Diagnostic Performances of Patient's Interview, Uroflowmetry Alone and Uroflowmetry Paired With Electromyography as Screening Tools to Identify Straining to Void
Bibliographic record
Abstract
AIMS: To assess the diagnostic performances of patient's interview, final uroflowmetry alone and final uroflowmetry paired with rectus abdominis muscle electromyography (EMG) as screening tools to identify straining to void. METHODS: All consecutive patients who underwent a multi-channel urodynamic study to explore filling phase disorders - including final uroflowmetry associated with intrarectal pressure monitoring - between 2020 and 2021 in our department of urology were considered eligible. Intrarectal pressure curves (gold-standard) were examined by two senior urologists and a continence nurse to determine by consensus the presence of straining to void. The final uroflowmetry curves and final uroflowmetry paired with EMG curves were retrospectively submitted for interpretation to 3 groups of urologists with different levels of experience (residents, fellows, seniors). Each group was composed of 3 independent examiners blinded to intrarectal pressure. The diagnostic performances of patient's interview, and the diagnostic performances as well as the inter- and the intra-examiner correlation of final uroflowmetry alone and final uroflowmetry paired with EMG were assessed. RESULTS: Overall, 282 neurogenic and non-neurogenic patients were included in the present study. The patient's impression to identify straining to void was associated with a sensitivity, a specificity, a predictive positive value (PPV) and a negative predictive value (NPV) of 68.4%, 63.9%, 68.0% and 64.3%, respectively. Final uroflowmetry alone was associated with a sensitivity, a specificity, a PPV and a NPV of 60.4%, 75.1%, 73.1% and 62.8%, respectively. Final uroflowmetry paired with EMG was associated with a sensitivity, a specificity, a PPV and a NPV of 61.3%, 84.9%, 81.6% and 66.8%, respectively. The inter- and intra-examiner agreement of final uroflowmetry alone was reported as moderate to poor, ranging between 0.17 and 0.72 and 0.58-0.79, respectively. The inter- and intra-examiner agreement of final uroflowmetry paired with electromyography was reported as moderate to poor, ranging between 0.26 and 0.73 and 0.59-0.81, respectively. CONCLUSION: Patient's interview, final uroflowmetry alone and paired with rectus abdominis muscle EMG, are not reliable enough to be considered as screening tools for straining to void.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".