"We make the argument in our discussion of this paper that any discussion further on cost needs to include encounters," says David D. Thiel, MD.
In this interview, David D. Thiel, MD, discusses potential future research from the study, “Conversion to Disposable Cystoscopes Decreased Post-procedure Encounters and Infections Compared to Reusable Cystoscopes.” Thiel is the chief of clinical practice at Mayo Clinic in Jacksonville, Florida.
Further research on this topic can go a long way. Number 1, there's going to be the cost issue. Other papers have started to discuss the cost issue of disposable scopes versus reusable scopes, but it's important when you look at the further research, you can't just say reusable scopes versus disposable scopes. When you look at reuse reusable scopes as a cost item, you have to do everything that comes with it: the preparation, the instrument processing, and that instrument processing not only includes the machines, the chemicals, but also the personnel required to do that. So, it has to include all of that.
And then, we make the argument in our discussion of this paper that any discussion further on cost needs to include encounters, because every time you call, we get a culture. Anytime you engage the system, that increases cost. So, we think that should be part of the cost argument.
There have been other papers that have demonstrated efficacy when you look at just surveillance of office cystoscopy, showing there's not much difference between reusable scopes and the disposable scopes. We don't think there's further avenue in that. I don't think there's going to be any more to saying "hey, can we see a tumor as well with the disposable scope compared to a reusable scope." I don't think there's much more to go there, so I think a lot of it's going to be in cost.
A third avenue will be the environmental concerns. But it's important when you look at that too, you can't just look at reusable scopes, "hey we reuse it," versus disposable scopes, we throw away, and you're going to say there's a lot of environmental concerns with that. But there's environmental concerns too with instrument processing as far as the amount of water that it generates, chemical waste, and so on. So, that's a further avenue to go with these disposable scopes. On a side note, it'll be interesting to note as more vendors come to the market – and this is laid out in editorial by Dr. Steinberg, as well, and it’s in our discussion – the cost of the disposable scopes will continue to go down as more and more vendors hit the market.
This transcription has been edited for clarity.