Methodologies and practice for improving measurement in urodynamics – quantifying accuracy, quality and contractility

Gammie, Andrew

Abstract

Any clinical practitioner using a physiological measurement relies on assurance of the quality of that measurement. In urodynamics, the measurement of lower urinary tract function, poor quality results leading to incorrect diagnoses could result in misguided treatment at best and unnecessary operations at worst. It is therefore of the utmost importance to patients and also health services that quality in urodynamic measurements be reliably assessed.

The fact that quality is an issue in urodynamics has long been claimed anecdotally, and my work as central reader in recent clinical trials has confirmed this. There are now publications to show this is true through assessment of trace data and there are moves to improve the training required by urodynamicists in order to rectify the situation. I have developed a metric for the measurement of the quality of a urodynamic trace, which can now be used to monitor and audit trace quality. To support this, I have published work analysing the accuracy of different methods of measuring patient pressures, and have also produced a library of training material for staff development. Guidelines produced through my work are now in the public domain for equipment specification, assessment of accuracy and refined metrics for grading the contractile strength of the urinary bladder.

The urodynamic community worldwide now has the tools for assessment and improvement of urodynamic measurement, and the professional community in the UK has a direction for urodynamicist certification. I look forward in hope to patients in urology departments benefiting from more reliable and technically improved urodynamic services.

• Thesis Type: Thesis
• Deposit Date: Feb 2, 2023
• Publicly Available Date: Jun 28, 2023
• Public URL: https://uwe-repository.worktribe.com/output/10417940
• Award Date: Jun 28, 2023