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JU INSIGHT Expert Consensus on Pediatric Urodynamics Reporting Using Modified Delphi Technique
By: Kristen M. Meier, MD, Children’s Mercy Hospital, Kansas City, Missouri; Claudia Mata, MPH, Children’s Hospital of Colorado, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora; Jill L. Kaar, PhD, Children’s Hospital of Colorado, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora; Adam J. Rensing, MD, Oklahoma University Health Sciences Center, Oklahoma City; Anne G. Dudley, MD, Connecticut Children’s Hospital, Hartford; Alonso Jr Carrasco Jr, MD, Children’s Minnesota, Minneapolis; Beth A. Drzewiecki, MD, Massachusetts General for Children, Boston; Brian A. VanderBrink, MD, Cincinnati Children’s Hospital, Ohio; Courtney S. Streur, MD, University of Michigan, Ann Arbor; Darius J. Bagli, MD, The Hospital for Sick Children and Research Institute, Toronto, Ontario, Canada; David J. Chalmers, MD, Maine Medical Center, Portland; Duncan T. Wilcox, MD, Children’s Hospital Colorado, Aurora; Elizabeth B. Yerkes, MD, Lurie Children’s Hospital, Chicago, Illinois; Glen A. Lau, MD, University of Utah Health, Salt Lake City; Gino J. Vricella, MD, Children’s Mercy Hospital, Kansas City, Missouri; Sarah L. Hecht, MD, Oregon Health & Science University Doernbecher Children’s Hospital, Portland; Hillary L. Copp, MD, University of California, San Francisco Benioff Children’s Hospitals; Hans G. Pohl, MD, Children’s National Hospital, Washington, District of Columbia; Israel Franco, MD, Yale School of Medicine, New Haven, Connecticut; Jennifer Ahn, MD, Seattle Children’s Hospital, Washington; John S. Wiener, MD, Duke University Medical Center, Durham, North Carolina; Jennifer S. Singer, MD, University of California, Los Angeles Health; Christopher J. Long, MD, Children’s Hospital of Philadelphia, Pennsylvania; Melise A. Keays, MD, Boston Children’s Hospital, Massachusetts; Michael R. Daugherty, MD, Cincinnati Children’s Hospital, Ohio; Molly E. Fuchs, MD, Nationwide Children’s Hospital, Columbus, Ohio; Paul F. Austin, MD, Texas Children’s Hospital, Houston; Charlotte Q. Wu, MD, Johns Hopkins University School of Medicine, Baltimore, Maryland; Rebecca S. Zee, MD, Children’s Hospital of Richmond at Virginia Commonwealth University; Rosalia Misseri, MD, Riley Hospital for Children at Indiana University Health, Indianapolis; Stacy T. Tanaka, MD, Children’s Hospital of Alabama, Birmingham; Stuart B. Bauer, MD, Boston Children’s Hospital, Massachusetts; Kyle O. Rove, MD, Children’s Hospital Colorado, Aurora | Posted on: 17 Jul 2024
Meier KM, Mata C, Kaar JL, etal. Expert consensus on pediatric urodynamics reporting using modified Delphi technique. J Urol. 2024;212(1):165-176. doi:10.1097/JU.0000000000004000
Study Need and Importance
Urodynamic studies (UDS) are commonly used by pediatric urologists to assess lower urinary tract function, particularly in medically complex children such as those with spina bifida, anorectal malformations, etc. Historically, UDS reporting has been based on provider preferences, leading to variability in documentation. Prior efforts have been made within the pediatric world to ensure we are speaking a common language. We queried a diverse think tank of pediatric UDS specialists to devise a statement on how a pediatric UDS report should be constructed. We surmise that standardized reporting could improve patient care and promote research collaboration.
What We Found
Knowing this would be a time-intensive process, we invited a diverse group of 30 specialists across North America to participate, with a goal to recruit 15. All responded and participated, though not all participated in every round. The Figure details the structure and participation by round. Involvement was diverse across geographic, societal, patient-care expertise, and tenure variables. Through this study, essential elements of a pediatric UDS report were identified, useful clinical decision support elements and billing language were agreed upon, and we were able to create a consensus statement of recommended elements and structure.
Limitations
This study exclusively involves North American (primarily US) providers, focusing on North American electronic health record systems and US-centric billing. This project does not include how providers interpret urodynamics, and these recommendations have not been investigated in a real-world setting to date, but this will be a focus of future studies.
Interpretation for Patient Care
This study is the first to define optimal pediatric UDS report structure and essential elements. This statement will guide the creation of a standardized pediatric UDS report that will be openly available within the Epic system and easily adaptable to providers using other electronic health records. We hope that this will improve patient care, promote research collaboration, and increase provider efficacy and satisfaction.
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