MP37-07 COGNITIVE IMPAIRMENT, TECHNOPHILIA, AND SACRAL NEUROMODULATION DEVICE USE IN AN OLDER PATIENT POPULATION WITH OVERACTIVE BLADDER
Bibliographic record
Abstract
You have accessJournal of UrologyCME1 Apr 2023MP37-07 COGNITIVE IMPAIRMENT, TECHNOPHILIA, AND SACRAL NEUROMODULATION DEVICE USE IN AN OLDER PATIENT POPULATION WITH OVERACTIVE BLADDER Chen Shenhar, Jacquelyn Booher, Lauren Gleich, Sarah Martin, Glenn T. Werneburg, Emily Slopnick, Sandip P. Vasavada, Bradley Gill, Howard B. Goldman, and Jacqueline Zillioux Chen ShenharChen Shenhar More articles by this author , Jacquelyn BooherJacquelyn Booher More articles by this author , Lauren GleichLauren Gleich More articles by this author , Sarah MartinSarah Martin More articles by this author , Glenn T. WerneburgGlenn T. Werneburg More articles by this author , Emily SlopnickEmily Slopnick More articles by this author , Sandip P. VasavadaSandip P. Vasavada More articles by this author , Bradley GillBradley Gill More articles by this author , Howard B. GoldmanHoward B. Goldman More articles by this author , and Jacqueline ZilliouxJacqueline Zillioux More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003275.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Anticholinergics, a common treatment for overactive bladder (OAB), are associated with new-onset dementia and their use for >3 months was recently cautioned against in all age groups. Non-anticholinergic therapies, including sacral neuromodulation (SNM), should therefore be optimized; however, data on SNM in older or cognitively impaired (CI) populations are limited. The aim of this study was to assess cognitive impairment, technophilia, and device utilization in an older population undergoing SNM for refractory OAB. METHODS: This is a secondary analysis of an ongoing IRB-approved prospective study on cognitive function and SNM outcomes, focusing on technophilia and device utilization. Patients aged ≥60 years undergoing test-phase SNM for refractory OAB were recruited. Cognitive function was assessed using the validated Montreal Cognitive Assessment (MoCA) tool, with scores <26/30 considered CI. Baseline functional status and technology comfort/use were assessed using a novel questionnaire, and OAB symptoms were assessed initially and at follow-up utilizing validated questionnaires (OAB-q SF, IIQ7, UDI-6, PGI-I). Patient device utilization, familiarity with communicator and ability to adjust amplitude/program were recorded at follow-up. Baseline technology use/comfort and post-implant device utilization were compared based on CI. RESULTS: Fifty-eight patients underwent test-phase (36 PNE, 22 Stage 1). Mean age was 73±8 years and 95% were women. Mean MoCA score was 23.1±4.4, and 67% met CI criteria. Forty-nine (85%) had successful test-phase, of which 45 patients have undergone full implant and 38 have available follow-up data. At baseline, patients with CI had lower use and comfort levels with various technologies (Table 1). At mean 4.1±2 months follow-up, patients with CI were less involved in changing programs (p=0.004) or amplitudes (p=0.007) on their own, but patient-reported improvement did not differ (Table 1). CONCLUSIONS: Older patients presenting for SNM for OAB have a high incidence of CI. Despite lower baseline self-reported use/comfort with technology and lower SNM device utilization post-implant among those with CI, patient-reported outcomes appear similar over short-term follow-up. Source of Funding: Investigator initiated Medtronic research grant © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e515 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chen Shenhar More articles by this author Jacquelyn Booher More articles by this author Lauren Gleich More articles by this author Sarah Martin More articles by this author Glenn T. Werneburg More articles by this author Emily Slopnick More articles by this author Sandip P. Vasavada More articles by this author Bradley Gill More articles by this author Howard B. Goldman More articles by this author Jacqueline Zillioux 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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.070 | 0.007 |
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".