Comparison of a Voiding Diary With Clinical Management Tool As an Outpatient Screening Tool for Childhood Functional...

Area of Science:

• Pediatric Urology
• Clinical Diagnostics
• Child Health

Background:

• Nocturnal enuresis and voiding disorders are common in children.
• Accurate differentiation is crucial for appropriate management.
• Questionnaire-based tools offer initial screening, but their diagnostic accuracy requires validation.

Purpose of the Study:

• To evaluate the agreement between a questionnaire-based assessment (Clinical Management Tool - CMT) and a 48-hour voiding diary.
• To determine the utility of each tool in differentiating primary mono-symptomatic nocturnal enuresis from other voiding disorders in children aged 5-12 years.

Main Methods:

• A prospective study involving 100 children (5-12 years) with enuresis.
• Parents completed a CMT questionnaire and a 48-hour voiding diary.
• Classification agreement was assessed using Cohen's kappa statistic.

Main Results:

• The study analyzed 100 children, with 11.2% of 1276 screened participants reporting enuresis.
• Questionnaire-based assessment identified 65% as having a voiding disorder, while the voiding diary identified 71%.
• Moderate agreement (Cohen's kappa = 0.542) was found between the two methods, with 20% classification discordance. The voiding diary identified an additional 7% of cases with voiding disorders.

Conclusions:

• The Clinical Management Tool (CMT) questionnaire and voiding diary demonstrate moderate agreement in diagnosing childhood voiding disorders.
• Voiding diaries are recommended for children who initially screen negative via questionnaire-based tools to ensure accurate diagnosis.
• Further refinement of diagnostic tools is needed for optimal management of pediatric voiding dysfunction.