Diagnostic models for male lower urinary tract symptom management in primary care
File(s)
Published version (accepted)
Author(s)
Type
Journal Article
Abstract
Objectives - To develop and independently validate risk-prediction models for three common urological conditions based on a combination of simple, minimally-invasive index tests in men with lower urinary tract symptoms (LUTS) presenting to primary care. Design - A prospective, multicentre, diagnostic accuracy study with independent development and validation cohorts. Setting - 67 general practices in England and Wales. Participants – 601 men presenting to primary care with LUTS: 350 in the development cohort and 251 in the validation cohort. Interventions –Index tests - validated symptom assessment, bladder diary, physical examination, serum prostate specific antigen, uroflowmetry and post-void residual volume estimation. Invasive urodynamic studies provided a diagnostic reference standard. Risk prediction models were developed and validated in independent cohorts. Main outcome measures - Discriminative and calibration performance of the risk prediction models for diagnosing bladder outlet obstruction (BOO), detrusor underactivity (DU) and detrusor overactivity (DO) using the c-index, calibration slope and plot and sensitivity and specificity of the models. Results - The BOO model from the development cohort demonstrated good discriminative performance (optimism-corrected c-index of 0.80). The models derived from the development cohort for DU and DO demonstrated moderate discriminative ability (optimism-corrected c-indices of 0.64 and 0.67 respectively). Similar estimates of c-index were observed for each model within the independent validation cohort (BOO=0.82, DU= 0.63 and DO =0.62).. Conclusions – Using a combination of simple, non-invasive index tests can accurately predict common urological diagnoses in men with LUTS, potentially facilitating earlier initiation of evidence-based treatments and improved management in primary care
Date Issued
2026-06-04
Date Acceptance
2026-04-06
Citation
British Journal of General Practice, 2026
ISSN
0960-1643
Publisher
Royal College of General Practitioners
Journal / Book Title
British Journal of General Practice
Copyright Statement
© 2026 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/). Published by British Journal of General Practice. For editorial process and policies, see: https://bjgp.org/authors/bjgp-editorial-process-and-policies
License URL
Identifier
10.3399/BJGP.2025.0513
Publication Status
Published online
Article Number
BJGP.2025.0513
Date Publish Online
2026-06-04