2. METHODS
2.1. Data identification
For the 2023 Primary Urethral Carcinoma Guidelines, new and relevant evidence has been identified, collated, and appraised through a structured assessment of the literature. An updated systematic literature search was performed to identify studies reporting data on urethral malignancies published since the prior search, covering a time frame between August 9th, 2022 and May 1st, 2023. Databases searched included Ovid (Medline), EMBASE and the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews. A total of 68 unique records were identified, retrieved, and screened for relevance. Only one new reference was included in this 2023 publication. A detailed search strategy is available online: https://uroweb.org/guidelines/primary-urethral-carcinoma/publications-appendices.
Recommendations within the Guidelines are developed by the panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms which accompany each guideline statement, addresses a number of key elements:
- the overall quality of the evidence which exists for the recommendation [4];
- the magnitude of the effect (individual or combined effects);
- the certainty of the results (precision, consistency, heterogeneity and other statistical or study related factors);
- the balance between desirable and undesirable outcomes;
- the impact and certainty of patient values and preferences on the intervention.
Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower-quality evidence, and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [5]. The strength rating forms will be available online.
Additional information can be found in the general Methodology section of this print, and online at the EAU website: https://uroweb.org/guidelines. A list of Associations endorsing the EAU Guidelines can also be viewed online at the above address.
2.2. Review
This document was peer-reviewed prior to publication in 2021.