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RESECT: A Randomised Controlled Trial of Audit and Feedback in Non–muscle-invasive Bladder Cancer Surgery

Title:	RESECT: A Randomised Controlled Trial of Audit and Feedback in Non–muscle-invasive Bladder Cancer Surgery
Authors:	Gallagher, Kevin; MacLennan, Steven; Bhatt, Nikita; Clement, Keiran; Zimmermann, Eleanor; Khadhouri, Sinan; Kulkarni, Meghana; Gaba, Fortis; Anbarasan, Thineskrishna; Asif, Aqua; Light, Alexander; Ng, Alexander; Chan, Vinson Wai-Shun; Nathan, Arjun; Cooper, David; Aucott, Lorna; Sakthivel, Deerush; Akand, Murat; Piazza, Pietro; Marcq, Gautier; O'Brien, Tim; Nielsen, Matthew; Giudice, Francesco Del; Simpson, Keith; Orecchia, Luca; Teixeira, Bernardo; Dawam, Daben; Geisenhoff, Alexander; Hill, George; Fukuokaya, Wataru; Hidalgo, Beatriz Gutiérrez; El-Hajj, Albert; Elgamal, Mostafa; Fanshawe, Jack; Wang, Betty; Lee, Taeweon; Manecksha, Rustom; McCann, Conor; Rivas, Juan Gomez; Arda, Ersan; Elhadi, Muhammed; Rossi, Sabrina; Teoh, Jeremy Yuen-Chun; Mariappan, Paramananthan; Kasivisvanathan, Veeru; Princiotta, Alessandro A.; Trabacchin, Nicolò; Antonelli, Alessandro; Cerruto, Maria Angela A. A.; Rubilotta, Emanuele; Hussein, Israa; Longshaw, Anna; Kostakopoulos, Nikolaos; Khadhouri, Sinan A. S.; Kruczynska, Anna E.; Dimitropoulos, Konstantinos K. D.; McPhee, Arthur; Gilanliogullari, Kemal P.; Natalie, Simon; Rutigliani, Luca; Shallcross, Olivia R.; Dokubo, Ibifuro I.; Lamb, Benjamin W.; Jimie, Joachim H.; Hussein, Baher; Bayomy, Abdulhakeem; Abdelazim, Hassan; Mohamed, Eslam Metwally M.; Abozied, Hesham; Jena, Rahul; Aggarwal, Amit; Choudhary, Gautam Ram R.; Upadhyay, Akshaya U.; Mittal, Ankur; Panwar, Vikas K.; Mandal, Arup K.; O'Neill, Carole; Nelson, Abigail R.; MacLeod, Alex; Chawareb, Elia Abou; Hoyek, Elio E.; Heidar, Nassib Abou; Ragavan, Narasimhan; Jain, Nitesh; Sakthivel, Deerush Kannan; Pluchart, Agusti Marfany; Muñoz Rivero, Marta Viridiana V.; Estigarribia Benitez, Cayo Augusto C.; Arumainayagam, Nimalan; Maqboul, Fouad; Agrawal, Sachin; Reddy Adapala, Rajesh Kumar; Burns, Hannah; Bekarma, Holly J.; Grosso, Antonio Andrea; Ciaralli, Elena; Di Maida, Fabrizio; Giudici, Sofia; Minervini, Andrea; Mari, Andrea; Costi, Carlo C. G. C.; Zorzi, Federico; Claps, Francesco; Rossin, Giulio G. R.; Vedovo, Francesca; Doherty, Elinor A.; Sugrue, Diarmuid D.; Davis, Niall F.; Stephens, Jacob R.; Geisenhoff, Alexander M.; Burks, Frank; Karmakar, Antara; Yiu, Ting Wai; Li, Mo; Sengupta, Shomik; Mohammad, Sabir; Misurati, Muftah O.; Raslan, Mutie Y.; Anwar, Adeel; Gkikas, Christos; Alexander, Cameron; Warren, Hannah; Byrnes, Kevin; Edison, Marie; Croghan, Stefanie; Oo, Elly; Beder, Daniel; Thurtle, David R.; Janebdar, Husay; Reeves, Felicity; Mathijssen, Ruud J. G.; Duijvesz, Diederick; Szostek, Aleksandra; Drugeon, Jeremy; Villers, Arnauld A. V.; Marcq, Gautier G. M.; Rocha, Alexandra; Tavares, Catarina T.; Mendes, Gonçalo G.; Correia, Jorge; de Oliveira, Manuel Castanheira; Mesquita, Sofia; Marques-Monteiro, Miguel M.; Teixeira, Bernardo L.; Oliveira, Bárbara B. J.; Coutinho, Aníbal A. C.; Araújo, Débora C.; Costa, Pedro; Bastos, Samuel S.; Marramaque, Carolina; Xambre, Luís X.; Chua, Chong U.; Mcalindon, Jonathan; Hasan, Hira; Yun Ng, Peng; Mayor, Nikhil; Attar, Hama A.; Delacave, Henry S. T.; Atiyah, Ayah; Atiyah, Zeid; Jelski, Joseph E. R.; Peacock, Julian; Davenport, Kim; shipstone, david; Malla, Raiees A.; Krishna, krishna K. I.; Simard, Francis F. S.; Lodde, Michele; Kissel, Anne A. K.; Larré, Stéphane; Fayek, Fayek T.; Djouhri, Mehdi; Fiard, Gaelle; Hamid, Agus Rizal A. H.; Stemberger, Andrew T.; Tomaszewski, Jeffrey J.; Tan, Wei Phin; Nizov, Aleksei; Somov, Pavlo; Ahmed, Zachery; Glackin, Anthony J.; Asaad, Wael; Bain, Ailsa J.; Bain, Ailsa; Bordenave, Matthieu G.; Ray, Eleanor R.; Ghonaimy, Ahmed S.; Madaan, Sanjeev; Fontaine, Christina L. L.; Daggamseh, Abdallah M. K.; Pascoe, John J.; Horn, Charles; Fuge, Oliver; atienzar, Ana Utiel; Gomez diez, Nidia N.; Botto Lugo, Sarai Margarita M.; Cuenca, Maria Desamparados M. D.; López Gonzalez, Jose Agustín L. G.; Laoye, Adeyinka; Deytrikh, Andrew; Thomas, Aron G.; Ravishankar, Kalleshachar; Budaya, Taufiq N.; Seputra, Kurnia P.; Kusuma, A. H. Wisda W.; Soerohardjo, Indrawarman; Hendri, Ahmad Zulfan; Danarto, Danarto; Mishra, Jaya; Gills, Jessie R.; Westerman, Mary E.; Delacroix, Scott E.; Clark, Matthew C.; Panayi, Zoe; Shillito, Samuel H.; Srirangam, Shalom J.; Rajevskaja, Olga O. R.; Yurtseven, Emre C.; Akyol, Alp; Kızılay, Fuat; Sylvester, Richard; Micheli Micheli, Filippo F.; Morena, Tonino; Peroni, Angelo; Romani, Martina; Francavilla, Simone; De Leonardis, Federico; Colalillo, Gaia; Miano, Roberto; Bradley, Caroline; Lee, Xiang Wei Jonathan W. J.; Mcilhenny, Craig; Leask, Jamie; Sarkar, Somita; Chetwood, Andrew S. A.; Paramore, Louise; Ali, Ahmed S. A.; Langas, Georgios; Vakalopoulos, Ioannis; Sountoulides, Petros; Ibrahim, Alaeldin; Alkhalifa, Elmustafa M. M. B.; Abdalla, Yassin Y. A.; Odey, Joseph; Sheweita, Mohammad S. S; Ekwueme, Kingsley C.; Yogeswaran, Carnjini; Mohamed, Youssef; Trimboli, Mariele; Shafii, Mahmoud; Duffy, Siobhan A.; Morton, Simon; Bandeira de Mello, Kathryn L.; Harris, Andrew; Bruce, Angus; Fanshawe, Jack R.; Tan, Nataniel Jin; Mensah, Elsie; Pramod, Sawkar Vijay; Safriadi, Ferry; Zaza, Mohamed; Ali, Mohamed Hassan; ElAzab, Mohamed; Ramadan, Abdelraouf; Salem, Tarek; Walters, Uma; Lami, Mariam; Omar, Mohammad Ali; Huber, Philipp M.; Martin, Robin; Roumeguere, Thierry; Albisinni, Simone; Gomez Rivas, Juan J. G. R.; Moreno Sierra, Jesus J. M. S.; Gutiérrez Hidalgo, Beatriz B.; López González, Pedro A.; Crespo, Natalia Vidal; Araújo, Ana S. P.; Oliveira, Carlos A.; Chávez, Cristobal Castro; Ruiz, Seiichi Fuziwara; Salas García, Andrés G.; Bile-Silva, Andreia; Mota, Renato L.; Fonseca, Rita R.; Portugal-Gaspar, Frederico M. G. F.; Lopes, Filipe A.; Carneiro, Arie A. C.; Andrade, Guilherme M.; Lemos, Gustavo C.; Martin Christofe, Nicolle M.; Priante Kayano, Paulo P.; Cogo Badan, Stefano C.; Wroclawski, Marcelo L.; Prieto Fernandes, Fábio Peretti; Moura, Felipe C.; de Almeida e Paula, Felipe A.; Tienza, Antonio; Peraire, Maria; Guldris, Ricardo; Bauza, Jose Luis; Catalá, Juan Boronat; Szczesniewski Dudzik, Juliusz Jan; María García-Cano Fernández, Alba; Llanes González, Luis L.; Alfaro, Alejandro González; Gomariz, Ignacio Velázquez; Garcia, Gabriel Teja; Carrion, Diego M.; del Álamo, Julio Fernández; Herranz Fernández, Luis Miguel L. H. F.; Gómez-Acebo Núñez, María M. G. N.; Moreno Fontela, María Pilar M. P.; Yebes, Alvaro; Pellejero, Alejandro Sanchez; Ortega Polledo, Luis Enrique E.; Palacios, Nelson Morales; Walz, Jochen; Dewulf, Karel; Richter, Konstantin; Branger, Nicolas; Knipper, Sophie; Pignot, Géraldine; Kadhim, Hassan; Gami, Mayur N.; Hawizy, Azad A. M. H.; Chessa, Francesco; Fontanella, Luca L. F.; Lampariello, Luca; Spinozzi, Luca; Tamburini, Sara; Schiavina, Riccardo; Brunocilla, Eugenio; Volpi, Gabriele G.; Alessio, Paolo; Checcucci, Enrico; İplikci, Ayberk; Yildirim, Asif; Culpan, Meftun; Yucel, Cem; Celik, Orcun; Ulker, Volkan; Devadoss, Bennet J.; Breish, Mohamed; Pina, Ines; Cresswell, Jo; Al-Jarrah, Amar A.; Ababneh, Malak S.; Ababneh, Hazim S.; Al-Zu'bi, Mohammad Talal; Dargaj, Jan J. D.; Bris, Lukas L. B.; Svihra, Jan; Al-Shami, Khayry; Khamees, Almu'atasim; Aledwan, Ghazi; Diamand, Romain; Abou Zahr, Rawad R.; Peltier, Alexandre; Lee, Hsiang-Ying; Simsekoglu, Muhammed Fatih M. F.; Akca, Oktay O.; Kulimbet, Mukhtar B.; Gassanov, Ziyo; Tanabayev, Baimakhan; Fakhradiyev, Ildar R.; Simoes, Adrian; Papadopolous, Georgios G.; Thomas, Milan M. T.; Ahmed, Issam I. A.; Sekhon, Nisa C.; Alleemudder, Adam; Amin Alsayed Alkhawalka, Mohammad Alsayed; Okwuchi, Dumebi D.; Willmott, Sarah V.; Majumdar, Purnendu; Coyle, Meghan; Simson, Nick; Egbe, Azelle; Nair, Arun; Nair, Manu A. N; Kailavasan, Mithun; Douglas-Moore, Jayne L.; Elajnaf, Mohamed R.; Jackson, Ben L.; Hamami, Heba; Hemmant, Joshua; Siraj, Mamoon; Craciun, Marius E.; Lyttle, Margaret; Shendy, Mostafa S.; Abdalla, Ahmed; Mukherjee, Rono; Mihuna, Aishath; Kantartzi, Anastasia; Atkins, Caitlin R. M.; Uddin, Juber; Motiwala, Faiz; Fanshawe, Jack B.; Chan, Kimberley H. Y.; Vasdev, Nikhil N. V.; Gupta, Gopal N.; Rac, Goran; Patel, Hiten D.; Hassan, Mohamed M.; Pushkaran, Anish K.; Salik, Muhammad M. S.; Barrass, Barnaby J. R.; Salhab, Rawand Q.; Barbarawi, Wadee; Aldeen, Riyad Salah; Jones, Adam; Shakir, Jafar; Waterhouse, Robert H.; Tan, Silvian; Shah, Shail; Simpson, Richard G.; Mohee, Amar R.; Smith, Peter M.; Middela, Seshi G.; Gunendran, Thiru; Tanidir, Yiloren Y. T.; Sokolakis, Ioannis; Pyrgidis, Nikolaos; Hatzichristodoulou, Georgios; Mares, Jan; Keane, Kevin G.; Galvin, David J.; Waqar, Usama; Aziz, Wajahat; Amin Malik, Muhammad Jawad; Khan, Daniyal Ali; Biyabani, Syed Raziuddin; Moser, Daniel; Laukhtina, Ekaterina; Shariat, Shahrokh F.; Bhat, Tahir; Mehmood, Shahbaz M.; Masood, Shikohe; Hagag, Esraa S.; Hammad, Mohamed Ahmed; Afia, Asem; Karna, Sourabh; Ibiok, Imoh A.; Ollandini, Giangiacomo; Kiciak, Alexander E.; Bekkema, Jordan A. N.; Wang, Betty H.; Wollin, Timothy A.; Yarwood, Adam; Hill, George T.; Kanda Swamy, Gokul V.; Parikh, Aditya A. P; Sabnis, Chaitanya R.; Batra, Rohan R. B.; Coelho, Victor V.; Sharma, Tanishq; Sabnis, Ravindra R. S.; Healy, Rion; Faek Halaseh, Sattam Ammar; Lee, Su-min; Lim, Qi Yang; Wu, Qing Hui; Wang, Ziting; Chiong, Edmund; Hughes, Charlotte M.; Ali, Omar H.; Boaz, Ranil Johann; Gabriel, Melissa M.; Finch, William; Hammad, Omar O.; Heba, Sherif T.; Yun, Jae W.; Pandian, Shiv K.; Oliver, Rachel L.; Almpanis, Stefanos S. A.; Boxall, Nicholas E.; Adamu-Biu, Fatima I.; Pushpa-Rajah, Jonathan A.; Miakhil, Iqbal; Mera, Zaid; Sultana, Abida; Potter, John J.; Coombs, Laurence; Laghari, Shahzad; Khan, Israr A.; Warner, Ross M.; Olaitan, Oluwabukola; Akman, James; Green, William J. F.; Law, Kenny L. H.; Wong, Albert H. G.; Li, James; Dooldeniya, Mohantha D.; Turo, Rafal K.; Kabia, Angela A.; Onowa, Victor E.; Lo Giudice, Arturo A.; Scandura, Carmen C.; Russo, Giorgio Ivan G.; Kurpik Kurpik, Adam A.; Kaczmarek, Krystian; Lemiński, Artur; Anand, Chanakya V.; Tanasescu, George G. T.; Sells, Lauren A.; Acyatan, Mark G.; Smith, Terence G.; Lokman, Utku U. L.; Ramachandra, Meghana; Hodgson, Dominic J.; Sid Ahmed, Momen A. M. B.; Moghe, Dhanashree; Ong, Kelly K.; Tasleem, Ali M.; Lie, Henry H. Y.; Tsu, James H.; Dean, Lucas W.; Blick, Christopher; Toia, Bogdan B. T.; Maduwe Gedara, Sagara Ruwan Kumara R. K.; Mohsin, Hadi; Bleakley, Cait; McGrath, John; Ng, Michael G.; Parsons, Brian; Lindsay, Jamie S.; Volanis, Dimitrios; Wijayasuriya, Don S. C. R; Wilkinson, James; White, Angus; Cox, Adam; Calmuc, Alina; Fung, Claire; Taktak, Sam; Lazarowicz, Henry P.; Starmer, Benjamin; Chippagiri, Arvinda S.; Gallegos, Christopher; Kerr, Eva; Penny, Nancy M.; Green, Euan A.; Jones, Craig M.; Colvin, Holly V.; David, Rotimi; Davies, Melissa; Williams, Leah E.; Woodle, Tarah; Umbreit, Eric C.; Gubbiotti, Marilena; Pirola, Giacomo Maria; Manfredi, Matteo M.; Sica, Michele M.; Amparore, Daniele D.; Qamar, Beenish Q.; Humayun-Zakaria, Nada K.; Hussain, Amer; Dhanasekaran, Ananda Kumar; Scornajenghi, Carlo Maria; Carino, Dalila; Bologna, Eugenio; Proietti, Flavia; Maggi, Martina; asero, vincenzo; Canale, Vittorio; Sciarra, Alessandro; Leonardo, Costantino; De Berardinis, Ettore; Del Giudice, Francesco; Mangera, Altaf F.; Pereca, Jelizaveta L. P.; Akinjise-Ferdinand, Oluwaseun; Rosario, Derek J.; Amir, Muhammad Ayhan; Khan, Raza Zubair; Riaz, Umar; Tahir, Muhammad Abdullah; Rahim, Waqas; Dhother, Jasreen; Mohamed, Guleed; Nee Jenny Bo, Yen; Chin Chin, Yew Fung Y. F.; Varma, Raghav K.; Elves, Andrew; Manolitsis, Ioannis; Tzelves, Lazaros; Skolarikos, Andreas; Babaian, Kara N.; Case, Lia; Damm, Tiffany; Dynda, Danuta I.; Elmansouri, Ahmad J. N. V.; Edris, Faisal F. E.; Voss, James; Parfitt, Charlotte M.; Buckland, George R. E.; Antoniou, Vaki; Sinha, Mriganka M.; Douglas, James; Campbell, Juliet M.; Bondad, Jasper; Khuoge, Sangawaka; Gipson, Chrissie; Lecoyte, Arabella; Waley, Laura G.; Hawthorne, Rachel; Ridgway, Alexander; Warren, Kate S.; Maniarasu, Sarveen; Mistry, Rahul; Shembesh, Hassan A.; Simeone, Claudio; Mondini, Francesca; Zamboni, Stefania; Suardi, Nazareno Roberto; Stroman, Luke; Hassan, Mahabub; Ayres, Benjamin; Pinkney, Rory T. M.; El-Taji, Omar; McCabe, John; Considine, Shane; Ryan, Paul C.; Manecksha, Rustom P.; Sparanese, Sydney; Mayson, Brian E.; Oliyide, Abisola E.; Chibuzo, Ijeoma N. C.; Vaggers, Sophie N.; Dyer, James E.; O'Sullivan, Niall J.; Penny, Zakya; Casey, Rowan Z.; Yong, Daniel Z. P.; Leow, Jeffrey J.; Choo, Zhen Wei; Liu, Zhenbang; Chong, Yew Lam; Gupta, Sujoy; Aggarwal, Gaurav; Liu, Alex Qinyang; Leung, David; Teoh, Jeremy; Xu, Ning; Lin, Yun zhi; yong Wei, Yong Wei; Nishi, Eriko; Suzuki, Hirotaka; Miki, Jun; Okamoto, Maria; Matsuura, Taishi; Yanagisawa, Takafumi; Imai, Yu; Matsukawa, Akihiro; Obayashi, Koki; Kimura, Shoji; MacKenzie, Kenneth R.; Miller, Alexandra; Tait, Campbell D.; Thorman, Hannah E.; Ippoliti, Simona; Ilie, Petre Cristian; Kamat, Ashish M.; Zimmermann, Eleanor F.; Babawale, Omikunle D.; Mitchell, Victoria; O'Rourke, Seanan; Oz, Goktan G.; Arikan, Mehmet G. G.; Atakan, Irfan H. H.; Arda, Ersan E.; Alshareea, Entisar; Dikna, Abdalkdos; Abdulwahed, Eman A.; Ghmagh, Reem; Rosenfeld, Benjamin H.; Ristau, Benjamin T.; Ross, Amy; O'Halloran, Rachel; Hayes, John; Gray, Samuel B.; Verlinden, Sophie M.; Maessen, Aniek W.; Willemse, Peter-Paul M.; Travino, Alfredo; Iannuzzi, Andrea; Prata, Francesco F.; Tedesco, Francesco; Deanesi, Noemi; Scarpa, Roberto Mario M.; Papalia, Rocco R.; Esperto, Francesco; Day, Elizabeth K.; Shirwac, Hafsa; Jaibaji, Raian; Tang, Stanley C.; Kennedy, Clio; Szabados, Bernadett; Baldini, Cinzia; Nowers, Jennifer; Sarmah, Piyush P. B.; Williams, Kevin G.; Tan, Lieo J.; Boden, Alasdair K.; Simpkins, Samuel J.; Clement, Keiran D.; Khan, Rehan S. S.; Ravindraanandan, Manoj; Lango, Artemisia; Kitchen, Mark; Gommersall, Lyndon M.; Thomas, Megan; Al-Mitwalli, Abdullah; Featherstone, Jon M.; Pitoni, Lucia; De Angelis, Maria Vittoria; Delle Fave, Rocco Fracesco; Palagonia, Erika E.; Dell'Atti, Lucio L.; Galosi, Andrea Benedetto; Baekelandt, Loïc; Cleynenbreugel, Ben Van; Joniau, Steven; Van der Aa, Frank; Chai, Chu Ann; Jeffery ZK, Lim; Yeoh, Wei Sien; Seevalingam, Kanesh K.; Ong, Teng Aik T. A.; Fang, Andrew M.; Moon, Sol C.; Glaser, Zachary A.; Rais-Bahrami, Soroush; Jacobsen, Niels B.; Abbasi, Behzad; Hakam, Nizar; Lui, Jason L.; Li, Kevin D. D; Breyer, Benjamin N.; Pessoa, Rodrigo; Kim, Simon; Funkhouser, Rylee R. J. F.; Zakrajsek, Jonathan K.; Kukreja, Janet E. B.; Sevim, Mehmet; Kazan, Ozgur O.; Aras, Bekir; Banti, Matthew M.; Lee, Eugene E. K. L.; Kannady, Brandon K. G.; Maldonado, Jonathan; Hensley, Patrick; McSpadden, Madeleine R.; Ray, Danielle; Randolph, Jennifer L.; Murray, Katie S.; Catto, James; Ivanov, Atanas S.; Antonov, Petar; Edwan, Mohamed; Elkarta, Ahmed A. E.; Elbaset, Mohamed A.; Ezzat, Osama; Ashour, Rawdy; Mosbah, Ahmed; Sparanese, Sydney E.; Black, Peter C.; Chari, Natasha; Nikolinakos, Panagiotis; Ellis, David S. J.; Papadopoulos, Dimitrios I.; Charitopoulos, Konstantinos; Carey, Michelle M.; Gordon, Emma M.; Korotõts, Dmitri; Okas, Rauno; Lau, David Hua Wu H.; El-Koubani, Osman; Ayers, Jennifer R. S.; Hina, Saddaf; Gartner, Tobias; James, Joe E. G.; Simpson, Keith R. S.; Ibrahim, Mohamed E.; Dallash, Mohammed H.; Jallad, Samer; Bencatova, Zuzana; Karanjia, Rustam N.; Whiting, Danielle; Frymann, Rob J.; Farag, Soma S. F.; Whitburn, Jessica A. S.; Miah, Saiful; Khattab, Hany; Kondylis, Filip
Contributors:	Gallagher, Kevin; Maclennan, Steven; Bhatt, Nikita; Clement, Keiran; Zimmermann, Eleanor; Khadhouri, Sinan; Kulkarni, Meghana; Gaba, Forti; Anbarasan, Thineskrishna; Asif, Aqua; Light, Alexander; Ng, Alexander; Chan, Vinson Wai-Shun; Nathan, Arjun; Cooper, David; Aucott, Lorna; Sakthivel, Deerush; Akand, Murat; Piazza, Pietro; Marcq, Gautier; O'Brien, Tim; Nielsen, Matthew; Giudice, Francesco Del; Simpson, Keith; Orecchia, Luca; Teixeira, Bernardo; Dawam, Daben; Geisenhoff, Alexander; Hill, George; Fukuokaya, Wataru; Hidalgo, Beatriz Gutiérrez; El-Hajj, Albert; Elgamal, Mostafa; Fanshawe, Jack; Wang, Betty; Lee, Taeweon; Manecksha, Rustom; Mccann, Conor; Rivas, Juan Gomez; Arda, Ersan; Elhadi, Muhammed; Rossi, Sabrina; Teoh, Jeremy Yuen-Chun; Mariappan, Paramananthan; Kasivisvanathan, Veeru; Princiotta, Alessandro A.; Trabacchin, Nicolò; Antonelli, Alessandro; Cerruto, Maria Angela A. A.; Rubilotta, Emanuele; Hussein, Israa; Longshaw, Anna; Kostakopoulos, Nikolao; Khadhouri, Sinan A. S.; Kruczynska, Anna E.; Dimitropoulos, Konstantinos K. D.; Mcphee, Arthur; Gilanliogullari, Kemal P.; Natalie, Simon; Rutigliani, Luca; Shallcross, Olivia R.; Dokubo, Ibifuro I.; Lamb, Benjamin W.; Jimie, Joachim H.; Hussein, Baher; Bayomy, Abdulhakeem; Abdelazim, Hassan; Mohamed, Eslam Metwally M.; Abozied, Hesham; Jena, Rahul; Aggarwal, Amit; Choudhary, Gautam Ram R.; Upadhyay, Akshaya U.; Mittal, Ankur; Panwar, Vikas K.; Mandal, Arup K.; O'Neill, Carole; Nelson, Abigail R.; Macleod, Alex; Chawareb, Elia Abou; Hoyek, Elio E.; Heidar, Nassib Abou; Ragavan, Narasimhan; Jain, Nitesh; Sakthivel, Deerush Kannan; Pluchart, Agusti Marfany; Muñoz Rivero, Marta Viridiana V.; Estigarribia Benitez, Cayo Augusto C.; Arumainayagam, Nimalan; Maqboul, Fouad; Agrawal, Sachin; Reddy Adapala, Rajesh Kumar; Burns, Hannah; Bekarma, Holly J.; Grosso, Antonio Andrea; Ciaralli, Elena; Di Maida, Fabrizio; Giudici, Sofia; Minervini, Andrea
Publication Year:	2026
Collection:	Sapienza Università di Roma: CINECA IRIS
Subject Terms:	Audit and feedback; Implementation science; Non–muscle-invasive bladder cancer; Quality improvement; Quality performance indicators
Description:	Background and objective: We aimed to determine whether audit, feedback, and education improves surgical performance after transurethral resection of bladder tumour surgery for non-muscle-invasive bladder cancer and as a secondary aim if it reduced recurrence rates. Methods: This cluster randomised controlled trial compared audit and feedback plus peer comparison and education, with audit alone for four coprimary outcomes: (1) Single-instillation chemotherapy, (2) detrusor muscle sampling, (3) documentation of tumour features, and (4) resection completeness. Early recurrence was a secondary outcome. Key findings and limitations: A total of 100 sites were randomised to intervention and 101 to control. In total, 14 915 patients were included. Intervention sites significantly improved documentation of tumour features (adjusted mean difference [95% confidence interval {CI}]: 6.0 [1.8, 10], p=0.005) and of resection completeness (adjusted mean difference [95% CI]: 5.5 [1.5, 9.5], p=0.007). There was no statistically significant difference in chemotherapy use (adjusted mean difference [95% CI]: 0.3 [-4.7, 5.3], p=0.9) or detrusor muscle sampling (adjusted mean difference [95% CI]: 2.6 [-1.3, 6.4], p=0.2). There was no statistically significant difference in early recurrence rate between arms (adjusted odds ratio [95% CI]: 1.02 [0.8, 1.4], p=0.9); however, in the control arm, the early recurrence rate reduced compared with baseline (adjusted odds ratio [95% CI]: 0.7 [0.6, 0.9]). Conclusions and clinical implications: Audit and feedback with education improved the documentation of important surgical findings that influence clinical management, but not the performance of detrusor muscle sampling, adjuvant chemotherapy use, or early recurrence rates. Improvements observed in the control arm may explain a lack of effect of the intervention in some outcomes.
Document Type:	article in journal/newspaper
Language:	English
Relation:	info:eu-repo/semantics/altIdentifier/pmid/41444076; volume:89; issue:4; firstpage:355; lastpage:365; numberofpages:11; journal:EUROPEAN UROLOGY; https://hdl.handle.net/11573/1763146
DOI:	10.1016/j.eururo.2025.09.4174
Availability:	https://hdl.handle.net/11573/1763146; https://doi.org/10.1016/j.eururo.2025.09.4174
Accession Number:	edsbas.CEB1A3D0
Database:	BASE