Related Experiment Video
Updated: Jun 1, 2026
Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing
Published on: August 14, 2019
Evaluation of consistency between physician clinical impression and 3 validated survey instruments for measuring
Dona Schneider1, Akira Yamamoto, Joseph G Barone
1Edward J. Bloustein School of Planning and Public Policy, Rutgers University (DS), New Jersey, USA.
Insights
The Nelson survey showed the strongest correlation with physician impression for older children with lower urinary tract symptoms. This tool is most accurate for assessing symptom severity in pediatric patients.
Area of Science:
- Pediatric Urology
- Clinical Assessment
- Symptomology
Background:
- Lower urinary tract symptoms (LUTS) in children are often managed based on clinical history and physical examination.
- Accurate assessment of LUTS severity is crucial for effective treatment planning.
- Several symptom surveys exist to quantify LUTS, but their correlation with clinical judgment varies.
Purpose of the Study:
- To compare the accuracy of three validated tools in correlating with physician clinical impression for pediatric lower urinary tract symptoms.
- To determine which symptom survey best reflects a pediatric urologist's assessment of LUTS severity.
Main Methods:
- A cohort of 71 children (36 males, 35 females) with LUTS were evaluated.
- Children aged 4-10 completed the Dysfunctional Voiding Symptom Score (DVSS) and Akbal survey.
- Children aged 11-17 completed the Nelson survey.
- Survey scores were compared to the pediatric urologist's clinical impression using Kendall's tau-b rank correlation.
Main Results:
- All three surveys demonstrated statistically significant correlations with physician assessment of LUTS severity.
- The Dysfunctional Voiding Symptom Score (DVSS) showed a moderate correlation (tau-b 0.43) for younger children.
- The Akbal survey had a slightly lower correlation (tau-b 0.41) for younger children.
- The Nelson survey exhibited the strongest correlation (tau-b 0.48) for older children.
Conclusions:
- The Nelson survey is the most accurate tool for assessing lower urinary tract symptom severity in older pediatric patients, aligning best with clinical judgment.
- All evaluated surveys show statistical significance in correlating with physician impression.
- The choice of survey may depend on the age group of the pediatric patient.
Purpose:
Since many children with lower urinary tract symptoms are treated based on history and physical, it is important to know which symptom survey correlates best with the physician clinical impression. We evaluated 3 tools that have been demonstrated to predict severity of lower urinary tract symptoms, the Dysfunctional Voiding Symptom Score, the Akbal survey and the Nelson survey. Total scores from each survey were compared to clinical impression.
Materials And Methods:
Participants consisted of 36 males and 35 females referred to our pediatric urology center for lower urinary tract symptoms. A total of 37 children 4 to 10 years old completed the Dysfunctional Voiding Symptom Score with the help of their parents, and 34 of these parents completed the Akbal survey. A total of 35 children 11 to 17 years old completed the Nelson survey. Scores from the 3 instruments were compared to the clinical impression of a pediatric urologist using rank correlation (Kendall's tau-b test).
Results:
Mean total symptom scores were increased relative to physician rating for all 3 surveys. Symptoms reported by younger children using the Dysfunctional Voiding Symptom Score correlated better with physician rating of symptom severity (tau-b 0.43) compared to symptoms reported by parents using the Akbal survey (tau-b 0.41). Older children reporting symptoms using the Nelson survey had the strongest correlation with physician clinical impression (tau-b 0.48).
Conclusions:
All 3 surveys were statistically significantly correlated with the physician impression of severity for lower urinary tract symptoms, with the Nelson survey being the most accurate.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:22Nursing Assessment of the Genitourinary System III: Percussion and Auscultation
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:17Urinary Tract Infection IV: Nursing Management
01:30Urinary Tract Calculi III: Medical Management