Establishing a clinician-prioritized pediatric urology clinical research agenda in the United States.

INTRODUCTION

Most studies in pediatric urology have been limited to single-center retrospective designs with inherent limitations. Ideally, pediatric urology research would be collaborative, cross-institutional, and guided by shared priorities supported by funding mechanisms that enable rigorous study designs.

OBJECTIVE

To promote collaborative research in the highest-priority areas of the field, we aimed to engage pediatric urologists to establish a shared clinical research agenda through a structured, consensus-based process.

STUDY

DESIGN

We employed a 3-phase approach. First, we surveyed frontline pediatric urologists in the United States to elicit research questions addressing gaps in clinical knowledge. Next, we reviewed and refined responses to inform a three-round modified Delphi prioritization with a 22-member working group. Questions meeting consensus in the final Delphi round were advanced to the final phase where an in-person 11-member workshop developed a preliminary research agenda. This agenda was subsequently finalized through electronic feedback and endorsement by the full working group.

RESULTS

Eighty-eight pediatric urologists submitted 256 questions during the elicitation phase. Overlapping or redundant submissions were consolidated, resulting in 64 unique questions that advanced to prioritization. Following three Delphi rounds, this list was narrowed to 10, and the consensus workshop endorsed 6 final priorities.

DISCUSSION: We describe a structured, consensus-based process to establish clinical research priorities for pediatric urology. Through three phases of elicitation, prioritization, and a consensus workshop, we engaged the pediatric urology community to identify six clinical research priorities. Next steps include targeted dissemination to major funders and professional societies to guide future research and funding priorities. The initial phase of this study focused on clinician input and was limited in stakeholder diversity due to lack of representation from allied health professionals and researchers who are not practicing urologists and other specialists in urologic disease (e.g., nephrology, infectious diseases) as well as lack of patient or family perspectives. The next phase will include further refinement of these broad priorities into actionable research questions through an iterative, multi-stakeholder process involving affected patients and families as well as interdisciplinary providers and methodological panelists.

CONCLUSION

This clinician-prioritized research agenda reflects the most pressing clinical research gaps in pediatric urology in the United States, identified through broad engagement with pediatric urologists. Future work should ensure alignment of clinician-identified priorities with those of patients and caregivers. The ultimate goal is to direct collaborative, multi-institutional, and multinational efforts that strengthen the evidence base, inform clinical guidelines, and improve patient care in pediatric urology.