Interview with Bernadette Dellar, ASA Research Grant Co-Recipient 2020

ASA RESEARCH GRANTS

Bernadette Dellar

ASA Research Grant Co-Recipient 2020

Research Project: Is transpubic sonography a reliable assessment of functional voiding in asymptomatic females? Host Organisation: Absolute Ultrasound Services

What is your research project about? What methods are you using?

This is an inter-rater and intra-rater assessment of a dynamic ultrasound technique where two sonographers scan the same volunteer. This research might be unusual to most sonographers because we are assessing micturition. Yes, voiding is urination and, no, we don’t get urinated on at all. My research requires a volunteer to void in a seated position with the transducer held by the sonographer. Each volunteer attends 2 sessions each lasting about 3 hours. A total of 4 voids are performed by the volunteer to complete the study. Simultaneous ultrasound and uroflowmetry devices are used to visualise the urethra, pelvic floor, and flow pattern.

What is the current status of your research project?

Data collection is finished and the statistician and I are currently analysing 34 data sets.

Why did you want to undertake this research?

When I was working as a radiographer in a women’s hospital some years ago, women with voiding issues had to go through fluoroscopic micturating cystograms, while currently the gold standard test is urodynamics. Then, those techniques had limitations, like radiation and invasive catheterisation. Those tests were not even able to visualise soft tissue during voiding. It occurred to me that ultrasound was great at visualising soft tissue, a dynamic study was distinctly possible, and so began my research in this area. I found an article by GN Schaer, published in 1995, where he used ultrasound simultaneously with urodynamics assessment. I messaged Dr Schaer because he lives in Switzerland, and we had a good chat thanks to modern technology. He supported my research by writing a recommendation letter to help my grant application.

You were one of the recipients of the 2020 ASA Research Grant; why did you apply and how has the grant assisted your research?

In the past, I did an ethics approved research. The project took 6 months of my weekends. Fifty-five volunteers answered my local newspaper advertisement titled ‘Solving a wee problem’. I gave the volunteers a can of Coke and a Mars bar as a token of my appreciation for participating. I was using the hospital’s ultrasound machine and hours of my time spent to investigate if it was possible to ultrasound micturition. I could observe what was happening, but I couldn’t quantify what I saw. After more research, I became aware of the International Continence Society (ICS) and its ultrasound section with recommendations on what to measure. I looked further and realised that there is currently no data on normal measurements, hence I am now collecting that data. I am very thankful and appreciative to be a recipient of this grant. This ultrasound research will change the way functional voiding is assessed. When I present my work internationally at ICS 2023, I will be proud to say that ASA made it possible. Because research is very time consuming and costly, I needed money to pay normal volunteers (4 hours of their time) to wee for me, rental of the ultrasound equipment, Tristel wipes, rental of a uroflowmetry and the sonographers time to collect the data.

What are you hoping to achieve with your research?

I hope to see this research in clinical settings where simultaneous ultrasound with urodynamics adds value to women’s health imaging and diagnosis.

What did you gain from doing the research?

Research starts with a question; you find some answers and you have more questions. This topic has been an interest to me for a long time. Now that I am doing the research, I am in my happy place! I would like to share my knowledge about the processes of research and data presentation.

Would you undertake it again?

Research? Yes, definitely. Another grant would enable clinically relevant volunteers to participate. I would encourage sonographers who have a yearning question they want answered to apply for the grant and undertake their own research. The upcoming ASA2023 Conference will have sessions on research, so stay tuned.

What (if any) challenges did you face, and how did you overcome them?

COVID-19 presented challenges and delays. I discovered that people don’t read flyers and paper prints. I was encouraged when some volunteers answered my Facebook advertisements. My initial plan required volunteers to attend 4 sessions, and when I did not get any takers at all after a month of advertising, I panicked! After conferring with my supervisors and discovering that UQ had a website just for recruiting research volunteers, I applied to have my research advertised through UQ. I learnt when volunteering for another researcher’s project that participants don’t mind attending 2 sessions if they know for how long those sessions go. So, back to the drawing board. After submitting an ethics amendment and completing my data collection a little late because of COVID-19 and other delays, I did it! My next steps will be presenting the findings, writing, and publishing.