MP07-14 VALIDATION OF UPPER EXTREMITY MOTOR FUNCTION AS A KEY PREDICTOR OF BLADDER MANAGEMENT FOLLOWING SPINAL CORD INJURY
Bibliographic record
Abstract
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (MP07)1 Apr 2019MP07-14 VALIDATION OF UPPER EXTREMITY MOTOR FUNCTION AS A KEY PREDICTOR OF BLADDER MANAGEMENT FOLLOWING SPINAL CORD INJURY Christopher Elliott, Sara Lenherr*, Jeremy Myers, John Stoffel, Blayne Welk, Sean Elliott, and Kazuko Shem Christopher ElliottChristopher Elliott More articles by this author , Sara Lenherr*Sara Lenherr* More articles by this author , Jeremy MyersJeremy Myers More articles by this author , John StoffelJohn Stoffel More articles by this author , Blayne WelkBlayne Welk More articles by this author , Sean ElliottSean Elliott More articles by this author , and Kazuko ShemKazuko Shem More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555098.92014.58AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: In those unable to volitionally void after spinal cord injury (SCI), clean intermittent catheterization (CIC) is considered the gold standard in bladder management. Despite physician recommendation however, many persons with SCI choose alternative bladder management methods. Our prior research has identified that increased upper extremity (UE) motor function is highly predictive of increased CIC adoption and adherence after SCI. Our findings however have been questioned as the UE motor function scale used was based on expert opinion only. Our aim was to reexamine the role of UE motor function using a distinct validated instrument. METHODS: We examined the NBRG registry, a multicenter, prospective, observational study assessing patient reported outcomes among persons with SCI. We included all participants who were unable to volitionally void one year or more post-injury. Participants were dichotomized by bladder management (CIC vs other). In addition to demographic and clinical characteristics, UE motor function was examined using the SCI-Fine Motor Function Index employing a validated categorization scheme (1. no activities requiring hand function, 2. some activities involving gross hand movement, 3. some activities requiring dexterity or coordinated upper extremity movement or 4. most activities requiring dexterity and coordinated upper extremity movement). RESULTS: A total of 1326 individuals met inclusion criteria (66% performing CIC, 60% male and 82% Caucasian). On multivariate analysis, increasing UE motor function was statistically associated with an increased odds of performing CIC; the absolute proportion performing CIC as the SCI-Fine Motor Function Index increased was 37.9%, 34.2%, 57.1% and 78.6% respectively. Increasing age, increasing years since injury, obese females, non-white race, increasing Charlson comorbidity score and worse SF-12 physical scores were all associated with a significantly decreased odds of performing CIC (Table 1). CONCLUSIONS: In persons with SCI who are unable to volitionally void, UE motor function is highly associated with CIC adoption/adherence after SCI. These results validate our prior study findings and continue to suggest that UE motor function may predict the use of CIC more than any other factor following SCI. Source of Funding: Patient Centered Outcomes Research Institute (PCORI) CER14092138. San Jose, CA; Salt Lake City, UT; Ann Arbor, MI; Ontario, Canada; Minneapolis, MN; San Jose, CA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e95-e95 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Elliott More articles by this author Sara Lenherr* More articles by this author Jeremy Myers More articles by this author John Stoffel More articles by this author Blayne Welk More articles by this author Sean Elliott More articles by this author Kazuko Shem More articles by this author Expand All Advertisement PDF downloadLoading ...
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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 | 0.032 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.021 | 0.010 |
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".