The bladder contractility and bladder outlet obstruction indices in adult men: Results of a global Delphi consensus study

Aims This Delphi study was planned to examine global expert consensus with regard to utility, accuracy, and categorization of Bladder Contractility Index (BCI) and Bladder Outlet Obstruction Index (BOOI) and the related evidence. Methods Twenty-eight experts were invited to answer the two-round survey including three foundation questions and 15 survey questions. Consensus was defined as >= 75% agreement. The ordinal scale (0-10) in round 1 was classified into strongly agree, agree, neutral, disagree, and strongly disagree for the final round. A systematic search for evidence was conducted for therapeutic studies that have examined outcome stratified by the indices in men. Results Nineteen experts participated in the survey with 100% completion. Consensus was noted with regard to 6 of 19 questions. Experts strongly agreed with utility of quantifying bladder contractility and bladder outflow obstruction with near unanimity regarding the latter. There was consensus that BCI and BOOI were accurate, that BCI was clinically useful, and for defining severe bladder outflow obstruction as BOOI > 80. Systematic search yielded 69 publications (BCI 45; BOOI 50). Most studies examined the indices as a continuous variable or by standard cutoffs (BCI 100, 150; BOOI 20, 40). Conclusion There is general agreement among experts on need for indices to quantify bladder contractility and bladder outflow obstruction as well as with regard to accuracy and utility of BCI and BOOI indices. Few studies have examined the discriminant power of existing cutoffs or explored new ones. This is an extraordinary knowledge gap in the field of urology.

Automated summary

This study aimed to examine the utility, accuracy, and categorization of BCI and BOOI indices and related evidence. Results showed general agreement among experts regarding the utility and accuracy of the indices, as well as the clinical value of BCI. However, there is a significant knowledge gap in evaluating the discriminant power of existing cutoffs and exploring new ones.