Assessing the Correlation of At-home Audio Testing and In-office Uroflowmetry: Moving Towards a New Gold-standard

To determine whether audio-based uroflowmetry is equivalent in accuracy and reliability to the in-clinic gold standard.

Men over age 18 with a chief complaint of lower urinary tract symptoms (LUTS) conducted a standard in-office uroflowmetry and used the Emano Flow phone application for 1 week to conduct audio-based uroflowmetry. Pearson correlation coefficient (PCC) was utilized to assess the relationship between conventional and the mean of audio-based Qmax after adjusting for the effect of void volume by performing residualization.

Thirty-two participants were recruited. On average, a patient's home volume was 2.18x (SD 1.67) higher than their clinic volume. Prior to adjusting for void volume, conventional and the mean of multiple at-home maximum flow rates were not correlated (PCC = 0.21, P = .31). After adjusting for void volume, conventional and mean of multiple at-home Qmax were significantly correlated (PCC = 0.41, P = .04).

Prior to adjusting for void volume, conventional and at-home maximum flow rates were not correlated. This can be explained, in part, by patients having one uncharacteristically low in-clinic on-demand void. Once we adjusted for void volume, office and at-home Qmax were correlated. As office Qmax may not accurately capture a patient's natural voiding patterns, our findings underscore the potential value of at-home testing. Further work is needed to improve the tools that we use for diagnosing and evaluating LUTS.