Nomograms.docx
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Nomograms.docx
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Nomograms
DevelopmentofaReliableInstrumentforRecordingandAnalyzingUroflowProceduresthatincludestheLiverpool(Haylen,etal)Nomograms
A.C.COATS,M.D.
Life-Tech,Inc.,Houston,Texas,USA
Summary—ThescienceofanalysisofUroflowrecordingshasbeendescribedatlengthbytheInternationalContinenceSociety(ICS)andinnumerouspublicationsbyleadingcliniciansinthefieldofUrology1,2,3inrecentyears.Theclinicalresearchdemonstratedaneedforareliabledeviceforthedocumentationandanalysisofuroflowresultsthatincludedthe“goldstandard”LiverpoolNomograms.
TheMicroflo®(Life-Tech,Inc.,Houston,TX,USA)wasdevelopedtoprovideclinicianswithahighlyaccuratesystemfortherecordingandanalysisofUroflowprocedures,toincludethediagnosticreferenceplottingofthepatientontheLiverpoolUroflowNomograms. Thesystemfeaturesahighperformancemicroprocessor,collectingdataat8samplespersecondwhiledigitallydisplayingthe
Figure1:
Microflo2001N.
values.Thehighlyadvancedloadcelltechnologyprovidessuperioraccuracywhileminimizingmaintenanceandoperatingcost. Thesystemisfoundtobebotheconomicalandeasytooperate(Figure1).
Dataanalysisisautomaticandprovidesforthemanualentryofpatientinformationwhileprintingage,sex,positionandtheUroflowpattern. Thesystem’ssophisticatedalgorithmsautomaticallyanalyzetheUroflowstudywhilevirtuallyeliminatingartifacts. HighresolutionUroflowrecordingisautomaticallyprintedintheappropriatetimescaleof0-60sec.,0-120sec.,or0-180sec.(Figures2and3).
MicrofloretainsinmemorythelastrecordedUroflowandwithsubsequentprintoutthescalecanbechangedfrom0-50ml/sec.to0-25ml/sec.toimprovetheresolutionofabnormalUroflowwaveforms.
Figure2:
MicrofloPatientInformationandanalysisresult.
1
Copyright©2000Life-Tech,Inc..Allrightsreserved.
Figure3:
MicrofloUroflowtracings.
Figure4:
MicroflowithLiverpoolNomograms.
PerhapsthemostimportantfeatureofMicrofloistheautomaticplottingofthepatient’sUroflowresultsontheLiverpoolNomograms. TheseNomogramsareconsideredworld-widetobethe“goldstandard”ofUroflowinterpretation,offeringreferencerangesforbothmalesandfemales,forbothmaximumandaverageflowrates,overawiderangeofvoidedvolumes(Figure4).
Patient'sresultsareplottedasapercentageofnormalcy,bybothageandsex,forbothMaximumandAverageUroflow. AlloftheLiverpoolNomogramsforallageandsexconsiderationsareincludedinMicroflo’s
softwarepackage,andaredrawnuponasnecessarytoplotpatientpercentileofnormality.
Abrams,P.,Blaivas,J.,Stanton,S.,andAndersen,J.(1988),StandardisationofTerminologyofLowerUrinaryTractFunction.Pp.410-412.AlanR.Liss,Inc.
2Haylen,B.,Ashby,D.,etal.(1988),MaximumandaverageUrineFlowRatesinNormalMalandFemalePopulations–theLiverpoolNomograms.BritishJ.ofUrol.,64:
30-38
3Abrams,P.,Fenely,R.andTorrens,M(1983).Urodynamics.Pp.26-38Berlin:
Springer-Verlag.
2
Copyright©2000Life-Tech,Inc..Allrightsreserved.
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