Mission

Through worldwide collaboration, CROES seeks to assess, using evidence based scientific methodology, the various aspects of clinical endourology.

Vision

By applying rigorous scientific evaluation to the field of clinical endourology, CROES will enable all urologic surgeons to bring to their patients the most effective and efficient care possible.

Projects

Contact

For more information please contact Sonja van Rees Vellinga (info@croesoffice.org).

CLINICAL RESEARCH OFFICE OF THE ENDOUROLOGY SOCIETY—GIVING DEVELOPING COUNTRIES THE OPPORTUNITY TO BE INVOLVED IN RESEARCH

John Denstedt

The Clinical Research Office of the Endourology Society (CROES) has in a very short time produced a significant research output resulting in more than 30 presentations at scientific meetings and 24 publications in the peer-reviewed literature. The impact as measured by citations has been impressive with 7.72 citations per publication. The concept of CROES is relatively unique in bringing together urologists from throughout the world in contributing cases to the global database resulting in a rapid accumulation of “real world” data in a short time from multiple institutions in many different healthcare systems. Involvement is by way of an open concept with the only criteria being an interest in contributing, being a member of the Endourology Society, and abiding by the reporting rules as set by the CROES Audit Committee. ¹ A tangential and extremely important benefit, in my opinion, is the dedicated engagement by many urologists from developing countries who have embraced this idea and enthusiastically become active participants in many CROES studies.

The CROES concept has met with considerable enthusiasm throughout the world with more than 300 urologists from more than 50 countries contributing cases to various CROES studies. In fact, in the CROES Ureteroscopy (URS) Study, more than half of the patients (n = 7039) have been included by urologists located in developing countries. India has especially contributed with an extensive number of URS cases (n = 1521). In addition, for the Renal Mass Study, developing countries have contributed many patients, with about one quarter (n = 1135) of the total inclusion being added by 35 centers from developing countries. Aside from the sheer contributions of clinical cases, there are additional benefits to the trend of engagement by urologists from developing countries.

The CROES offers those from developing countries the opportunity to be involved in high-quality research in collaboration with persons from the traditional academic centers in developed countries. Such an opportunity may not easily exist otherwise. Any participant in a CROES study can develop an idea, mine the database, and spearhead development of a manuscript as lead autho—and indeed investigators from developing countries have. Involvement of urologists from developing countries in the various committees and leadership of CROES also offers the possibility of engagement in research and research leadership that may not otherwise exist.

Some journals have noted the lack of applicability of their published work to developing countries—a challenge that the CROES easily begins to address by way of its open engagement with many participants from less advantaged parts of the world. This translates not only to benefits for the investigators but also for patients in developing countries who are not often represented in clinical research published in traditional journals. Sufficient enabling conditions can create a receptive environment for national and regional strategies that can encourage and enforce an institutional commitment to protect people and promote ethical conduct in research. ² The CROES offers those in developing countries who may not have research training or experience to hone their research skills, get excited about research, improve the research profile at their institutions, and foster a research culture among young people in their programs. This is exceedingly important at a time when geopolitical winds are blowing increasingly toward Asia and other developing parts of the world. More governments than ever before, even in very poor countries, are interested in building national scientific capacity as part of overall development and to improve health. ³

At the inception of the CROES, the perceived benefits were more traditional in nature—good scientific work, discovery, and sharing results. I doubt at the time we could have envisioned the powerful impact this idea has had on developing countries, their participant urologists, and treatment of the many patients in these countries. This legacy may ultimately be as powerful as the pure science that has been generated by CROES.