The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP‐tool): a Delphi consensus project on standardised evaluation of flexible ureterorenoscopes

British Journal of Urology, vol. 131, pp. 494–502

Abstract

OBJECTIVE: To develop a standardised tool to evaluate flexible ureterorenoscopes (fURS). MATERIALS AND METHODS: A three-stage consensus building approach based on the modified Delphi technique was performed under guidance of a steering group. First, scope- and user-related parameters used to evaluate fURS were identified through a systematic scoping review. Then, the main categories and subcategories were defined, and the expert panel was selected. Finally, a two-step modified Delphi consensus project was conducted to firstly obtain consensus on the relevance and exact definition of each (sub)category necessary to evaluate fURS, and secondly on the evaluation method (setting, used tools and unit of outcome) of those (sub)categories. Consensus was reached at a predefined threshold of 80% high agreement. RESULTS: The panel consisted of 30 experts in the field of endourology. The first step of the modified Delphi consensus project consisted of two questionnaires with a response rate of 97% (n = 29) for both. Consensus was reached for the relevance and definition of six main categories and 12 subcategories. The second step consisted of three questionnaires (response rate of 90%, 97% and 100%, respectively). Consensus was reached on the method of measurement for all (sub)categories. CONCLUSION: This modified Delphi consensus project reached consensus on a standardised grading tool for the evaluation of fURS - The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP) tool. This is a first step in creating uniformity in this field of research to facilitate future comparison of outcomes of the functionality and handling of fURS.

Authors 37

1. Michaël M.E.L. Henderickx corresponding

   Amsterdam UMC Location University of Amsterdam

   Affiliation as printed

   Department of Urology Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands

   Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands

2. Nora Hendriks Aachen Department of Urology Alrijne Hospital Leiden The Netherlands Department of Urology, Alrijne Hospital

   Amsterdam UMC Location University of Amsterdam · Alrijne Ziekenhuis

   Affiliation as printed

   Department of Urology Alrijne Hospital Leiden The Netherlands

   Department of Urology Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands

   Department of Urology, Alrijne Hospital, Leiden, The Netherlands

   Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands

3. Joyce Baard

   Amsterdam UMC Location University of Amsterdam

   Affiliation as printed

   Department of Urology Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands

   Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands

4. Oliver J. Wiseman

   Cambridge University Hospitals NHS Foundation Trust

   Affiliation as printed

   Department of Urology Cambridge University Hospitals NHS Foundation Trust Cambridge UK

   Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

5. Kymora B. Scotland

   University of California, Los Angeles

   Affiliation as printed

   Department of Urology University of California Los Angeles CA USA

   Department of Urology, University of California, Los Angeles, CA, USA

6. Bhaskar Kumar Somani

   University Hospital Southampton NHS Foundation Trust

   Affiliation as printed

   Department of Urology University Hospitals Southampton NHS Trust Southampton UK

   Department of Urology, University Hospitals Southampton NHS Trust, Southampton, UK

7. Tarık Emre Şener

   Marmara University

   Affiliation as printed

   Department of Urology Marmara University School of Medicine Istanbul Turkey

   Department of Urology, Marmara University School of Medicine, Istanbul, Turkey

8. Esteban Emiliani

   Puigvert Foundation

   Affiliation as printed

   Department of Urology Fundacio Puigvert Barcelona Spain

   Department of Urology, Fundacio Puigvert, Barcelona, Spain

9. Laurian B. Dragos

   Cambridge University Hospitals NHS Foundation Trust

   Affiliation as printed

   Department of Urology Cambridge University Hospitals NHS Foundation Trust Cambridge UK

   Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

10. Luca Villa

    Vita-Salute San Raffaele University

    Affiliation as printed

    Department of Urology Università Vita – Salute San Raffaele Milan Italy

11. Michele Talso

    Luigi Sacco Hospital · ASST Fatebenefratelli Sacco

    Affiliation as printed

    Department of Urology ASST Fatebenefratelli Sacco – Ospedale Luigi Sacco University Hospital Milan Italy

12. Saeed Bin Hamri

    King Saud bin Abdulaziz University for Health Sciences · King Abdulaziz Medical City · King Abdullah International Medical Research Center

    Affiliation as printed

    Department of Urology, King Abdullah International Medical Research Center, College of Medicine, King Abdulaziz Medical City King Saud Bin Abdulaziz University for Health Science Riyadh Saudi Arabia

    Department of Urology, King Abdullah International Medical Research Center, College of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia

13. Silvia Proietti

    IRCCS Ospedale San Raffaele

    Affiliation as printed

    Department of Urology IRCCS San Raffaele Hospital Milan Italy

    Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy

14. Steeve Doizi

    Sorbonne Université · Assistance Publique – Hôpitaux de Paris · Hôpital Tenon

    Affiliation as printed

    Department of Urology Hopital Tenon Paris France

    Sorbonne Université, 27063, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire Paris France

    Department of Urology, Hopital Tenon, Paris, France

15. Olivier Traxer

    Sorbonne Université · Assistance Publique – Hôpitaux de Paris · Hôpital Tenon

    Affiliation as printed

    Department of Urology Hopital Tenon Paris France

    Sorbonne Université, 27063, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire Paris France

    Department of Urology, Hopital Tenon, Paris, France

16. Ben Hall Chew

    University of British Columbia

    Affiliation as printed

    Department of Urology University of British Columbia Vancouver BC Canada

    Department of Urology, University of British Columbia, Vancouver, BC, Canada

17. Brian Howard Eisner

    Harvard University · Massachusetts General Hospital

    Affiliation as printed

    Department of Urology, Harvard Medical School Massachusetts General Hospital Boston MA USA

    Department of Urology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

18. Manoj Monga

    University of California San Diego

    Affiliation as printed

    Department of Urology University of California San Diego San Diego CA USA

    Department of Urology, University of California San Diego, San Diego, CA, USA

19. Ryan S. Hsi

    Vanderbilt University Medical Center

    Affiliation as printed

    Department of Urology Vanderbilt University Medical Center Nashville TN USA

    Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA

20. Karen Stern

    Mayo Clinic · Mayo Clinic Hospital

    Affiliation as printed

    Department of Urology Mayo Clinic Phoenix AZ USA

    Department of Urology, Mayo Clinic, Phoenix, AZ, USA

21. David Leavitt

    Henry Ford Health · Henry Ford Hospital

    Affiliation as printed

    Department of Urology, Vattikuti Urology Institute Henry Ford Hospital Detroit MI USA

    Department of Urology, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA

22. Marcelino Rivera

    Indiana University Indianapolis · Indiana University School of Medicine

    Affiliation as printed

    Department of Urology Indiana University School of Medicine Indianapolis IN USA

    Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA

23. Daniel Arthur Wollin

    Brigham and Women's Hospital · Harvard University

    Affiliation as printed

    Department of Urology, Harvard Medical School Brigham and Women's Hospital Boston MA USA

    Department of Urology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA

24. Michael Seth Borofsky

    University of Minnesota

    Affiliation as printed

    Department of Urology University of Minnesota Minneapolis MN USA

    Department of Urology, University of Minnesota, Minneapolis, MN, USA

25. Noah E. Canvasser

    University of California Davis Medical Center · UC Davis Health · University of California, Davis

    Affiliation as printed

    Department of Urology University of California Davis Health System Sacramento CA USA

    Department of Urology, University of California Davis Health System, Sacramento, CA, USA

26. Johann Pall Ingimarsson

    Maine Medical Center · Maine Medical Center

    Affiliation as printed

    Department of Urology Maine Medical Center South Portland ME USA

    Department of Urology, Maine Medical Center, South Portland, ME, USA

27. Marawan M. El Tayeb

    Baylor Scott & White Medical Center - Temple

    Affiliation as printed

    Department of Urology Baylor Scott & White Medical Center – Temple Temple TX USA

28. Naeem Bhojani

    Centre Hospitalier de l’Université de Montréal · Université de Montréal

    Affiliation as printed

    Department of Urology, Centre Hospitalier de l'Université de Montréal Université de Montréal Montreal QC Canada

29. Nariman K. Gadzhiev
    Affiliation as printed

    Department of Urology Endourology Academy Istanbul Turkey

    Department of Urology, Endourology Academy, Istanbul, Turkey

30. Thomas O. Tailly

    Ghent University Hospital

    Affiliation as printed

    Department of Urology University Hospital Ghent Ghent Belgium

    Department of Urology, University Hospital Ghent, Ghent, Belgium

31. Otaš Durutović

    Univerzitetski Klinički Centar Srbije

    Affiliation as printed

    Department of Urology University Clinical Center of Serbia Belgrade Serbia

    Department of Urology, University Clinical Center of Serbia, Belgrade, Serbia

32. Udo Nagele
    Affiliation as printed

    Department of Urology General Hospital Hall I.T. Hall in Tirol Austria

    Department of Urology, General Hospital Hall I.T., Hall in Tirol, Austria

33. Andreas A. Skolarikos

    National and Kapodistrian University of Athens

    Affiliation as printed

    Department of Urology University of Athens Athens Greece

    Department of Urology, University of Athens, Athens, Greece

34. Barbara M. A. Schout Aachen Department of Urology Alrijne Hospital Leiden The Netherlands Department of Urology, Alrijne Hospital

    Alrijne Ziekenhuis

    Affiliation as printed

    Department of Urology Alrijne Hospital Leiden The Netherlands

    Department of Urology, Alrijne Hospital, Leiden, The Netherlands

35. Harrie P. Beerlage

    Amsterdam UMC Location University of Amsterdam

    Affiliation as printed

    Department of Urology Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands

    Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands

36. Rob C.M. Pelger Aachen Department of Urology Department of Urology, Leids UMC

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Department of Urology, Leids UMC University of Leiden Leiden The Netherlands

    Department of Urology, Leids UMC, University of Leiden, Leiden, The Netherlands

37. Guido Maarten Kamphuis

    Amsterdam UMC Location University of Amsterdam

    Affiliation as printed

    Department of Urology Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands

    Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands