A comparative analysis of pediatric uroflowmetry curves

Abstract

Moderate to substantial agreement on uroflowmetry curves can be reached, except for staccato. Agreement increases if staccato and interrupted flows are defined more sharply. Staccato is defined as three or more peaks and troughs of more than the square root of maximal flow without touching 0, whereas interrupted flow needs at least one 0 passage. In a normal, uninterrupted uroflow, flow time is under 15 sec.

Uroflowmetry with pelvic floor electromyography: inter-rater agreement on diagnosis of pediatric non-neurogenic voiding disorders

“…Previous investigations of inter-rater agreement have focused on uroflow patterns, with findings ranging from almost perfect agreement if assessment is limited to normal vs abnormal [7] to moderate or poor agreement if a more detailed description of the uroflow curve is required (e.g. normal, tower, plateau, staccato, or interrupted) [8,9]. A recent study suggested that patterning software might improve inter-rater agreement; however, there was no consensus (gold standard) diagnosis for the studies used in that analysis [10].…”

A multi-center study of pediatric uroflowmetry data using patterning software

“…This method consisted of two steps: 1) defining staccato and interrupted pattern if amplitude of fluctuation is less than square of maximal flow rate (MFR), clumped together as fluctuated pattern; and 2) classifying remaining curves according to deviation of MFR of a given curve from median value of a published nomogram [10]. The method was expected to overcome the inter-observer difference seen with subjective patterning [11], and showed that objective patterning is feasible. However, although logically simple, working and calculating with a nomogram is relatively time-consuming clinically, and the method itself has not become readily usable for all clinicians yet.…”

Interpretation of uroflow curves: A global survey measuring inter and intra rater reliability

“…We have recently shown a moderate agreement for females and even better for males using only the curve shape (BPT). 15 Vijverberg et al 16 found κ's of 0.45 for staccato and 0.67 for interrupted curves. Utilizing a modified rating system, they identified improved inter RR comparing normal, intermediate, and anomalous and found a high agreement between the observers.…”