Table 3Diagnostic value of the test for UI in women (pooled with random effects models and bivariate pooling)

Type of incontinenceMethod index/Reference StandardNumber of studies References
Number of subjects in analyses
Sensitivity/Bivariate poolingSpecificity/Bivariate poolingPositive likelihood ratioNegative likelihood ratioPositive predictive valueNegative predictive value
Urodynamic stress UISymptoms of stress UI/Urodynamic test27188,189,191,193,195,197,200,202, 203,206,207,209,213,217,228,229,238, 244,246,251,253,273,279283
5,780
0.93^
(0.90 to 0.95)
0.94
(0.91 to 0.96)
0.41^
(0.34 to 0.49)
0.41
(0.31 to 0.51)
1.54
(1.40 to 1.7)
0.20
(0.14 to 0.27)
0.74
(0.68 to 0.80)
0.74
(0.67 to 0.81)
Detrusor overactivitySymptoms of urgency UI/Urodynamic test23188,191,195,200,202,203,206,207, 209,213,216,217,228,229,238,244, 246,251,273,279281,284
5,485
0.82^
(0.76 to 0.87)
0.82
(0.75 to 0.88)
0.51^
(0.44 to 0.59)
0.52
(0.40 to 0.65)
1.54
(1.38 to 1.73)
0.39
(0.30 to 0.50)
0.56
(0.48 to 0.63)
0.80
(0.73 to 0.86)
Detrusor overactivitySymptoms of urgency/Urodynamic test9202,206,209,213,217,229,247,279, 284
6,418
0.84^
(0.59 to 0.95)
0.82
(0.70 to 0.92)
0.39^
(0.17 to 0.67)
0.39
(0.24 to 0.55)
1.36
(1.18 to 1.58)
0.47
(0.33 to 0.67)
0.48
(0.39 to 0.57)
0.75
(0.67 to 0.81)
Detrusor overactivity*Symptoms of urgency UI/Urodynamic test17191,195,200,203,206,207,209,211213,217,228,229,244,251,273,279
3,924
0.84^
(0.78 to 0.89)
0.84
(0.79 to 0.90)
0.43^
(0.36 to 0.50)
0.44
(0.34 to 0.54)
1.48
(1.31 to 1.66)
0.40
(0.29 to 0.54)
0.33
(0.26 to 0.41)
0.89
(0.83 to 0.93)
Detrusor overactivity*Symptoms of urgency/Urodynamic test6206,209,213,217,229,279
1,598
0.86
(0.83 to 0.89)
0.86
(0.80 to, 0.90)
0.31^
(0.24 to 0.39)
0.31
(0.20 to 0.45)
1.21
(1.11 to 1.32)
0.523
(0.41 to 0.67)
0.27
(0.17 to 0.40)
0.86
(0.76 to 0.93)
Mixed UISymptoms of stress and urgency UI/Urodynamic test11191,195,199,200,203,207,228,244, 246,251,273
2,767
0.73^
(0.61 to 0.82)
0.72
(0.58 to 0.83)
0.53^
(0.40 to 0.66)
0.53
(0.34 to 0.72)
1.45
(1.27 to 1.67)
0.61
(0.52 to 0.71)
0.26
(0.20 to 0.34)
0.89
(0.85 to 0.92)
Urodynamic stress UIPad test/Urodynamic test3225,271,275
574
0.84
(0.76 to 0.90)
0.83
(0.75 to 0.91)
0.77
(0.72 to 0.82)
0.77
(0.17 to 0.97)
3.62
(2.88 to 4.57)
0.22
(0.15 to 0.32)
0.82
(0.77 to 0.86)
0.78
(0.73 to 0.83)
Detrusor overactivityPad test/Urodynamic test2271,275
469
0.72^
(0.30 to 0.94)
0.56^
(0.38 to 0.72)
1.56
(0.62 to 3.90)
0.47
(0.10 to 2.33)
0.32
(0.04 to 0.83)
0.88
(0.83 to 0.91)
Urodynamic stress UISymptoms of predominant stress UI/clinical diagnosis5218,223,259,266,285
947
0.88^
(0.68 to 0.96)
0.86
(0.70 to 0.96)
0.67^
(0.54 to 0.78)
0.67
(0.51 to 0.81)
2.35
(1.97 to 2.81)
0.19
(0.09 to 0.41)
0.80
(0.66 to 0.89)
0.75
(0.58 to 0.87)
Detrusor overactivitySymptoms of predominant urgency UI/clinical diagnosis4218,223,259,266
735
0.82^
(0.73 to 0.89)
0.82
(0.73 to 0.90)
0.67^
(0.53 to 0.79)
0.67
(0.45 to 0.86)
2.52
(1.81 to 3.50)
0.26
(0.18 to 0.38)
0.72
(0.48 to 0.88)
0.79
(0.54 to 0.92)
Mixed UISymptoms of stress and urgency UI/clinical diagnosis3223,259,266
654
0.65^
(0.36 to 0.86)
0.64
(0.38 to 0.85)
0.54^
(0.21 to 0.84)
0.52
(0.06 to 0.94)
1.57
(0.68 to 3.59)
0.74
(0.28 to 1.95)
0.36
(0.27 to 0.47)
0.80
(0.43 to 0.96)
Urodynamic stress UILogistic regression model/Urodynamic test1258
488
0.770.561.760.410.680.65
Detrusor overactivityLogistic regression model/Urodynamic test1258
488
0.630.651.810.570.630.67
Urodynamic stress UIClinical algorithm/Urodynamic test1254
173
0.90
(0.85 to 0.94)
Urodynamic stress UIClinical algorithm/Urodynamic test1230
74
0.97
Urodynamic stress UIClinical algorithm based on EPIQ/Clinical diagnosis1262
110
0.800.9210.000.220.880.87
Detrusor overactivityClinical algorithm based on EPIQ/Clinical diagnosis1262
110
0.770.907.700.260.770.90
Detrusor overactivityClinical algorithm based on OAB- V8/Clinical diagnosis1264
1,260
0.980.835.660.020.441.00
Urodynamic stress UIQ-tip test/Urodynamic test3208,286,291
267
0.62
(0.53 to 0.70)
0.62
(0.49 to 0.74)
0.60^
(0.40 to 0.78)
0.58
(0.00 to 0.99)
1.70
(0.89 to 3.23)
0.60
(0.31 to 1.17)
0.58
(0.26 to 0.85)
0.67
(0.34 to 0.89)
Detrusor overactivityQ-tip test/Urodynamic test1208
100
0.400.400.661.500.330.47
Urodynamic stress UIUDI-6 question 3 score ≥ 2/Urodynamic test**1234
128
0.850.632.320.24
Urodynamic stress UIUDI-6 question 3 score ≥ 2/Urodynamic test**1244
202
0.880.551.970.210.860.60
Urodynamic stress UIDIS1208
250
0.600.772.610.520.820.52
Detrusor overactivityUDI-6 question 1 score ≥ 2/Urodynamic test1234
128
0.830.501.670.33
Detrusor overactivityUDI-6 question 2 score ≥ 2/Urodynamic test1234
128
0.750.331.110.77
Detrusor overactivityUDI-6 question 1 and 2 score ≥ 2/Urodynamic test1234
128
0.690.641.900.49
Urodynamic stress UIQUID stress score ≥ 4/Clinical diagnosis1259
117
0.850.712.930.210.900.61
Detrusor overactivityQUID urge score ≥ 6/Clinical diagnosis1259
117
0.790.793.760.270.950.43
Detrusor overactivityBIDI from diary/Urodynamic test1288
217
0.880.835.120.140.410.98
Detrusor overactivityLogistic regression model/Urodynamic test1277
200
0.810.722.890.260.740.79
Detrusor overactivity*Logistic regression model/Urodynamic test1276
207
0.560.9612.560.460.800.87
Urodynamic stress UIGaudenz- Incontinence- questionnaire predominant stress UI symptoms/Urodynamic test1220
1,911
0.560.451.010.990.880.18
Detrusor overactivityGaudenz- Incontinence- questionnaire predominant urgency UI symptoms/Urodynamic test1220
1,911
0.620.561.400.690.030.99
Urodynamic stress UI*Logistic regression/Urodynamic test1276
207
0.950.431.660.130.480.93
Urodynamic stress UILogistic regression/Urodynamic test1277
200
0.720.813.790.350.790.74
Urodynamic stress UI*Clinical algorithm based on I-QOL/Urodynamic test1250
86
0.76
Urodynamic stress UIClinical algorithm based on I-QOL/Urodynamic test1250
86
0.92
Urodynamic stress UI*Clinical algorithm/Urodynamic test1254
173
0.77
(0.7 to 0.83)
Urodynamic stress UIClinical algorithm/clinical diagnosis1254
173
0.98
(0.95 to 1.00)
Urodynamic stress UI*Clinical algorithm/clinical diagnosis1254
173
0.85
(0.79 to 0.90)
Urodynamic stress UI*Clinical algorithm/Urodynamic test1230
74
0.82
Urodynamic stress UI*Clinical algorithm retrospective/Urodynamic test1232
57
0.901.000.101.000.82
Urodynamic stress UI*Clinical algorithm prospective/Urodynamic test1232
19
0.621.000.381.000.55
Urodynamic stress UI*Clinical algorithm combining retrospective and prospective/Urodynamic test1232
76
0.831.000.171.000.73
Urodynamic stress UI*Q-tip test/Urodynamic test1208
100
0.380.440.671.420.220.63
Detrusor overactivity*Q-tip test/Urodynamic test1208
100
0.630.561.450.650.470.71
Urodynamic stress UISelf reported questionnaire/Uro dynamic test1197
161
0.680.793.230.400.820.63
Detrusor overactivitySelf reported questionnaire/UD1197
166
0.670.661.940.510.130.96
Detrusor overactivityBristol Female Lower Urinary Tract Symptoms Questionnaire, interview/Urodynamic test1253
72
0.850.161.010.94
Detrusor overactivityBristol Female Lower Urinary Tract Symptoms Questionnaire, self report/Urodynamic test1253
72
0.810.120.921.58
Urodynamic stress UIBristol Female Lower Urinary Tract Symptoms Questionnaire, interview/Urodynamic test1253
72
0.890.301.270.37
Urodynamic stress UIBristol Female Lower Urinary Tract Symptoms Questionnaire, self report/Urodynamic test1253
72
0.880.291.240.41
Urodynamic stress UIDiscriminant score/Urodynamic test1253
252
0.780.844.970.260.810.81
Urodynamic stress UI*Gaudenz- Incontinence- questionnaire score predominant stress UI symptoms/Urodynamic test1253
198
0.830.9210.120.180.950.76
Urodynamic stress UI*3IQ predominant stress UI symptoms/clinical diagnosis1266
301
0.770.793.630.290.740.82
Urodynamic stress UI*Clinical algorithm of predominant stress UI symptoms based on UITN/Urodynamic test1267
655
0.91
Detrusor overactivity*3IQ predominant stress UI symptoms/clinical diagnosis1238
301
0.570.874.520.490.750.76
Urodynamic stress UI3IQ predominant stress UI symptoms/clinical diagnosis1238
301
0.680.854.570.370.860.66
Detrusor overactivity3IQ predominant stress UI symptoms/clinical diagnosis1238
301
0.480.915.220.570.860.60
Detrusor overactivity*Gaudenz- Incontinence- questionnaire score predominant urgency UI symptoms/Urodynamic test1238
198
0.860.9624.280.140.810.98
Mixed UIGaudenz- Incontinence- questionnaire score mixed UI symptoms/Urodynamic test1238
198
0.610.874.560.450.540.89
Urodynamic stress UIGaudenz- Incontinence- questionnaire score predominant stress UI symptoms/Urodynamic test1238
198
0.980.552.180.030.790.95
Detrusor overactivityGaudenz- Incontinence- questionnaire score predominant urgency UI symptoms/Urodynamic test1238
198
0.900.702.970.150.340.98
Urodynamic stress UISymptoms, Q- tip, and cough test/Urodynamic test1347
87
0.940.845.850.080.940.84
Detrusor overactivitySymptoms, Q- tip, and cough test/Urodynamic test1347
87
0.780.875.980.250.840.82
Urodynamic stress UI*Symptoms, Q- tip, and cough test/Urodynamic test1347
87
0.920.451.670.180.560.88
Detrusor overactivity*Symptoms, Q- tip, and cough test/Urodynamic test1347
87
0.880.672.690.180.390.96
Mixed UISymptoms, Q- tip, and cough test/Urodynamic test1347
87
0.670.896.000.380.700.88
Urodynamic stress UIUltrasound (perineal, BND)/Urodynamic test1289
102
0.730.773.160.350.640.83
Urodynamic stress UIUltrasound (perineal, BND)/Urodynamic test1290
38
0.72
Urodynamic stress UIUltrasound (transrectal, drop of UV junction)/Urodynamic test1291
91
0.860.9620.300.140.950.88
Urodynamic stress UIUltrasound (transrectal, drop of UV junction)/Urodynamic test1292
85
0.940.877.100.070.810.96
Urodynamic stress UIUltrasound (vaginal, opening of bladder neck/proximal urethral with leakage during cough)/Urodynamic test1293
124
0.960.825.330.05
Detrusor overactivitySymptoms and pad test/Urodynamic test1348
100
0.88
*

pure type

**

not pooled because of poor reporting quality

#

68% women and 32% men, the golden standard was not clearly defined

^

significant heterogeneity

Clinical interpretations of likelihood ratios197

Likelihood RatioInterpretation
>10Large and often conclusive increase in the likelihood of disease
5 – 10Moderate increase in the likelihood of disease
2 – 5Small increase in the likelihood of disease
1 – 2Minimal increase in the likelihood of disease
1No change in the likelihood of disease

From: Results

Cover of Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness
Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness [Internet].
Comparative Effectiveness Reviews, No. 36.
Shamliyan T, Wyman J, Kane RL.

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