PD36-07 PREDICTION OF AUTONOMIC DYSREFLEXIA DURING URODYNAMICS
Bibliographic record
Abstract
INTRODUCTION AND OBJECTIVES: Urinary symptoms of overactive bladder (OAB), including urgency, frequency, nocturia, and urgency urinary incontinence are common in Parkinson disease (PD) and further worsen quality of life.Pelvic floor muscle exercise-based behavioral therapy is side effect free and effective for OAB symptoms in adults without PD.We sought to determine the efficacy of behavioral therapy for OAB symptoms in PD.METHODS: We conducted a randomized controlled trial of behavioral therapy compared to a control condition at two VA medical centers.Participants were diagnosed with PD by a movement disorders neurologist and had ! 4 episodes of urinary incontinence/week.Behavioral therapy included pelvic floor muscle exercises with urge suppression training, fluid modification, constipation management, and self-monitoring with a bladder diary.The control condition included a bladder diary and mirrored shape drawing.Outcomes were measured eight weeks postrandomization and included the International Consultation on Incontinence OAB symptom score (range 0-16) as well as bother and quality of life questionnaires (higher scores¼worse outcomes) and bladder diary-based weekly urinary incontinence.Outcomes were evaluated using intention-totreat analysis with generalized linear models adjusted for baseline symptoms and last observation carried forward for missing outcome data (11%).RESULTS: 53 participants were randomized and 47 reported 8week outcome data including 26 randomized to behavioral therapy and 21 to control (6 dropouts in control).Behavioral vs. control participants were similar with respect to age (71.0 Æ 6.1 vs. 69.7 Æ 8.2 years), gender (70% vs. 78% male), PD motor severity score, cognition, mean weekly urinary incontinence episodes (13.6 Æ 9.8 vs. 15.2Æ 11.1) and OAB symptoms (8.9 Æ 2.4 vs. 8.3 Æ 2.2).Behavioral therapy participants reported greater reduction in OAB symptoms compared to control ((-3.1 Æ 2.8) vs. (-1.3Æ 2.1), p¼0.02).Weekly urinary incontinence reduction was similar between behavioral (-5.3 Æ 8.7) and control participants (-4.9 Æ 11.5) (p¼0.4).After 8 weeks, quality of life and bother related to OAB were significantly improved among participants in behavioral therapy compared to control (p¼0.001 and p¼0.03).CONCLUSIONS: Behavioral therapy resulted in significantly greater improvement in OAB symptoms, bother, and quality of life compared with control.Weekly incontinence episodes improved in both groups, but without between-group differences.Providers should consider behavioral therapy as initial therapy for OAB symptoms in PD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".