An observational analysis of provider adherence to AUA guidelines on the management of benign prostatic hyperplasia

Gregory B. Auffenberg*, Chris M. Gonzalez, J. Stuart Wolf, J. Quentin Clemens, William Meeks, Kevin T. McVary

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Purpose: We retrospectively evaluated urologist adherence to the AUA guidelines on the management of new patients with benign prostatic hyperplasia related lower urinary tract symptoms in a large university urology group.

Materials and Methods: All first time benign prostatic hyperplasia/lower urinary tract symptom visits to the urology clinic at the Northwestern Medical Faculty Foundation between January 1, 2008 and December 31, 2012 were evaluated using an institutionally managed electronic medical record data repository. Clinical documentation and orders from each encounter were assessed to determine the rate of performance of guideline measures. Approximately 1% of all results were manually reviewed in a validation process designed to determine the reliability of the electronic medical record based system.

Results: A total of 3,494 eligible encounters were evaluated in the final analysis. Provider adherence rates with the 9 measures recommended in the guidelines varied by measure from 53.0% to 92.8%. The rate of performance of 5 not routinely recommended measures was 10.2% or less. Post-void residual and urinary flow measurement were optional measures, and were performed on 68.1% and 4.6% of new encounters respectively. Manual validation revealed the electronic medical record data extraction was concordant with manual review in 96.7% of cases (95% CI 94.8-98.5).

Conclusions: Using electronic medical record based data extraction techniques, we reliably document a baseline adherence rate with AUA guidelines on the management of benign prostatic hyperplasia. Establishing this benchmark will be important for future investigation into patient outcomes related to guideline adherence and into methods for improving provider adherence.

Original languageEnglish (US)
Pages (from-to)1483-1488
Number of pages6
JournalJournal of Urology
Issue number5
StatePublished - Nov 1 2014
Externally publishedYes


  • electronic health records
  • guideline
  • lower urinary tract symptoms
  • prostatic hyperplasia

ASJC Scopus subject areas

  • Urology


Dive into the research topics of 'An observational analysis of provider adherence to AUA guidelines on the management of benign prostatic hyperplasia'. Together they form a unique fingerprint.

Cite this