The Efficacy of Penile Duplex Ultrasound in Erectile Dysfunction Management Decision-Making: A Systematic Review
Bibliographic record
Abstract
INTRODUCTION: The diagnosis of erectile dysfunction (ED) often involves a combination of patient history, questionnaire responses, and laboratory results. Penile duplex ultrasound (PDU) with intracavernous injection of papaverine was introduced as a noninvasive tool to aid in the evaluation of penile circulation. Although PDU is widely used in the initial workup of ED, the true value and effect of PDU on management is still unclear. OBJECTIVE: The objective of this systematic review was to determine if PDU affects ED management. METHODS: A systematic literature review was conducted using PUBMED-Medline databases in June 2020, which included literature from 1991 through 2019. The search strategy used MeSH terms "penile", "duplex ultrasound", or "duplex ultrasonography". The database process yielded a total of 389 terms. Systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. RESULTS: 6 studies were included in the final analysis and included a total of 386 patients. These articles each discussed the clinical utility of PDU using venous and arterial parameters and correlated treatment response to sexual functioning questionnaires. The majority of the studies demonstrated PDU was unnecessary for diagnosis and ultimately did not affect treatment decision-making. CONCLUSION: PDU generally does not change management in men with established organic ED but may prove useful in special populations such as in younger patients or patients with anatomical abnormalities. Limitations include the small number of focused studies on the topic and paucity of randomized trials investigating PDU and clinician decision-making. Further investigations and studies are needed to determine if PDU modifies ED provider's management decision-making. Nashed A, Lokeshwar SD, Frech F, et al. The Efficacy of Penile Duplex Ultrasound in Erectile Dysfunction Management Decision-Making: A Systematic Review. Sex Med Rev 2021;9:472-477.
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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 | 0.012 | 0.063 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.011 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".