AI, science and empathy: The 2025 EAU Meets National Societies Meeting

The EAU Meets National Societies Meeting in Noordwijk, the Netherlands was hosted by the EAU and welcomed 66 representatives from 35 countries, representing 38 societies for a day of brainstorming and exchange of perspectives. Guests arrived on June 5th for a networking dinner and the meeting itself took up most of the 6th.

The meeting’s usual venue, the beachfront Grand Hotel Huis ter Duin was in the midst of preparations for the The Hague NATO Summit that would be held later in the month. While a prominent guest was expected to be staying in the Hotel, in the end it was the Dutch royal family who personally hosted the US President for his visit to the Netherlands.

• This first report covers the plenary talks in the first part of the programme. Separate articles will cover the afternoon break-out sessions, the Patient and Policy Offices’ contributions, as well as an interview with Adjunct-Secretary General Prof. Jens Sønksen

Delegates were welcomed by the EAU’s Secretary General, Prof. Arnulf Stenzl (DE), who immediately introduced his co-moderator for the first topic: Artificial Intelligence in urology. Prof. Thomas Knoll (DE), the recently appointed Section Office Chair, invited Dr. Karl-Friedrich Kowalewski (DE) chair of the EAU’s AI Working Group and Chair Prof. Maria Ribal (ES) on behalf of the Guidelines Office to present the EAU’s current activities in the field.

Prof. Knoll introduced the topic: “We really are on the edge of a significant transformation to the way we work. It’s already impacting our daily life, directly or indirectly.” He went on to outline the opportunities for AI specific to urology, including as a support for decision-making, predictive models in precision medicine, as part of robot-assisted surgery, meta-analysis of medical guidelines, services for patients, education, and data analysis. All these opportunities have led to the EAU forming an AI Working Group that brings together urologists and related medical specialists, AI specialists, data scientists and ethics and legal experts. 

Dr. Kowalewksi, leading this Working Group, explained more on the technical background of AI and what caused its recent breakthrough. “We were always limited by computational power, which is no longer an issue. Now there is a global race for high-quality data. Data is valuable, so capture it!” Dr. Kowaleski also pointed out that the first successes for AI in urology will be in the realms of radiology and pathology, whereas surgery is a more difficult, unpredictable environment where it is more difficult to capture data consistently.

The Guidelines Office took the opportunity to pre-launch its EAU Guidelines Chatbot in Noordwijk. Prof. Ribal enthusiastically extolled the virtues of this new feature of the online EAU Guidelines:

“By introducing AI into the Guidelines, and eventually into specifically-designed clinical decision-making tools, it can make us more efficient and consistent, which are missions of the EAU Guidelines in the first place.” User feedback, analysis and refining chatbot responses are essential to a successful roll-out of this first AI product by the Guidelines Office, matching the high standards of the Guidelines’ scientific content.

Prof. Ribal also touched upon copyright issues for this body of volunteer-based scientific work, as well as privacy for any patient data that might be used in future tools: “While they are freely available, the copyright lies with the EAU and any parties looking to use the EAU Guidelines as part of an AI tool, or for training purposes must ask for permission to use them.”

The AI session closed with EAU Patient Office Chair Prof. Eamonn Rogers (IE) and Vice-Chair Dr. Michael Van Balken outlining the Patient Office’s experience with AI helping translate patient information, as well as the possibility of offering a guidelines-based “lay” chatbot for urology patients to interact with. While AI can make translation fast and cheap, proofreading by doctors is still needed to make sure the information is accurate and appropriate. Dr. Christos Zampaftis (GR) gave examples from the Hellenic Urological Association and its own Patient Office.

• More reporting about the Patient Office at the National Societies Meeting is forthcoming.

Another area where the EAU can provide a platform for collaboration between Europe’s urologists is in the realm of research and science. Expanding real-world evidence has a high potential to boost urology research, and this is precisely what the EAU, through its Guidelines Office and with the help of national societies, is hoping to achieve with the UroEvidenceHub. This topic was introduced and presented by EAU Adjunct Secretary General Prof. James N’Dow (GB).

As Prof. N’Dow pointed out: “These studies and their AI applications need diverse data from all countries. One cannot blame AI for bias and poor results if it is based on incomplete information.” He encouraged urologists from all European countries to contribute to this project to get the best results. Prof. N’Dow also gave an update on ProReg, the flagship prostate cancer registry of the UroEvidenceHub. 

Using the real-world evidence from the UroEvidenceHub means the creation of more accurate and representative “living guidelines”, and their recommendations can be individualised for national or personal purposes. National societies were invited to join this pan-European project to reap the benefits while preserving patient privacy and data security at the highest levels.

Prof. Ribal returned to the stage to present the EAU’s efforts to Guidelines adherence, first piloted with IMAGINE under the guiding principle of “let’s not just write guidelines, let’s make sure they reach every patient.” By involving countries from across Europe in this project, variations in adherence can be detected across countries and hospitals; it can uncover barriers to adoption and tailor interventions to promote better care. 

The national societies are key to reaching clinicians and advising based on familiarity with the local context. A draft manuscript for IMAGINE II, which investigated antibiotic prophylaxis for cystoscopy is currently being prepared. 

• More reporting about the Policy Office at the National Societies Meeting is forthcoming.

Beyond medical, surgical or scientific skills, urologists were invited to examine the importance of empathy, lifelong learning and also their own wellbeing. These “soft” topics would raise a lot of discussion, particularly in the afternoon’s break-out sessions where representatives compared their experiences. 

The activities of the European Board of Urology, an independent regulatory body and its cooperation with the EAU, EU-ACME (European Urology – Accredited Continuing Medical Education) are cornerstones of urology education in Europe and representatives of both bodies, together with the European School of Urology led discussion on lifelong learning. 

Representatives from countries where the FEBU exam had been adopted as a national certification exam explained their motivations and experiences. Advantages include close alignment with the EAU Guidelines, a desire to adopt European standards and the convenience of not having to design a national curriculum where one did not previously exist.

One topic that led to a lot of reflection was presented by Dr. Pia Kraft (CH), member of the EAU’s Young Urologists Office. She recently co-authored an editorial for European Urology that addressed the challenges for future urologists and how they could prepare for them.

Dr. Kraft pointed out that with technology and AI, a urologist’s tools have tremendously evolved over the past decades, “…but have we?” Her presentation introduced ideas of key leadership values, the personal health of the urologist, work-(family) life balance and their importance to keeping younger generations of urologists involved in the field and happy and effective in their ultimate job: patient care. Subsequent discussion covered definitions of empathy, measuring it through personality tests and assessments.

This was also a bridge to Office Urology Section member Dr. Stefan Haensel (NL), who was encouraged by the attendance at its non-medical session on “better urology practice” at EAU25. The EAU currently features sessions on empathy and other non-technical skills at its Talent Incubator Programme and its annual EUREP meeting, and at its Annual Congress going forward. Suggestions for useful exercises covered discussing complications in small groups, peer support for (potential) traumatic experiences and moral case deliberation.

The session ended with a return by Prof. Rogers, who highlighted how uniquely urology as a field is affected by stress, burn-outs and depression among practitioners. Huge differences in figures exist across Europe, as well as when comparing Europe to American evidence. Some US urology centres have adopted a “Chief Wellness Officer” to create a better working environment. Subsequent discussion with the audience speculated that the urologist classically has a broad commitment to the patient, guiding a patient’s entire journey from first consultation to the most impactful of treatments and possibly death. 

• Read more about this topic in our interview with Prof. Sønksen
   
• Afternoon sessions to be covered in a separate article.