了解在英格兰肾肿瘤诊断途径中实施肾肿瘤活检 (RTB) 的促进因素和障碍。参与者包括在英格兰五个三级中心之一诊断和/或治疗肾肿瘤的患者、医疗保健机构参与直接护理肾肿瘤患者的专业人员以及临床服务经理和专员。该研究采用了混合方法的研究方法，包括个人访谈和在线调查，探讨个人感知和经历的促进因素和障碍的类型以及报告这些因素的频率。数据收集完成后举行了一次公共传播活动；以便于讨论实施 RTB 的潜在解决方案。对 50 名参与者进行了访谈（23 名患者、22 名临床医生和 5 名卫生服务专员/运营经理）。患者在线调查收到 52 份回复，临床医生调查收到 22 份回复。患者在选择是否接受 RTB 时最常报告的影响因素涉及想要了解其肾脏质量的诊断 (40%)、医疗保健专业人员提供的建议或信息 (40%) 以及不希望延误治疗 (23%) 。临床医生最常报告推荐 RTB 的障碍与诊断准确性的不确定性 (56%)、预约或医院床位的可用性 (52%)、对出血风险的担忧 (44%)、播种风险 (41%) 和延迟实现国家癌症途径目标（41%）。 18 名参与者（7 名患者和 11 名临床医生）参加了传播活动。改进实施的建议包括通过共识声明减少差异和促进实践标准化、增加证据基础（临床医生）以及通过开发更好的患者辅助工具（例如视频和图表）改善沟通（患者和临床医生）。RTB 的实施可能取决于所提供信息的质量、格式和信息的可靠性。通过就活检的作用达成共识声明，患者表达对患者视频等替代信息辅助工具的偏好，可以提高 RTB 的利用率。© 2024 作者。 BJU International 约翰·威利 (John Wiley) 出版

To understand the facilitators and barriers to the implementation of renal tumour biopsy (RTB) in the diagnostic pathway for renal tumours in England.Participants consisted of patients who had a renal tumour diagnosed and/or treated at one of five tertiary centres in England, healthcare professionals involved in the direct care of patients diagnosed with renal tumours, and clinical service managers and commissioners. The study employed a mixed-methods research methodology consisting of individual interviews and an on-line survey that explored the types of facilitators and barriers individuals perceived and experienced and the frequency in which these were reported. A public dissemination event took place following the completion of data collection; to facilitate discussion of potential solutions to implementing RTB.There were 50 participant interviews (23 patients, 22 clinicians, and five health service commissioners/operations managers). The patient on-line survey received 52 responses, and the clinician survey received 22 responses. Patients most frequently reported influences in choosing whether to undergo RTB pertained to wanting to know the diagnosis of their kidney mass (40%), the advice or information provided by healthcare professionals (40%), and not wishing to delay treatment (23%). Clinicians most frequently reported barriers to recommending RTB related to their uncertainty of diagnostic accuracy (56%), availability of appointments or hospital beds (52%), concerns of risk of bleeding (44%), risk of seeding (41%), and delays in meeting national cancer pathway targets (41%). The dissemination event was attended by 18 participants (seven patients and 11 clinicians). Suggestions to improve implementation included reducing variation and promotion of standardisation of practice by a consensus statement, increasing the evidence base (clinicians) and improved communication by developing better patient aids such as videos and diagrams (patients and clinicians).Implementation of RTB may be dependent on the quality of information provided, its format and perceived reliability of the information. Increased utilisation of RTB may be improved by development of a consensus statement on the role of biopsy, with patients expressing a preference for alternative information aids such as patient videos.© 2024 The Author(s). BJU International published by John Wiley & Sons Ltd on behalf of BJU International.