Standardized protocol for voiding cystourethrogram: Are recommendations being followed?

This serves to provide supporting evidence that physicians and researchers are aware of the trauma caused by VCUGs, yet actively choose to ignore it.

This study highly advocates for the VCUG procedure but anyone who has experience reading and analyzing research articles could see that this study is poorly designed and incredibly biased.

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Internal Validity

Cohort not recruited in an acceptable way (not representative of the population of individuals who receive VCUGs): 

• “Studies performed on patients >18 years of age and those obtained for trauma evaluation were excluded from study.” 

Authors also fail to explain why they made the choice to exclude these individuals. The above excerpt also indicates that the authors exhibited selection bias.

External Validity

• Results indicate that: “Timing of reflux [which would be revealed through VCUG] has been shown to predict likelihood of spontaneous resolution and risk of breakthrough urinary tract infection; thus, its omission may limit the information used to counsel families and provide individualized care.” 

However, as the results are not representative of the whole population of individuals who receive VCUGs, they cannot be applied to the whole population of individuals who receive VCUGs. Someone reading this research article may easily wrongly assume that these results are applicable to all individuals receiving VCUGs if they skip over the methodology section of this article.