Comparative analysis of Pediatric Uroflowmetry

Abstract

OBJECTIVE In literature, comparative analysis of Uroflowmetry has only been done for prostate obstruction. Inter- and intra-observer agreement for pediatric Uroflowmetry has never been tested systematically. MATERIAL AND METHODS Eight professionals in pediatric incontinence care judged 480 pediatric uroflows in a web-based computer system that had been designed for professional use in the sewer industry. Uroflows were assessed on 4 items: staccato, interrupted, flow-time, and obstruction in a 1-5 scale. For intra-observer agreement 100 flows were judged a second time one month later. Statistical analysis was done to determine Kappa values for agreement. Kappa 0.4- 0.6 was considered moderate agreement, 0.6- 0.8 substantial agreement and >0.8 almost perfect agreement. RESULTS In the inter-observer agreement Kappa was 0.45 for staccato, 0.67 for interrupted, 0.59 for flow-time and 0.66 for obstruction. For intra-observer agreement the overall mean Kappa was 0.47 for staccato, 0.65 for interrupted, 0.55 for flow-time and 0.65 for obstruction. CONCLUSIONS Standardized analysis of pediatric Uroflowmetry in a structured way learns that moderate to substantial agreement exists between professionals. This agreement is very comparable with the intra-observer agreement for each of the professionals. Uroflowmetry is both for diagnosis of LUTS in children and for follow-up during urotherapy a reliable and reproducible, non-invasive tool.