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Assessment of urinary symptoms in children with dysfunctional elimination syndrome
Hüsnü Tokgöz1, Mustafa Ozgür Tan, Ilker Sen
1Faculty of Medicine, Department of Urology, Gazi University, Ankara, Turkey.
Insights
A new 15-item scale helps diagnose dysfunctional elimination syndrome (DES) in children by assessing urinary and bowel symptoms. This validated tool aids in diagnosis, treatment monitoring, and screening for pediatric DES.
Area of Science:
- Pediatric Urology
- Clinical Assessment Tools
- Child Health
Background:
- Dysfunctional elimination syndrome (DES) presents with various urinary and bowel symptoms in children.
- Accurate diagnosis and assessment are crucial for effective management of pediatric DES.
- Existing diagnostic methods may lack objective symptom severity assessment.
Purpose of the Study:
- To develop and validate a symptom scale for the diagnosis and assessment of dysfunctional elimination syndrome (DES) in children.
- To create an objective tool for evaluating symptom severity in pediatric DES patients.
- To establish a reliable scoring system for diagnosis, treatment confirmation, and follow-up.
Main Methods:
- A 35-item questionnaire was administered to 81 children with DES symptoms and 102 controls.
- Statistical analysis, including P-value <0.05 and AUC >0.6, was used to select relevant questions.
- A final 15-item scale was developed based on the analysis of questionnaire data.
Main Results:
- The final scale comprised 15 questions.
- A total population cut-off score of 7.5 demonstrated high sensitivity (85.2%) and specificity (93.1%) for DES diagnosis (AUC=0.943).
- Specific cut-off scores were identified for males (4.5) and females (7.5) with high diagnostic accuracy.
Conclusions:
- A validated 15-item scoring system provides objective assessment for children with DES.
- The developed scale can be a valuable tool for diagnosis, treatment evaluation, and follow-up of pediatric DES.
- The scale may also serve as an effective screening tool for identifying children with DES.
Objective:
This study was organized to form a symptom scale for diagnosis and assessment of urinary and bowel symptoms in children with dysfunctional elimination syndrome (DES).
Methods:
The study group included 81 children presented to our clinic with symptoms of DES like enuresis, abnormal voiding, urinary tract infection and urgency, between January 2003 and February 2004. Age matched 102 children with no history of urological complaints were randomly recruited from a public school as control group. Children with isolated, mono-symptomatic nocturnal enuresis were not taken to the study. All children and parents were requested to fill a 35-item questionnaire related to symptoms of DES. After statistical analysis, questions from the initial form that had a P-value <0.05 and an area under curve (AUC) value >0.6 were selected to form a final scale.
Results:
The mean ages for study and control groups were 8.7 +/- 2.5 and 8.3 +/- 2.2 years, respectively (P = 0.236). The final scale was composed of 15 questions. The cut-off score for the presence of DES was determined as 7.5 (sensitivity 85.2%, specificity 93.1%, AUC value = 0.943) for the total population. When only the male population were concerned the cut-off score was 4.5 (sensitivity 93.8%, specificity 78%, AUC value = 0.913) while the cut-off score for the female population was 7.5 (sensitivity 87.7%, specificity 94.2%, AUC value = 0.953).
Conclusion:
Providing objective assessment of symptom severity, formation of a validated scoring system for children with DES might be a good tool for diagnosis, confirmation of treatment results and follow up. It might also be useful for screening purposes.
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