Ambulatory Uroflowmetry
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Eric A. Kurzrock, M.D. | |
UC Davis |
Project's details
Ambulatory Uroflowmetry | |
Clinical problem: Bothersome lower urinary tract symptoms (LUTS) affect up to one third of men over the age of 65. Current assessment includes a subjective questionnaire and a more objective test called uroflowmetry. This is a clinic-based test where the patient voids into a chamber and the volume/time is calculated with an electronic weight-based apparatus and the clinician is provided a flow diagram with extracted data points such as maximum and mean flow. The accurate reflection of the patient’s real flow and the clinician’s interpretation are critical to choosing appropriate medical and/or surgical treatment. Requirements for uroflowmetry described by a 2002 International Continence Society Standardization Report include: adequate privacy, a normal desire to void and repeated and representative measurements. Numerous studies have demonstrated that clinic-based measurement is not accurate since it is a single-event test and patients are apprehensive and may not have a full bladder. Thus, validity and reliability are questioned. There have been attempts to design an ambulatory (home-based) uroflowmetry device. To date, none have satisfied the requirements for clinical decision making. These clinic-based devices are essentially restricted to urology offices since the equipment costs are between one and three thousand dollars and require a dedicated restroom. Translational importance: The current clinical testing with single-event, office-based uroflowmetry is expensive, inconvenient and inaccurate. The production of a less-expensive (disposable) device would provide for more convenient and repeatable testing at home with objective measurements that truly reflect the patient’s voiding patterns. This would result in earlier diagnosis of obstruction and more appropriate and prompt treatment by a primary care physician. Current analysis has shown approximately one million uroflowmetry tests are performed each year. Current cost of office-based testing is $130-150 per event (Medicare rates). The cost savings of an ambulatory device would be tremendous. More importantly, the testing would be more convenient and accurate. |
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Multi-disciplinary approach: This project will require a team approach. The team will consist of one to two physicians, three to four computer science students and two to three biomedical engineering students. All three groups will be integral to ensure that the collection and measurement device integrates with the camera and software and is safe, ergonomic and user friendly for older patients. CS team will develop software that interprets the volume changes (optical) via the smartphone camera and convert these data points into volume measurements at each time point. In addition, if time allows, CS team will develop a mobile app that communicates with and instructs patients on use of the app. | |
The development of a user-friendly home-based uroflowmetry device. • The ergonomic design would address the needs and safety of an older population (BME team). • Smartphone application that measures flow rate via optical recognition of volume (CS) • The mechanical design and software have to be integrated to accurately reflect the changes in volume over time. (BME/CS) • Volume and time date would be translated into a graphical plot of flow rate (Y axis) and time (X axis) for the entire void and calculate maximum flow, mean flow and voided volume. (BME/CS) • Smartphone application designed for older patient population (CS) |
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N/A | |
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30-60 min weekly or more | |
Client wishes to keep IP of the project | |
Attachment | N/A |
Yes | |
Team members | N/A |
Albara | |
N/A |