AccScience Publishing / Bladder / Online First / DOI: 10.14440/bladder.2024.0073
RESEARCH ARTICLE

Quality review of typical value ranges in urodynamic measurements using statistical process control: A single-center retrospective study

Xiao Zeng1 Hong Shen1 Tao Jin1* Deyi Luo1*
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1 Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
Submitted: 5 December 2024 | Revised: 13 January 2025 | Accepted: 27 February 2025 | Published: 27 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Background: Urodynamic study (UDS) is essential for assessing lower urinary tract function, but quality control methods remain limited. Statistical process control (SPC), a tool originally developed in manufacturing, has shown promise in healthcare for improving quality and reducing variability. Objective: This study explored the application of SPC to analyze the typical value ranges (TVR) of urodynamic measurements. Methods: A total of 84 urodynamic traces that met all inclusion criteria were included for analysis. We recorded the TVR for initial intravesical pressure (Pves), initial abdominal pressure (Pabd), and initial detrusor pressure (Pdet) from each enrolled UDS trace. These data were then compared with the standard TVR. In addition, we used the X-bar and S control charts of SPC for process performance analysis. Results: The study included 20 females and 64 males, with an average age of 58.02 ± 16.09 years. Of the participants, 32 were diagnosed with neurogenic bladder dysfunction, and 52 were diagnosed with non-neurogenic bladder dysfunction. The average TVR for initial Pves was 34.81 ± 10.78 cmH2O, Pabd 30.92 ± 11.14 cmH2O, and Pdet 4.20 ± 3.73 cmH2O. We further analyzed the data using scatter plots. In the X-bar control chart, the control limit (CL) was 22.48, the upper CL (UCL) was 32.04, and the lower CL (LCL) was 12.92. In the S control chart, the CL was 15.78, the UCL was 22.57, and the LCL was 8.9. Two cases exceeded the UCL in the X-bar control chart, and one case exceeded the UCL in the S control chart. Conclusion: The clinical value of SPC in the quality review of UDS has been confirmed in previous studies. In this study, we preliminarily verified the use of SPC for continuous variable data, such as the TVR of UDS parameters. The results of this study need to be further validated in a larger sample size, multi-center, and prospective study.

Keywords
Statistical process control
Urodynamic study
Typical value ranges
Quality review
Continuous variable data
Funding
This study was funded by the National Natural Science Fund of China (Grant No. 81770673).
Conflict of interest
The authors declare no conflicts of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific