Publications by authors named "Matthew J Resnick"

209 Publications

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Sep 9:101097JU0000000000002221. Epub 2021 Sep 9.

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http://dx.doi.org/10.1097/JU.0000000000002221DOI Listing
September 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Aug 18:101097JU0000000000002164. Epub 2021 Aug 18.

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http://dx.doi.org/10.1097/JU.0000000000002164DOI Listing
August 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Oct 20;206(4):1054-1056. Epub 2021 Jul 20.

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http://dx.doi.org/10.1097/JU.0000000000002128DOI Listing
October 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Sep 15;206(3):761-763. Epub 2021 Jun 15.

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http://dx.doi.org/10.1097/JU.0000000000001909DOI Listing
September 2021

Differential effect of body mass index by gender on oncological outcomes in patients with renal cell carcinoma.

J Cancer Res Ther 2021 Apr-Jun;17(2):420-425

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Objectives: To investigate the relationship between gender, body mass index (BMI), and prognosis in renal cell carcinoma (RCC) patients.

Materials And Methods: We retrospectively reviewed 1353 patients with RCC who underwent a partial or radical nephrectomy between 1988 and 2015. The association among sex, BMI, stage, grade, overall survival (OS), and recurrence-free survival (RFS) was analyzed.

Results: The median age of the patients was 59.4 ± 11.9 years. Female patients had proportionally lower grade tumors than male patients (Grade I-II in 75.5% vs. 69.3% in women and men, respectively, P = 0.022). There was no relationship between Fuhrman grade and BMI when substratified by gender (p > 0.05). There was a nonsignificant trend toward more localized disease in female patients (p = 0.058). There was no relationship between T stage and BMI when stratified by gender (p > 0.05). Patients with higher BMI had significantly better OS (p = 0.0004 and P = 0.0003) and RFS (P = 0.0209 and P =0.0082) whether broken out by lower 33 or 25 percentile. Male patients with higher BMI had significantly better OS and RFS rates. However, there was no relationship between BMI and OS or RFS for female patients (P > 0.05). Multivariate analysis of the entire cohort demonstrated that a BMI in the lower quartile independently predicts OS (hazard ratio 1.604 [95% confidence interval: 1.07-2.408], P = 0.022) but not RFS (P > 0.05). When stratified by gender, there was no relationship between BMI and either OS or RFS (P > 0.05).

Conclusions: Increasing BMI was associated with RCC prognosis. However, the clinical association between BMI and oncologic outcomes may be different between men and women.
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http://dx.doi.org/10.4103/jcrt.JCRT_546_18DOI Listing
June 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Aug 13;206(2):466-468. Epub 2021 May 13.

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http://dx.doi.org/10.1097/JU.0000000000001862DOI Listing
August 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Jul 21;206(1):149-150. Epub 2021 Apr 21.

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http://dx.doi.org/10.1097/JU.0000000000001804DOI Listing
July 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Jun 1;205(6):1813-1814. Epub 2021 Apr 1.

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http://dx.doi.org/10.1097/JU.0000000000001743DOI Listing
June 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 May 24;205(5):1505-1506. Epub 2021 Feb 24.

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http://dx.doi.org/10.1097/JU.0000000000001668DOI Listing
May 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Apr 21;205(4):1215-1217. Epub 2021 Jan 21.

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http://dx.doi.org/10.1097/JU.0000000000001615DOI Listing
April 2021

Value-Based Healthcare in Urology: A Collaborative Review.

Eur Urol 2021 05 4;79(5):571-585. Epub 2021 Jan 4.

Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address:

Context: In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and remunerated.

Objective: To systematically review the literature regarding the implementation and impact of value-based healthcare in urology.

Evidence Acquisition: A systematic review was performed to identify studies that described the implementation of one or more elements of value-based healthcare in urologic settings and in which the associated change in healthcare value had been measured. Twenty-two publications were selected for inclusion.

Evidence Synthesis: Reorganization of urologic care around medical conditions was associated with increased use of guidelines-compliant care for men with prostate cancer, and improved outcomes for patients with lower urinary tract symptoms. Measuring outcomes for every patient was associated with improved prostate cancer outcomes, while the measurement of costs using time-driven activity-based costing was associated with reduced resource utilization in a pediatric multidisciplinary clinic. Centralization of urologic cancer care in the UK, Denmark, and Canada was associated with overall improved outcomes, although systems integration in the USA yielded mixed results among urologic cancer patients. No studies have yet examined bundled payments for episodes of care, expanding the geographic reach for centers of excellence, or building enabling information technology platforms.

Conclusions: Few studies have critically assessed the actual or simulated implementation of value-based healthcare in urology, but the available literature suggests promising early results. In order to effectively redesign care, there is a need for further research to both evaluate the potential results of proposed value-based healthcare interventions and measure their effects where already implemented.

Patient Summary: While few studies have evaluated the implementation of value-based healthcare in urology, the available literature suggests promising early results.
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http://dx.doi.org/10.1016/j.eururo.2020.12.008DOI Listing
May 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 Mar 23;205(3):920-922. Epub 2020 Dec 23.

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http://dx.doi.org/10.1097/JU.0000000000001552DOI Listing
March 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 02 17;205(2):620-621. Epub 2020 Nov 17.

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http://dx.doi.org/10.1097/JU.0000000000001496DOI Listing
February 2021

Socioeconomic Factors, Urological Epidemiology and Practice Patterns.

J Urol 2021 01 12;205(1):295-296. Epub 2020 Nov 12.

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http://dx.doi.org/10.1097/JU.0000000000001465DOI Listing
January 2021

Re: Primary Care Practice Finances in the United States amid the COVID-19 Pandemic.

J Urol 2020 12 22;204(6):1370-1371. Epub 2020 Sep 22.

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http://dx.doi.org/10.1097/JU.0000000000001278.01DOI Listing
December 2020

Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline PART I.

J Urol 2021 Jan 22;205(1):14-21. Epub 2020 Sep 22.

Purpose: The summary presented herein represents Part I of the two-part series dedicated to Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline discussing prognostic and treatment recommendations for patients with biochemical recurrence without metastatic disease after exhaustion of local treatment options as well as those with metastatic hormone-sensitive prostate cancer. Please refer to Part II for discussion of the management of castration-resistant disease.

Materials And Methods: The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE (1998 to January Week 5 2019), Cochrane Central Register of Controlled Trials (through December 2018), and Cochrane Database of Systematic Reviews (2005 through February 6, 2019). An updated search was conducted prior to publication through January 20, 2020. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles.

Results: The Advanced Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with advanced prostate cancer. Such statements are summarized in figure 1[Figure: see text] and detailed herein.

Conclusions: This guideline attempts to improve a clinician's ability to treat patients diagnosed with advanced prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to improve the level of care for these patients.
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http://dx.doi.org/10.1097/JU.0000000000001375DOI Listing
January 2021

Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline PART II.

J Urol 2021 Jan 22;205(1):22-29. Epub 2020 Sep 22.

Purpose: The summary presented herein represents Part II of the two-part series dedicated to Advanced Prostate Cancer: AUA/ASTRO/SUO Guideline discussing prognostic and treatment recommendations for patients with castration-resistant disease. Please refer to Part I for discussion of the management of patients with biochemical recurrence without metastatic disease after exhaustion of local treatment options as well as those with metastatic hormone-sensitive prostate cancer.

Results: The Advanced Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with advanced prostate cancer. Such statements are summarized in figure 1[Figure: see text] and detailed herein.

Materials And Methods: The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE (1998 to January Week 5 2019), Cochrane Central Register of Controlled Trials (through December 2018), and Cochrane Database of Systematic Reviews (2005 through February 6, 2019). An updated search was conducted prior to publication through January 20, 2020. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles.

Conclusions: This guideline attempts to improve a clinician's ability to treat patients diagnosed with advanced prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to improve the level of care for these patients.
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http://dx.doi.org/10.1097/JU.0000000000001376DOI Listing
January 2021

Re: Managing COVID-19 in Surgical Systems.

J Urol 2020 11 8;204(5):1087-1088. Epub 2020 Sep 8.

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http://dx.doi.org/10.1097/JU.0000000000001256.02DOI Listing
November 2020

The Impact of Hospital Volume on Short-term and Long-term Outcomes for Patients Undergoing Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma.

Urology 2021 Jan 4;147:135-142. Epub 2020 Sep 4.

Department of Urology, Vanderbilt University Medical Center, Nashville, TN. Electronic address:

Objectives: To examine the effect of hospital volume on short and long-term outcomes for radical nephroureterectomy (RNUx). Upper tract urothelial carcinoma is a rare malignancy that few surgeons have experience with. The hospital volume-outcome relationship has been well established for other cancers but not RNUx.

Methods: The National Cancer Database was queried for all cases of upper tract urothelial carcinoma that underwent RNUx from 2004 to 2016. Average annual hospital volume for radical nephroureterectomy was stratified into tertiles. The upper tertile, defined as 6 or more RNUx per year, was considered high volume while low volume was less than 6 RNUx per year. Kaplan-Meier and Cox proportional hazards regression were used to identify independent predictors of overall survival, and logistic regression was used to identify predictors of perioperative outcomes.

Results: We identified 37,479 RNUx performed across 1290 hospitals. There were no differences in baseline health or cancer staging between patients who presented at low- versus high-volume centers. Both peri-operative survival (30- and 90-day mortality) and long-term overall survival were improved in patients treated at high-volume centers. On multivariable survival analysis, treatment at a high-volume center was associated with improved hazards of survival. This relationship for long-term survival remained consistent on landmark analysis where patients who died within 90 days of surgery were removed.

Conclusions: Treatment at a high-volume hospital was associated not only with improved short-term perioperative outcomes but also with improved overall long-term survival. The mechanism behind this is likely multifactorial with surgeon volume, and ancillary support services all playing critical roles.
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http://dx.doi.org/10.1016/j.urology.2020.07.062DOI Listing
January 2021

National Variation in Elective Colon Resection for Diverticular Disease.

Ann Surg 2020 Jul 24. Epub 2020 Jul 24.

Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.

Objective: This study aims to characterize the extent of geographic variation in elective sigmoid resection for diverticulitis and to identify factors associated with observed variation.

Introduction: National guidelines for treatment of recurrent diverticulitis fail to offer strong recommendations for or against surgical intervention. We hypothesize that healthcare market factors will be significantly associated with geographic variation in colon resection for diverticulitis, a discretionary surgical intervention.

Methods: We used Center for Medicare Services 100% inpatient Limited Data Set (LDS) files from January 2013 through September 2015 to calculate an observed to expected standardized colon resection ratio for each hospital referral region (HRR). We then analyzed patient, hospital-, and market-level factors associated with variation of colectomy. For each HRR, a Herfindahl-Hirschman index, a measure of market competition, was calculated.

Results: A total of 19,557 Medicare patients underwent an elective colon resection for diverticulitis at 2462 hospitals over the study period. Standardized colon resection ratios ranged from 0 in the Tuscaloosa HRR to 3.7 in the Royal Oak, MI HRR. Few patient factors were associated with variation, but a number of hospital factors (size, area, profit status, and critical access designation) all were associated with variation. In an analysis of market factors, increased surgeon density, and decreased market competition were associated with higher predicted rates of colon resection.

Conclusion: We observed pronounced variation (excess of 3-fold) in standardized colon resection ratios for recurrent diverticulitis. Surgeon density and hospital level factors were strongly associated with this variation and may be the main drivers of colonic resection for diverticular disease. Further investigation and stronger national guidelines are needed to optimize patient selection for colectomy.
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http://dx.doi.org/10.1097/SLA.0000000000004236DOI Listing
July 2020

Re: Health Care Hotspotting-A Randomized, Controlled Trial.

J Urol 2020 09 26;204(3):609-610. Epub 2020 Jun 26.

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http://dx.doi.org/10.1097/JU.0000000000001171.02DOI Listing
September 2020
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