{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T23:28:37Z","timestamp":1716938917108},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Over the past decade, clinical practice guidelines and educational campaigns have counselled against the use of routine ultrasound (US) in the diagnosis of undescended testes (UDT). We aimed to establish whether or not there has been change in the proportion of children with UDT undergoing pre-referral US prior to referral to our centre over this period. We also sought to determine whether type of referring specialist, UDT diagnosis, and patient distance from the hospital had impacted the rate of pre-referral US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A select sample of hospital charts of children undergoing orchidopexy at a single tertiary paediatric urological referral centre between 2010 and 2019 were reviewed. Data regarding age at surgery, cryptorchidism diagnosis, type of referring physician, patient distance from institution, and evidence of US as part of diagnostic work-up were extracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred charts were examined. Referring provider specialty impacted the number of US ordered (P=0.01). On subset analysis, paediatricians ordered fewer US for children with palpable UDT in 2014 (P=0.03). In 2018, community urologists ordered no US (P=0.02). These findings had temporal relationships with guideline release. The proportion of children undergoing US each year remained consistently between 50% and 62%, except in 2014, when only 36% had US. Distance from hospital and UDT diagnosis were of no significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite clinical practice guidelines and Choosing Wisely campaign recommendations, significant numbers of children with UDT still undergo US. Transient changes in sub-specialty guideline adherence are observed. Strategies to improve sustained guideline awareness in referring clinicians need to be considered.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pch\/pxaa099","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T11:48:56Z","timestamp":1602071336000},"page":"299-304","source":"Crossref","is-referenced-by-count":3,"title":["Unnecessary ultrasounds in children with undescended testes: An interrogation of the impact of the Choosing Wisely campaigns and clinical practice guidelines"],"prefix":"10.1093","volume":"26","author":[{"given":"Karen","family":"Milford","sequence":"first","affiliation":[{"name":"The Division of Urology, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Pokarowski","sequence":"additional","affiliation":[{"name":"The Division of Urology, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Chua","sequence":"additional","affiliation":[{"name":"The Division of Urology, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"The Division of Urology, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Koyle","sequence":"additional","affiliation":[{"name":"The Division of Urology, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"issue":"1","key":"2021072819100542800_CIT0001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2605.2007.00770.x","article-title":"The frequency of undescended testis from birth to adulthood: A review","volume":"31","author":"Sijstermans","year":"2008","journal-title":"Int J Androl"},{"issue":"7","key":"2021072819100542800_CIT0002","doi-asserted-by":"crossref","first-page":"E251","DOI":"10.5489\/cuaj.4585","article-title":"Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism","volume":"11","author":"Braga","year":"2017","journal-title":"Can Urol Assoc J"},{"issue":"2","key":"2021072819100542800_CIT0003","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.juro.2014.05.005","article-title":"Evaluation and treatment of cryptorchidism: AUA guideline","volume":"192","author":"Kolon","year":"2014","journal-title":"J Urol"},{"issue":"4","key":"2021072819100542800_CIT0004","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/fampra\/cmx128","article-title":"Use of ultrasound for the palpable undescended testis: A wasteful practice","volume":"35","author":"Wayne","year":"2018","journal-title":"Fam Pract"},{"issue":"12","key":"2021072819100542800_CIT0005","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1016\/j.jpedsurg.2011.08.008","article-title":"Diagnostic imaging in cryptorchidism: Utility, indications, and effectiveness","volume":"46","author":"Tasian","year":"2011","journal-title":"J Pediatr Surg"},{"issue":"1","key":"2021072819100542800_CIT0006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1542\/peds.2010-1800","article-title":"Diagnostic performance of ultrasound in nonpalpable cryptorchidism: A systematic review and meta-analysis","volume":"127","author":"Tasian","year":"2011","journal-title":"Pediatrics"},{"issue":"3","key":"2021072819100542800_CIT0007","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1542\/peds.2015-0222","article-title":"Inappropriate use of ultrasound in management of pediatric cryptorchidism","volume":"136","author":"Kanaroglou","year":"2015","journal-title":"Pediatrics"},{"key":"2021072819100542800_CIT0008","author":"Tekgu\u0308l","year":"(2011, 8 - 11).","journal-title":"Guidelines on Paediatric Urology"},{"key":"2021072819100542800_CIT0009","author":"Penson","year":"2012"},{"key":"2021072819100542800_CIT0010","first-page":"1","article-title":"American Urological Association (AUA) guideline\u2014evaluation and treatment of cryptorchidism: American Urological Association Cryptorchidism","author":"Kolon","year":"2014","journal-title":"AUA Clin Guidel"},{"key":"2021072819100542800_CIT0011","author":"Al-Hamali S, Barnes N, Davies P, et al. Commissioning Guide: Paediatric Orchidopexy for Undescended Testis. British Association of Paediatric Surgeons","year":"2015"},{"key":"2021072819100542800_CIT0012","author":"American Urological Association.","year":"2013"},{"key":"2021072819100542800_CIT0013","volume-title":"Urology: Five Things Physicians and Patients Should Question","author":"Canadian Urological Association.","year":"2017"},{"key":"2021072819100542800_CIT0014","volume-title":"The College of Physicians and Surgeons of Ontario","author":"Doctor Search [Internet]","year":"2019"},{"key":"2021072819100542800_CIT0015","author":"Google Map Data [Internet]. 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