Corresponding author:Tim Idzenga, Erasmus Medical Center, Department of Urology, PO BOX 20403000 CA Rotterdam, Netherlands
Received: July 18, 2017; Published: July 31, 2017
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Objectives: The current standard method for diagnosing bladder outlet obstruction in patients with Lower Urinary Tract Symptoms (LUTS) is a pressure-flow study. Electronic perineal auscultation, i.e. recording sound with a contact microphone behind the scrotum during voiding, might be an easy-to-use non-invasive alternative. Of major importance for the clinical applicability of perineal auscultation is the quality of the sound recording.
Methods: In a clinical population of 74 male LUTS patients we studied two measures for assessing the quality of electronic perineal auscultation: a Normalized Correlation Coefficient (NCC) and Signal-To-Noise Ratio (SNR). We compared these measures with the visual assessment of the electronic auscultatory signal by three experienced observers. The agreement between the experienced observers was expressed using the Weighted Kappa statistic. Both quality measures were compared to the combined visual assessments using the Kruskal Wallis test and the usefulness was evaluated using ROC-analysis.
Results: The Weighted Kappa values between the three observers were 0.73, 0.66 and 0.76 (p<.05).For recordings classified as ‘good’ by the observers, the NCC was significantly higher than for the ‘medium’ and ‘poor’ quality recordings (p<.05). The areas under the ROC curve were 0.84 and 0.66 (both significant, p<.05) for NCC and SNR, respectively.
Conclusion: We developed quality criteria to assess the quality of electronic perineal auscultation in patients with LUTS. These quality measures can be used to select auscultatory measurement signals that are suitable for further analysis and for improving the perineal auscultation setup.