Urodynamic Report Writer (URapp): A GPT-4o-Based App for Urodynamic Interpretation and Draft Report Generation
Synopsis
This study developed and validated the Urodynamic Report Writer App (URapp), a GPT-4o-based virtual assistant modeled on scientific literature and international urodynamic guidelines, fine-tuned under supervision by two expert urodynamicists using examinations from multiple referral centers, and evaluated by functional urology specialists on a 0-5 Likert scale, scoring high on interpretative accuracy (4.5 ± 0.2), explanation of urodynamic concepts (5.0 ± 0), adherence to evidence-based standards (4.8 ± 0.3), clarity and practicality of recommendations (4.2 ± 0.3), clinical relevance (3.8 ± 0.3), and diagnostic usefulness (3.5 ± 0.5), with all 100 consecutive urodynamic studies (median age 61 yr) receiving overall scores ≥4.
Interpretation
The study built URapp, a GPT-4o-based virtual assistant that supports interpretation of clinician-supplied urodynamic data and draft report generation. Relative to the time-consuming, operator-dependent conventional workflow for urodynamic interpretation and reporting, this work brings a large language model into that specific clinical step, modeled on international urodynamic guidelines and scientific literature. Development took approximately 6 months; training used urodynamic examinations from multiple referral centers with supervised fine-tuning by two expert urodynamicists.
In validation by functional urology specialists using a 0-5 Likert scale, URapp received high scores across multiple domains. The validation provides domain-specific quantitative ratings for interpretative accuracy, concept explanation, evidence-based adherence, clarity and practicality of recommendations, clinical relevance, and diagnostic usefulness, rather than only an overall impression. Interpretative accuracy 4.5 ± 0.2, explanation of urodynamic concepts 5.0 ± 0, adherence to evidence-based standards 4.8 ± 0.3, clarity and practicality of recommendations 4.2 ± 0.3, clinical relevance 3.8 ± 0.3, and diagnostic usefulness 3.5 ± 0.5.
In the final phase, URapp generated reports for 100 consecutive urodynamic studies, independently evaluated by two expert urologists, and all cases received overall scores ≥4. This phase extends evaluation from specialist ratings to a consecutive case sample, providing an observation of performance across consecutively enrolled cases. A consecutive sample of 100 cases, median age 61 yr, independently evaluated by two expert urologists, with all receiving overall scores ≥4.
Perspective
The results are intended for clinical settings supporting urodynamic interpretation and draft report generation, in a workflow where clinicians supply urodynamic data and URapp assists with interpretation and draft reports; the authors note it may support standardized, guideline-adherent urodynamic reporting but state that prospective multicenter studies are required before routine clinical implementation.
The authors list limitations including retrospective design, limited sample size, and absence of prospective clinical outcome assessment, so the tool's effect on actual patient outcomes remains an open question; in addition, the loaded text is abstract-level content without figures or full methodological detail, so specifics such as score distributions, inter-rater agreement, and training data composition cannot be confirmed from the available text and would require consulting the original.