Altan Mesut, Çitamak Burak, Bozaci Ali Cansu, Mammadov Emin, Doğan Hasan Serkan, Tekgül Serdar
Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
Urology. 2017 May;103:204-208. doi: 10.1016/j.urology.2016.12.055. Epub 2017 Jan 9.
To investigate the diagnostic properties of 3 different scoring systems (Dysfunctional Voiding Symptom Score [DVSS], Dysfunctional Voiding and Incontinence Symptoms Score [DVISS], Incontinence Symptom Index-Pediatric [ISI-P, for children older than 11 years]) that are used to evaluate lower urinary tract symptoms in pediatric population.
Eighty-four participants were evaluated by detailed history, physical examination, 3 different scoring systems (DVSS, DVISS, ISI-P), ultrasonography, and uroflowmetry. Depending on the tests, cases were stratified as healthy or lower urinary tract symptoms (LUTS) by 2 urologists who were blinded to the questionnaires. Patients were reevaluated by the same tests and questionnaires 3 months after treatment. Diagnostic properties of questionnaires were calculated. Additionally, parents were asked to scale the improvement of symptoms subjectively from 0% to 100% to correlate to each of the three scoring systems.
The mean ages of the normal and the LUTS groups were 9.1 ± 2.6 years and 10.1 ± 2.8 years, respectively (P = .301). Gender (male:female) distribution was 21:21 in the LUTS group and 25:17 in the control group (P = .381). In terms of diagnosis, DVISS has the highest accuracy (sensitivity: 81%, specificity: 97.6%, accuracy: 89%) followed by ISI-P (sensitivity: 55.6%, specificity: 100%, accuracy: 82%) and DVSS (sensitivity: 54.8%, specificity: 97.6%, accuracy: 76%). The similar order was valid for the 23 patients older than 11 years (accuracy for DVISS: 87%, for ISI-P: 82%, and for DVSS: 78%). In terms of response to treatment, all 3 tests showed good correlation with parents' ratings (DVSS: P < .001, DVISS: P = .005, ISI-P: P = .042).
Although DVISS had the highest accuracy in distinguishing the patients from healthy controls, all 3 questionnaires seem to be equivalent for the evaluation of response to treatment.
研究3种不同评分系统（排尿功能障碍症状评分[DVSS]、排尿功能障碍和尿失禁症状评分[DVISS]、小儿尿失禁症状指数[ISI-P，适用于11岁以上儿童]）用于评估儿科人群下尿路症状的诊断特性。
84名参与者接受了详细病史、体格检查、3种不同评分系统（DVSS、DVISS、ISI-P）、超声检查和尿流率测定。根据检查结果，由2名对问卷不知情的泌尿科医生将病例分为健康或下尿路症状（LUTS）。治疗3个月后，患者再次接受相同的检查和问卷评估。计算问卷的诊断特性。此外，要求家长对症状改善情况进行主观评分，范围从0%到100%，以与三种评分系统中的每一种进行关联。
正常组和LUTS组的平均年龄分别为9.1±2.6岁和10.1±2.8岁（P = 0.301）。LUTS组的性别（男:女）分布为21:21，对照组为25:17（P = 0.381）。在诊断方面，DVISS的准确性最高（敏感性：81%，特异性：97.6%，准确性：89%），其次是ISI-P（敏感性：55.6%，特异性：100%，准确性：82%）和DVSS（敏感性：54.8%，特异性：97.6%，准确性：76%）。对于23名11岁以上的患者，顺序相似（DVISS的准确性：87%，ISI-P的准确性：82%，DVSS的准确性：78%）。在治疗反应方面，所有3项检查均与家长评分显示出良好的相关性（DVSS：P < 0.
