The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
Diagnostic models for male lower urinary tract symptom management in primary care: a prospective, multicentre, diagnostic accuracy study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Harding Chris, Agarwal Ridhi, Bates Janine, Bray Alison, Milosevic Sarah, Thomas-Jones Emma, Drinnan Michael, Drake Marcus, Michell Peter, Pell Bethan, Ahmed Haroon, Joseph-Williams Natalie, Schatzberger Tom, Davies Jane, Hood Kerenza, Takwoingi Yemisi, Edwards Adrian
Аннотация
BACKGROUND: Recent research has concluded that primary care assessment and management of lower urinary tract symptoms (LUTS) requires practical resources.
AIM: To develop and independently validate risk-prediction models for three common urological conditions based on a combination of simple, minimally invasive index tests in men with LUTS presenting to primary care.
DESIGN AND SETTING: A prospective, multicentre, diagnostic accuracy study with independent development and validation cohorts set in 67 general practices in England and Wales.
METHOD: A total of 601 men presenting to primary care with LUTS, 350 in the development cohort and 251 in the validation cohort, underwent index tests - validated symptom assessment, bladder diary, physical examination, serum prostate specific antigen, uroflowmetry, and post-void residual volume estimation. Invasive urodynamic studies provided a diagnostic reference standard. Risk-prediction models for urodynamic diagnoses were developed and then validated in independent cohorts. Discriminative and calibration performance of the risk-prediction models for diagnosing bladder outlet obstruction (BOO), detrusor underactivity (DU), and detrusor overactivity (DO) using the c-index, calibration slope and plot, and sensitivity and specificity of the models was undertaken.
RESULTS: The BOO model from the development cohort demonstrated good discriminative performance (optimism-corrected c-index of 0.80). The models derived from the development cohort for DU and DO demonstrated moderate discriminative ability (optimism-corrected c-indices of 0.64 and 0.67, respectively). Similar estimates of c-index were observed for each model within the independent validation cohort (BOO, 0.82; DU, 0.63; and DO, 0.62).
CONCLUSION: Using a combination of simple, non-invasive index tests can accurately predict common urological diagnoses in men with LUTS, potentially facilitating earlier initiation of evidence-based treatments and improved management in primary care.
AIM: To develop and independently validate risk-prediction models for three common urological conditions based on a combination of simple, minimally invasive index tests in men with LUTS presenting to primary care.
DESIGN AND SETTING: A prospective, multicentre, diagnostic accuracy study with independent development and validation cohorts set in 67 general practices in England and Wales.
METHOD: A total of 601 men presenting to primary care with LUTS, 350 in the development cohort and 251 in the validation cohort, underwent index tests - validated symptom assessment, bladder diary, physical examination, serum prostate specific antigen, uroflowmetry, and post-void residual volume estimation. Invasive urodynamic studies provided a diagnostic reference standard. Risk-prediction models for urodynamic diagnoses were developed and then validated in independent cohorts. Discriminative and calibration performance of the risk-prediction models for diagnosing bladder outlet obstruction (BOO), detrusor underactivity (DU), and detrusor overactivity (DO) using the c-index, calibration slope and plot, and sensitivity and specificity of the models was undertaken.
RESULTS: The BOO model from the development cohort demonstrated good discriminative performance (optimism-corrected c-index of 0.80). The models derived from the development cohort for DU and DO demonstrated moderate discriminative ability (optimism-corrected c-indices of 0.64 and 0.67, respectively). Similar estimates of c-index were observed for each model within the independent validation cohort (BOO, 0.82; DU, 0.63; and DO, 0.62).
CONCLUSION: Using a combination of simple, non-invasive index tests can accurately predict common urological diagnoses in men with LUTS, potentially facilitating earlier initiation of evidence-based treatments and improved management in primary care.