Peter Schulam, MD, PhD, argues that adopting robotic assisted surgery into urological practices can reduce medical errors and surgeon performance variability. Furthermore, he explains the need for larger and more structured medical data sets. This will enable machine learning when developing artificial intelligence (AI) to enhance prognostic and diagnostic accuracy, cancer mortality prediction, and interpretation of digitized images.
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Peter Schulam MD, PhD, discusses the 2016 American Urological Association (AUA)/ Endourology Society guidelines regarding observation of renal calculi, the treatment of ureteral and renal stones, urolithiasis during pregnancy, and the role of open surgery in stone disease. Specifically, he discusses medical expulsive therapy (MET), ureteroscopy, and shockwave lithotripsy (SWL).
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Peter Schulam, MD, PhD, reviews the controversy surrounding prostate cancer screening, explains the literature that led to the United States Preventive Services Task Force (USPSTF) coming out with a C recommendation for prostate cancer screening, and notes the limitations in the current standard of transrectal ultrasound (TRUS) biopsy. He then discusses how MRI fusion biopsy could address these limitations.
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Peter Schulam MD, PhD, emphasizes the importance of staging renal tumors based on weighted risk, including risk of metastases, histologic subtypes, and adverse pathologic characteristics, and not simply mass size. This is essential when considering partial nephrectomy, radical nephrectomy, active surveillance, ablative techniques, or other management options for individual patients.
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Peter Schulam MD, PhD, compares and contrasts the Surveillance, Epidemiology, and End Results (SEER) database and the National Cancer Database (NCDB) in terms of reliability for assessing upper tract urothelial carcinoma (UTUC) outcomes and risk factors when determining whether to treat a patient with definitive therapy or the “Watchful Waiting” strategy.
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