
  
  OBJECTIVE
  To address the quality of reporting of PN complications.
  
  
  METHODS
  A systematic review of papers reporting outcomes of PN was conducted through the electronic search of databases, including Medline, PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews.
  
  
  METHODS
  Analysis was carried out on structured forms. The quality criteria that the EAU Working Group proposed for reporting complications were recorded for each paper, and adherence to the Martin criteria was assessed.
  
  
  CONCLUSIONS
  Standardised criteria to report and grade complications were used in 71 out of 204 evaluable studies (34.8%). Only six studies (2.9%) fulfilled all criteria that the EAU Guidelines Office ad hoc panel proposed. The mean number did not change significantly by time or by surgical approach used. The most underreported criteria (in <50% of the studies) were who collected the data (18.6%), whether he or she were involved in the treatment (13.7%), duration of follow-up (47.1%), mortality data and causes of death (33.8%), definition of procedure-specific complications (39.2), separate reporting of intra- and postoperative complications (45.1%), complication severity or grade (32.4%), risk factors analysis (44.1%), readmission rates (12.7%), and percentage of patients lost to follow-up (6.9%). The mean number fulfilled was 6.5 ± 2.9 (mean plus or minus standard deviation) and did not change significantly by time or by surgical approach used.
  
  
  CONCLUSIONS
  The only way to improve the quality of the surgical scientific literature and to allow sound comparisons among different approaches, especially with the lack of randomised trials, is the use of more rigorous methodology than the one recently proposed to report outcomes and complications.
  
  
  RESULTS
  A rigorous methodology is mandatory when surgeons report about complications after surgery. Otherwise, the rate of adverse events is underestimated.
authors.affiliation: 1st Department of Urology, University of Athens Medical School, Athens, Greece. Electronic address: dmp@otenet.gr.
authors.forename: Dionysios
authors.initials: D
authors.lastname: Mitropoulos
authors.affiliation: Department of Surgery, Urology Clinic, University of Verona, Verona, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.affiliation: Department of Urology, Pinderfields General Hospital, Wakefield, United Kingdom.
authors.forename: Chandra Shekhar
authors.initials: CS
authors.lastname: Biyani
authors.affiliation: Department of Urology, Aarhus University Hospital, Skejby, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Bjerggaard Jensen
authors.affiliation: Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria.
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.affiliation: Academic Department of Urology, Hospital Pitié-Salpétrière, Assistance Publique Hopitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France.
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Department of Urology, Klinikum Dortmund GmbH, Dortmund, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Truss
mesh_terms: D017408:Guidelines as Topic; D006801:Humans; D009392:Nephrectomy / Q000009:adverse effects* / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D012107:Research Design / Q000592:standards*
keywords: EAU recommendations; Partial nephrectomy; Postoperative complications; Standardisation