title: [Gap between postulated and real outcome quality of radical prostatectomy].
abstract: BACKGROUND
  Certified Prostate Centers proclaim congruent process and outcome quality results for treatment of prostate carcinoma. Therapy in accordance with the guidelines after presentation of the patient in an interdisciplinary conference and regular documented follow up are not in themselves a guarantee for good quality results (complication free, continence, erectile function, negative surgical margins, biochemical recurrence free), and are significantly influenced by factors not contained within the certification framework.
  
  
  CONCLUSIONS
  An association between exceeding the minimum number of operations and quality assurance exists, if at all, only vaguely and on no account justifies the absolute numbers necessary for certification. Although good measuring instruments for a Pentafecta analysis are available, the gathering of quality results for a center are limited to questionnaires for functional quality results and in the non-differentiated request for a pT2R1 rate of under 10 % for oncological quality results.
  
  
  CONCLUSIONS
  The reasons for this systematic ignoring of the for the patient so important quality results with a simultaneous excessive regard for standardizing organizational procedure processes are manifold. They comprise valid verifiability of process quality, the unclear effects of standardized treatment pathways on actual operation quality and the capitulation to statistical and patient determined problems with sufficient acquisition of comparable functional OP results. Whereas the outcome quality is more important than the process quality for patients with prostate carcinoma, the certified centers conduct themselves in exactly the opposite manner, thus creating a virtually insoluble dilemma.
authors.affiliation: Urologische Klinik und Poliklinik der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. jasmin.wrogemann@unimedizin-mainz.de.
authors.forename: C
authors.initials: C
authors.lastname: Hampel
authors.affiliation: Urologische Klinik und Poliklinik der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Roos
authors.affiliation: Urologische Klinik und Poliklinik der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: J W
authors.initials: JW
authors.lastname: Thüroff
authors.affiliation: Urologische Klinik und Poliklinik der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Neisius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D011468:Prostatectomy / Q000592:standards* / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011785:Quality Assurance, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Certified prostate center; Confounder; Process quality; Prostate cancer; Quality assurance