Behavioral Economics in Urology: A Scoping Review

Purpose: Behavioral economics is the study of human behavior in the context of irrationality, self-control and self-interest. It has been leveraged in a variety of ways in health care, including efforts to decrease smoking, encourage weight loss and promote medication adherence. Concepts from this field can be used to help urologists better understand and improve behavior-dependent clinical outcomes. Our objective in this scoping review was to assess the current state of behavioral economics in the urological literature. Materials and Methods: We conducted a scoping review of behavioral economic research in urology by performing a broad search in MEDLINE(R), Embase(R) and Scopus(R) databases from inception to August 30, 2021. Abstracts were screened, assessed for relevancy and selected for full-text review. A qualitative synthesis of selected manuscripts was then performed. Results: A total of 1,855 articles were identified. Sixty-one articles were selected for full-text review. Of those, 13 were selected for qualitative synthesis. The selected articles included reports of prospective trials (6), ongoing prospective trial methods (1), abstracts without a published manuscript (4) and commentaries (2). A variety of topics were covered: prostate cancer (5), resident education (2), hematuria (1), incontinence (1), surgical costs (1), care pathways (1), nephrolithiasis (1) and bladder cancer (1). Conclusions: There is a very limited number of articles, and even fewer trials, in urology that leverage behavioral economic concepts. Given this, and the successful application of behavioral economics in other medical disciplines, there is a need for behavioral economic informed urological interventions and welldesigned trials to evaluate behavioral economics outcomes in urology.