Yang and colleagues (2021) define diagnostic excellence as “an optimal process to attain an accurate and precise explanation about a patient’s condition. An optimal process would be timely, cost-effective, convenient, and understandable to the patient. An accurate and precise diagnosis gains clinical value insofar as it leads to better choices in treatment.” The American Urological Association (AUA) highlighted “enhancing diagnostic excellence” as a top priority in its National Quality Agenda and Strategies for Urologic Practice, emphasizing its importance in improving urologic health and urologic health care.

PSA Screening: Resources for Urologists, Primary Care Providers, and Patients

The Prostate-Specific Antigen (PSA) test is the tool most commonly used by both primary care providers (PCPs) and urologists to screen for prostate cancer. In its 2023 Early Detection of Prostate Cancer guideline, the AUA provides age- and risk-based recommendations for PSA screening and encourages shared decision-making regarding when to initiate, resume, and discontinue screening. Appropriate use of PSA screening is a key component of diagnostic excellence for urology. 

In 2023, the AUA received a grant from the Council of Medical Specialty Societies to promote diagnostic excellence and health equity in urology care. The objectives of this project were to increase awareness of general principles of diagnostic excellence and address the diagnostic challenges faced by urologists, PCPs, and Black men related to the early detection of prostate cancer. The AUA believes that the resources developed as part of this project will be valuable for urologists, PCPs, and patients in enhancing the early detection of prostate cancer through PSA screening.

Development of the following resources was funded by the Gordon and Betty Moore Foundation and the John A. Hartford Foundation through a grant program administered by the Council of Medical Specialty Societies. 

• Advancing Diagnostic Excellence and Health Equity: The Role of PSA Screening in Early Detection of Prostate Cancer
  Designed for urologists and PCPs, this resource includes an infographic on prostate cancer disparities and screening practices in the U.S. and an algorithm highlighting AUA’s PSA screening recommendations.
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• Prostate Cancer Screening Talking to Your Health Care Team Assessment Tool
  This patient-friendly screening assessment tool is designed to self-assess symptoms to help guide conversations about prostate cancer screening. This resource is offered from the Urology Care Foundation, the official foundation of the American Urological Association, and is available as a free download or may be ordered and shipped free in the U.S.
  
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• Prostate Cancer Screening What You Should Know
  This patient-friendly fact sheet is designed to aid in decision making about prostate cancer screening. This resource is offered from the Urology Care Foundation, the official foundation of the American Urological Association, and is available as a free download or may be ordered and shipped free in the U.S.
  
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• From Error to Excellence: An Evolving Paradigm for Improving the Diagnostic Process
  This JU Forum article introduces the concept of diagnostic excellence within the context of urology and describes several high-profile efforts to enhance diagnostic excellence by the AUA and others.
  • Link to the article pre-print
• Inside Tract Podcast Episode 244: Diagnostic Excellence in Urology Care
  In this podcast episode, Dr. Matthew Nielsen and Dr. David Friedlander define diagnostic excellence, provide examples of diagnostic excellence in urology, identify some of the challenges related to the diagnostic process for urology, and discuss some of the ways that the AUA is planning to help enhance diagnostic excellence going forward.
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