Assessing health-related quality of life in urology - a survey of 4500 German urologists.

BACKGROUND: Urological diseases and their treatment may negatively influence continence, potency, and health-related quality of life (HRQOL). Although current guidelines recommend HRQOL assessment in clinical urology, specific guidance on how to assess HRQOL is frequently absent. We evaluated whether and how urologists assess HRQOL and how they determine its practicality. METHODS: A random sample of 4500 (from 5200 identified German urologists) was drawn and invited to participate in a postal survey (an initial letter followed by one reminder after six weeks). The questionnaire included questions on whether and how HRQOL is assessed, general attitudes towards the concept of HRQOL, and socio-demographics. Due to the exploratory character of the study we produced mainly descriptive statistics. Chi2-tests and logistic regression were used for subgroup-analysis. RESULTS: 1557 urologists (85% male, with a mean age of 49 yrs.) participated. Most of them (87%) considered HRQOL assessment as 'important' in daily work, while only 7% reported not assessing HRQOL. Patients with prostate carcinoma, incontinence, pain, and benign prostate hyperplasia were the main target groups for HRQOL assessment. The primary aim of HRQOL assessment was to support treatment decisions, monitor patients, and produce a 'baseline measurement'. Two-thirds of urologists used questionnaires and interviews to evaluate HRQOL and one-quarter assessed HRQOL by asking: 'How are you?'. The main barriers to HRQOL assessment were anticipated questionnaire costs (77%), extensive questionnaire length (52%), and complex analysis (51%). CONCLUSIONS: The majority of German urologists assess HRQOL as part of their clinical routine. However, knowledge of HRQOL assessment, analysis, and interpretation seems to be limited in this group. Therefore, urologists may benefit from a targeted education program. TRIAL REGISTRATION: The clinical trial was registered with the code VfD_13_003629 at the German Healthcare Research Registry ( www.versorgungsforschung-deutschland.de ).

Genetic effects of impure and pure saccharin in yeast.

Yeast cells were grown in media containing impure or purified saccharin preparations. Dose-dependent increases in frequencies of cells possessing aberrant cell morphologies were revealed by light microscopy. At each test dose, cells grown in impure saccharin exhibited up to sevenfold higher frequencies of mitotic crossing-over or gene conversion in three of four assays for genetic recombination than cells grown in purified saccharin from the same lot. With one exception, the sweetener produced by the Maumee process caused larger increases in recombination and gene reversion than the sweetener produced by the Remsen-Fahlberg process. The several test markers did not respond equally to any test saccharin. Cells grown in liquid media containing no saccharin or two of three test concentrations of saccharin produced cell titers that were approximately equivalent.

Recombinogenicity and mutagenicity of saccharin in Saccharomyces cerevisiae.

Diploid yeast grown in the presence of a commercial lot of saccharin exhibited reproducible, dose-dependent increases in intergenic and intragenic recombination, and mutation. Cells grew to nearly the same titer in media without saccharin and containing 2 or 20 mg saccharin/ml, although cell viability was somewhat reduced in saccharin-containing media. At the high test dose of 100 mg/ml, titers and cell viability were more markedly lowered. Differences between this study and previous (negative) tests of saccharin in yeast are described.