Usefulness of the Toronto Voiding Symptom Score in the Diagnosis of Occult Tethered Cord Syndrome
Bibliographic record
Abstract
OBJECTIVES: Occult tethered cord syndrome is a neurological condition characterized by bladder control difficulties owing to spinal cord tethering. It is often missed on routine magnetic resonance imaging as it lacks typical signs. We investigated whether the Toronto Dysfunctional Voiding Symptom Score can screen occult tethered cord syndrome in children with daytime urinary incontinence. METHODS: We retrospectively analyzed 109 children with daytime urinary incontinence. Based on clinical symptoms and specialized magnetic resonance imaging findings, the children were categorized into two groups: 15 children diagnosed with and 94 children without occult tethered cord syndrome. We used the Mann-Whitney U test to compare the Toronto Dysfunctional Voiding Symptom Score between groups. A diagnosis of occult tethered cord syndrome was confirmed with the presence of a thickened filum terminale on prone-position magnetic resonance imaging and non-responsiveness to anticholinergic medication. RESULTS: The median Toronto Dysfunctional Voiding Symptom Score was significantly higher in the group with occult tethered cord syndrome (11.0) versus the control group (9.0). Analysis revealed that a cutoff Toronto Dysfunctional Voiding Symptom Score of 10 yielded sensitivity of 80.0% and specificity of 57.4% in identifying occult tethered cord syndrome. Notably, scores < 10 had a negative predictive value of 94.7%, indicating a low probability of occult tethered cord syndrome. CONCLUSION: Our study findings suggested that the Toronto Dysfunctional Voiding Symptom Score at the first visit can effectively screen occult tethered cord syndrome in children with daytime urinary incontinence. This finding can potentially streamline the diagnostic process and prevent unnecessary medical investigations.
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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 | 0.000 | 0.000 |
| 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".