Pediatric cystogram: Are we considering age-adjusted bladder capacity?
Bibliographic record
Abstract
INTRODUCTION: There are a small number of reports in the literature describing bladder rupture during cystograms in children. We hypothesized that children undergoing cystograms may have their bladder overfilled during the test. We aimed to evaluate the current practice when performing cystograms in our institution, contrasting actual volume used to fill the bladder to the age-adjusted bladder capacity. METHODS: We performed a retrospective review of all voiding cystourethrograms(VCUG) and radionuclide cystograms (RNC) performed at the Children's Hospital of Eastern Ontario from 2006-2013. Formulas used to estimate age-adjusted bladder capacity: 1) infants <1 year: Capacity (mL) = (2.5 × age [months]) + 38 (Holmdahl et al, 1996); and 2) older children >1 year: Capacity (mL) = (2 + age [years]) × 30 (Koff et al, 1983). RESULTS: A total of 2411 cystograms were done (1387 VCUG; 1024 RNC) in 817 infants and 1594 children older than one year - 1113 boys and 1298 girls. Generally, bladders tended to be overfilled with 32% more volume in mL than the expected age-adjusted bladder capacity - VCUG 151 (122) mL vs 120 (97) mL (p< 0.001) and RNC 191 (97) mL vs. 151(74) mL (p<0.001). Most importantly, infants had a striking overfilling rate of 64% and 38 % more volume than their expected age-adjusted bladder capacity for VCUG and RNC, respectively (p<0.001). CONCLUSION: Bladders are filled above the estimated age-adjusted capacity in mL at the following rates: 32% in the whole group and 64% in infants undergoing VCUG. It raises concern of possible bladder rupture in this age group. Furthermore, this may lead to overgrading and overdiagnosing of vesicoureteric reflux, as well as overestimation of post-void residual. Attention should be paid to filling to age-adjusted bladder capacity and allowing the child adequate time to void during performance of the cystogram.
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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 | 0.004 | 0.038 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".