Trends in future urodynamics: computer support-data base-digitized imaging.
The use of computers in urodynamics must be based preferably on the structure of the urodynamic investigation itself. This enables implementation of computerized systems in the urodynamic laboratory in the most natural way and provides transparency of urodynamic software for the investigators. Additionally, the algorithms of the urodynamic software then can provide for a urodynamic investigation following a logical path based on the patient's history and clinical data and (automatically interpreted) results from earlier steps in the urodynamics. As an extension of this structured logical reasoning, the computer use in urodynamics can be extended to include validation and decision rules, comprising measurement data and rules for interpretation and combination of history, clinical and measurement data. Conclusions will be presented then in the form of a preliminary differential diagnosis, including the odds for each of the possible diagnoses. These kinds of computerized interpretation systems will be validated by comparison with the classical clinical diagnoses and are generally known as expert systems. These systems rely on logical branching-as opposed to systems that are statistical in nature and use large data bases to classify individual data into known groups. Data bases will remain for the purpose of documentation, based on individual patients and comprising all patient data-comparable to the existing patient files in the hospital's archives. The computer files have to include also the original data from functional studies like urodynamics-and not just the abstracted conclusions-and from imaging techniques. Intelligent compression of data prevents the data bases from exploding. Digital imaging techniques combined with computerized urodynamic investigations open possibilities for dynamic analysis of morphologic data and combination thereof with urodynamic measurement data.