是时候重新考虑我们如何记录儿科尿流研究了吗? : SPU Voiding Dysfunction工作组的一项研究
Jason P Van Batavia1, Hans G Pohl2, Walid A Farhat3
1Division of Urology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
Journal of pediatric urology
|June 11, 2023
概括
对于儿童的尿液流量测量解释,使用当前的标准显示不太一致. 基于流量指数和曲线图案的新系统为下尿道疾病提供了更可靠和客观的评估.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 诊断成像 诊断成像 诊断成像
- 医疗器械技术 医疗器械技术
背景情况:
- 尿流量计对于诊断和监测下尿路疾病至关重要.
- 儿科尿液流量计缺乏标准化正常值,这阻碍了临床解释.
- 目前的曲线模式分析严重依赖于主观医生的裁量权.
研究的目的:
- 评估在解释儿科尿液流曲线时的评估者间可靠性.
- 定义尿液流量计参数的客观标准.
- 改善尿流研究解释的标准化.
主要方法:
- 7名评级人员分析了来自5个地点的119个未识别的尿流研究.
- 使用国际儿童节制协会 (ICCS) 标准和光滑/分数 (SF) 系统来评估曲线模式.
- 计算了最大 (Qmax) 和平均 (Qavg) 流量的流量指数 (FI).
主要成果:
- 对ICCS (Kappa 0.34) 和钟/塔/高原 (BTP) 方法 (Kappa 0.28) 的互评价协议是公平的.
- 对于平滑曲线与分数曲线的分类,达成了实质性的协议 (Kappa 0.70).
- 差别分析显示,流量指数Qmax作为主导向量,使用SF系统的平滑曲线的预测率为72%,分数曲线的预测率为65.5%.
结论:
- 目前用于尿流曲线模式分析的ICCS标准显示,儿童的评分器间可靠性较差.
- 一个使用流量指数和光滑/断片曲线模式的拟议系统显示出更高的可靠性.
- 建议使用这种客观系统,以便在各中心之间更一致地解释尿流.
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