CPS Medical Management of Kidney Stones (2015)

Overview

AUA Guidelines provide a comprehensive and rigorous summary of evidence relating to a variety of disease conditions, providing an indispensable resource for urologic education. The Clinical Problem Solving (CPS) Protocols guideline-based Case Scenarios were designed to help maximize the impact of the guidelines. Kidney stone disease is a common malady, affecting nearly 1 in 11 individuals in the United States at some point in their lives, and there is evidence that the number of those who have had a stone is rising. Unlike appendicitis and other surgical conditions, surgical treatment of stones is not the endpoint of the disease process, as stones are likely to recur, with at least 50% of individuals experiencing another stone within 10 years of the first occurrence. For those who have experienced a stone or undergone surgical intervention for a stone, there is strong motivation to avoid a repeat episode. Consequently, these patients often seek advice from a variety of practitioners on how to prevent recurrent stones. However, misinformation abounds in the lay community and on the internet, and even medical providers often promulgate recommendations that are contrary to evidence-based medicine. This Guideline is aimed at practitioners from a variety of disciplines who are confronted with patients afflicted with stone disease, and it is based on a systematic review of the literature with respect to the evaluation, treatment and follow-up of first-time and recurrent stone formers. Patient preferences and goals must be taken into account by the practitioner when considering these guidelines, as the cost, inconvenience and side effects of drugs and dietary measures to prevent stone disease must be weighed against the benefit of preventing a recurrent stone.

Target Audience

  • Urologists (Practicing; Recertification Candidates; International)
  • Residents

Learning Objectives

After completion of this activity, participants should be able to:

  1. Interpret and explain the appropriate diagnosis, prevention and treatment of the related guideline
  2. Perform appropriate methods of evaluation and management according to the guideline
  3. Analyze the risks and benefits for treatment according to the guideline
  4. Integrate AUA guidelines into clinical practice
Course summary
Available credit: 
  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 Non-Physician Participation
Course opens: 
03/01/2015
Course expires: 
03/01/2018
Rating: 
0

Faculty Disclosures                                    
Cynthia J. Denu-Ciocca, MD:  Amgen: Scientific Study or Trial                                    
Caner Z. Dinlenc, MD: Nothing to disclose                                                                                                                        
Blake Douglas Hamilton, MD: MextMed, Inc.: Consultant or Advisor; Karl Storz Endoscopy: Meeting Participant or Lecturer; Cook Urological: Consultant or Advisor             
Brian R. Matlaga, MD, MPH: Boston Scientific: Consultant or Advisor 
Elspeth Marguerita McDougall, MD: Nothing to disclose                                              

Planner Disclosures
Education Council
Christopher Lee Amling, MD: Janssen: Meeting Participant or Lecturer
Gopal Badlani, MD: Lithotripsy Group: Piedmont stone & Physician Discovery: Investment Interest; Society of University Urologist: Leadership Position; NIDDK: Leadership Position
Timothy Charles Brand, MD: Nothing to disclose
Peter Robert Carroll, MD: NIH: Scientific Study or Trial; Department of Defense: Scientific Study or Trial; Myriad Genetics: Scientific Study or Trial; Genomic Health: Scientific Study or Trial; Abbott Pharmaceuticals: Scientific Study or Trial; AUA Update: Leadership Position; Astra Zeneca: Meeting Participant or Lecturer; Genome Dx: Consultant or Advisor; Intuitive: Meeting Participant or Lecturer; Genomic Health: Consultant or Advisor; Takeda Pharmaceutical Company: Meeting Participant or Lecturer; Teva Pharmaceutical Industries: Meeting Participant or Lecturer; Janssen Pharmaceutical Companies: Meeting Participant or Lecturer; Intuitive Surgical Inc.: Meeting Participant or Lecturer
Sam S. Chang, MD: Janssen: Consultant or Advisor, Meeting Participant or Lecturer; Astellas: Consultant or Advisor; Dendreon: Consultant or Advisor; NIH: Scientific Study or Trial; Cold Genesys, Inc.: Scientific Study or Trial; Cepheid: Scientific Study or Trial
Pat Fox Fulgham, MD: Urology Clinics of North Texas: Investment Interest
Bruce R. Gilbert, MD, PhD: Bayer Healthcare Pharmaceuticals Inc.: Scientific Study or Trial; Auxilium: Scientific Study or Trial; Clarus Pharmaceutcals: Scientific Study or Trial; Eli Lilly: Scientific Study or Trial; Warner Chilcott: Scientific Study or Trial
Christina Hernandez (AUA Staff): Nothing to disclose
Douglas A. Husmann, MD: Nothing to disclose
Wes Kassouf, MD: Nothing to disclose
Louis Koncz, PA-C: Nothing to disclose
Cheryl Taylore Lee, MD: Adolor: Scientific Study or Trial; Tengion, Inc.: Consultant or Advisor, Scientific Study or Trial; Endo Pharmaceuticals: Consultant or Advisor, Scientific Study or Trial; Photocure: Consultant or Advisor; CVI: Consultant or Advisor
Thomas Sean Lendvay, MD: Spi Surgical Inc.: Consultant or Advisor, Owner, Product Development; MIMIC Technologies Inc.: Other
Vinata B. Lokeshwar, PhD: Nothing to disclose
Elspeth Marguerita McDougall, MD: Nothing to disclose
John Patrick Mulhall, MD: Association of Peyronie's Disease Advocates (APDA): Leadership Position; Pfizer: Scientific Study or Trial; Vivus: Consultant or Advisor, Scientific Study or Trial; Nexmed: Consultant or Advisor; Absorption Pharmaceuticals: Consultant or Advisor; AMS: Consultant or Advisor, Scientific Study or Trial; Meda: Consultant or Advisor; Lilly: Consultant or Advisor; Alliance for Fertility Preservation: Leadership Position
J. Kellogg Parsons, MD: AMS: Meeting Participant or Lecturer; Sophiris: Consultant or Advisor; Watson: Consultant or Advisor
Lee Richstone, MD: Wundercare LLC: Consultant or Advisor
Marianne D. Sadar, PhD: ESSA Pharma Inc.: Leadership Position, Consultant or Advisor, Investment Interest
Karl-Dietrich Sievert, MD, PhD: AMS: Meeting Participant or Lecturer; Karl Storz: Meeting Participant or Lecturer; Photocure: Scientific Study or Trial; Medtronics: Meeting Participant or Lecturer, Scientific Study or Trial; Allergen: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Neotract: Meeting Participant or Lecturer
Sheila Stark, PhD (AUA Staff): Nothing to disclose
William Donald Steers, MD: National Institutes of Health: Consultant or Advisor, Meeting Participant or Lecturer; Allergan: Scientific Study or Trial; New England Research Institute (NERI): Consultant or Advisor, Scientific Study or Trial
Chandru P. Sundaram, MD: Cook Medical Inc.: Scientific Study or Trial; North Central Section of the AUA: Leadership Position; Journal of Endourology and Videourology: Leadership Position; Society of Urological Robotic Surgeons: Leadership Position
Ashutosh Kumar Tewari, MD: Intuitive Surgical: Scientific Study or Trial; Kalyani Prostate Cancer Institute: Leadership Position; Global Prostate Cancer Foundation: Leadership Position; Peter Georgescu Foundation Award: Leadership Position; Chris Lange Foundation: Other; Peter Kalikow Foundation: Other; Craig Effron Foundation: Other; Tim O'Neill Foundation: Other; Patent for a Catheter-less device and approach: Other; NIH RO1 Funding-PI: Other
Paul Jacob Turek, MD: MandalMed: Leadership Position; Medical Board of California: Consultant or Advisor; BioQuiddity, Inc.: Consultant or Advisor, Investment Interest; HealthLoop.com: Consultant or Advisor, Investment Interest; Doximity, Inc.: Consultant or Advisor, Investment Interest; Fertility Planit, Inc.: Consultant or Advisor, Investment Interest
Alan J. Wein, MD, PHD (HON): Allergan: Consultant or Advisor, Meeting Participant or Lecturer; Medtronic: Consultant or Advisor, Meeting Participant or Lecturer; Ferring Pharmaceuticals: Consultant or Advisor, Meeting Participant or Lecturer; Pfizer; Consultant or Advisor, Meeting Participant or Lecturer; Astellas: Consultant or Advisor, Meeting Participant or Lecturer; Merck: Consultant or Advisor; opko: Consultant or Advisor; theravida: Consultant or Advisor

Method of Participation

Learners will participate in this interactive online educational activity by completing a pre-test, reading the AUA Guideline, complete the slides and case studies, answering multiple choice questions, examining patient tools and resources and completing the post-test and evaluation. To claim CME credit for this enduring material, learners must complete the posttest, passing with 80% accuracy and submit the program evaluation.

Estimated time to complete each activity: 2.0 hours

Release Date: February, 2015
Expiration Date: February, 2018

AUA Disclosure Policy

All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) participating in an educational activity provided by the AUA are required to disclose to the provider any relevant financial relationships with any commercial interest. The AUA must determine if the individual’s relationships may influence the educational content and resolve any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.

Resolution of Identified Conflict of Interest

All disclosures will be reviewed by the program/course directors or editors for identification of conflicts of interest. Peer reviewers, working with the program directors and/or editors, will document the mechanism(s) for management and resolution of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to resolve conflict of interest:

  • Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or Education Content Review Committee or its subgroup
  • Limit content to evidence with no recommendations
  • Introduction of a debate format with an unbiased moderator (point-counterpoint)
  • Inclusion of moderated panel discussion
  • Publication of a parallel or rebuttal article for an article that is felt to be biased
  • Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
  • Divestiture of the relationship by faculty

Accreditation Statement

The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

The American Urological Association designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Non-physician Health Professionals

The AUA is not accredited to offer credit for non-physician health professionals. However, the AUA will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 Credit™.

Evidence-Based Content

It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.

Off-label or Unapproved Use of Drugs or Devices

It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias. The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the product prescribing information for full disclosure of approved uses.

Disclaimer

The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.

Reproduction Permission

Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the American Urological Association.

AUA Privacy and Confidentiality Policy

www.auanet.org/education/confidentiality-statement.cfm

Contact Information

American Urological Association
Office of Education
1000 Corporate Blvd
Linthicum, MD 21090

Toll Free (U.S. only): 1-866-RING AUA (1-866-746-4282)
Phone: 410-689-3700
Fax: 410-689-3800

CME Information

For all inquiries regarding CME credit email: cme@AUAnet.org

Available Credit

  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 Non-Physician Participation
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