187 The Clinical Significance of the Subtypes of Detrusor Overactivity: A Systematic Review
Bibliographic record
Abstract
Abstract Aim Detrusor overactivity (DO) is the ‘occurrence of detrusor contraction(s) during filling cystometry[1] and can be ‘phasic’ or ‘terminal’.[2] The aim of this systematic review was to establish whether there is any clinical significance between the different subtypes of DO in terms of demographics, underlying pathophysiology, symptoms, other urodynamic parameters and response to treatment. Method A systematic search was performed using PubMed, Cochrane, MEDLINE, Web of Science and EMBASE databases in February 2024, following the PRISMA guidelines. The Newcastle Ottawa critical appraisal tool was used to assess the risk of bias in the included studies Results Sixteen studies with a total of 3,380 patients were included in the systematic review. Patients with terminal DO (TDO) were found to be significantly older (p=0.0003) and were more likely to have suffered spinal cord trauma (p=0.04) compared to those with phasic DO (PDO). Patients with TDO were also found to have higher symptom scores and more likely to also suffer with incontinence than those with PDO. Patients with TDO were found to have smaller functional capacities than those with PDO on urodynamics. Success rates, following trans-urethral resection of the prostate (TURP), were 69.2% for patients with PDO and 9.5% for those with TDO. Conclusions Patients with TDO are more likely to experience more severe symptoms and respond less favourably to medical and surgical treatment than those with PDO. These findings suggest distinct pathophysiological origins underlying TDO and PDO, highlighting the need for tailored therapeutic approaches to these two subtypes of DO.
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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 | 0.009 | 0.048 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.013 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".