Table 3, Diagnostic value of the test for UI in women (pooled with random effects models and bivariate pooling) - Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness

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

Type of incontinence	Method index/Reference Standard	Number of studies References Number of subjects in analyses	Sensitivity/Bivariate pooling	Specificity/Bivariate pooling	Positive likelihood ratio^†	Negative likelihood ratio^†	Positive predictive value	Negative predictive value
Urodynamic stress UI	Symptoms of stress UI/Urodynamic test	27¹⁸⁸^,¹⁸⁹^,¹⁹¹^,¹⁹³^,¹⁹⁵^,¹⁹⁷^,²⁰⁰^,²⁰²^,²⁰³^,²⁰⁶^,²⁰⁷^,²⁰⁹^,²¹³^,²¹⁷^,²²⁸^,²²⁹^,²³⁸^,²⁴⁴^,²⁴⁶^,²⁵¹^,²⁵³^,²⁷³^,²⁷⁹^–²⁸³ 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 overactivity	Symptoms of urgency UI/Urodynamic test	23¹⁸⁸^,¹⁹¹^,¹⁹⁵^,²⁰⁰^,²⁰²^,²⁰³^,²⁰⁶^,²⁰⁷^,²⁰⁹^,²¹³^,²¹⁶^,²¹⁷^,²²⁸^,²²⁹^,²³⁸^,²⁴⁴^,²⁴⁶^,²⁵¹^,²⁷³^,²⁷⁹^–²⁸¹^,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 overactivity	Symptoms of urgency/Urodynamic test	9²⁰²^,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 test	17¹⁹¹^,¹⁹⁵^,²⁰⁰^,²⁰³^,²⁰⁶^,²⁰⁷^,²⁰⁹^,²¹¹^–²¹³^,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 test	6²⁰⁶^,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 UI	Symptoms of stress and urgency UI/Urodynamic test	11¹⁹¹^,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 UI	Pad test/Urodynamic test	3²²⁵^,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 overactivity	Pad test/Urodynamic test	2²⁷¹^,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 UI	Symptoms of predominant stress UI/clinical diagnosis	5²¹⁸^,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 overactivity	Symptoms of predominant urgency UI/clinical diagnosis	4²¹⁸^,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 UI	Symptoms of stress and urgency UI/clinical diagnosis	3²²³^,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 UI	Logistic regression model/Urodynamic test	1²⁵⁸ 488	0.77	0.56	1.76	0.41	0.68	0.65
Detrusor overactivity	Logistic regression model/Urodynamic test	1²⁵⁸ 488	0.63	0.65	1.81	0.57	0.63	0.67
Urodynamic stress UI	Clinical algorithm/Urodynamic test	1²⁵⁴ 173					0.90 (0.85 to 0.94)
Urodynamic stress UI	Clinical algorithm/Urodynamic test	1²³⁰ 74					0.97
Urodynamic stress UI	Clinical algorithm based on EPIQ/Clinical diagnosis	1²⁶² 110	0.80	0.92	10.00	0.22	0.88	0.87
Detrusor overactivity	Clinical algorithm based on EPIQ/Clinical diagnosis	1²⁶² 110	0.77	0.90	7.70	0.26	0.77	0.90
Detrusor overactivity	Clinical algorithm based on OAB- V8/Clinical diagnosis	1²⁶⁴ 1,260	0.98	0.83	5.66	0.02	0.44	1.00
Urodynamic stress UI	Q-tip test/Urodynamic test	3²⁰⁸^,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 overactivity	Q-tip test/Urodynamic test	1²⁰⁸ 100	0.40	0.40	0.66	1.50	0.33	0.47
Urodynamic stress UI	UDI-6 question 3 score ≥ 2/Urodynamic test^**	1²³⁴ 128	0.85	0.63	2.32	0.24
Urodynamic stress UI	UDI-6 question 3 score ≥ 2/Urodynamic test^**	1²⁴⁴ 202	0.88	0.55	1.97	0.21	0.86	0.60
Urodynamic stress UI	DIS	1²⁰⁸ 250	0.60	0.77	2.61	0.52	0.82	0.52
Detrusor overactivity	UDI-6 question 1 score ≥ 2/Urodynamic test	1²³⁴ 128	0.83	0.50	1.67	0.33
Detrusor overactivity	UDI-6 question 2 score ≥ 2/Urodynamic test	1²³⁴ 128	0.75	0.33	1.11	0.77
Detrusor overactivity	UDI-6 question 1 and 2 score ≥ 2/Urodynamic test	1²³⁴ 128	0.69	0.64	1.90	0.49
Urodynamic stress UI	QUID stress score ≥ 4/Clinical diagnosis	1²⁵⁹ 117	0.85	0.71	2.93	0.21	0.90	0.61
Detrusor overactivity	QUID urge score ≥ 6/Clinical diagnosis	1²⁵⁹ 117	0.79	0.79	3.76	0.27	0.95	0.43
Detrusor overactivity	BIDI from diary/Urodynamic test	1²⁸⁸ 217	0.88	0.83	5.12	0.14	0.41	0.98
Detrusor overactivity	Logistic regression model/Urodynamic test	1²⁷⁷ 200	0.81	0.72	2.89	0.26	0.74	0.79
Detrusor overactivity^*	Logistic regression model/Urodynamic test	1²⁷⁶ 207	0.56	0.96	12.56	0.46	0.80	0.87
Urodynamic stress UI	Gaudenz- Incontinence- questionnaire predominant stress UI symptoms/Urodynamic test	1²²⁰ 1,911	0.56	0.45	1.01	0.99	0.88	0.18
Detrusor overactivity	Gaudenz- Incontinence- questionnaire predominant urgency UI symptoms/Urodynamic test	1²²⁰ 1,911	0.62	0.56	1.40	0.69	0.03	0.99
Urodynamic stress UI^*	Logistic regression/Urodynamic test	1²⁷⁶ 207	0.95	0.43	1.66	0.13	0.48	0.93
Urodynamic stress UI	Logistic regression/Urodynamic test	1²⁷⁷ 200	0.72	0.81	3.79	0.35	0.79	0.74
Urodynamic stress UI^*	Clinical algorithm based on I-QOL/Urodynamic test	1²⁵⁰ 86					0.76
Urodynamic stress UI	Clinical algorithm based on I-QOL/Urodynamic test	1²⁵⁰ 86					0.92
Urodynamic stress UI^*	Clinical algorithm/Urodynamic test	1²⁵⁴ 173					0.77 (0.7 to 0.83)
Urodynamic stress UI	Clinical algorithm/clinical diagnosis	1²⁵⁴ 173					0.98 (0.95 to 1.00)
Urodynamic stress UI^*	Clinical algorithm/clinical diagnosis	1²⁵⁴ 173					0.85 (0.79 to 0.90)
Urodynamic stress UI^*	Clinical algorithm/Urodynamic test	1²³⁰ 74					0.82
Urodynamic stress UI^*	Clinical algorithm retrospective/Urodynamic test	1²³² 57	0.90	1.00		0.10	1.00	0.82
Urodynamic stress UI^*	Clinical algorithm prospective/Urodynamic test	1²³² 19	0.62	1.00		0.38	1.00	0.55
Urodynamic stress UI^*	Clinical algorithm combining retrospective and prospective/Urodynamic test	1²³² 76	0.83	1.00		0.17	1.00	0.73
Urodynamic stress UI^*	Q-tip test/Urodynamic test	1²⁰⁸ 100	0.38	0.44	0.67	1.42	0.22	0.63
Detrusor overactivity^*	Q-tip test/Urodynamic test	1²⁰⁸ 100	0.63	0.56	1.45	0.65	0.47	0.71
Urodynamic stress UI	Self reported questionnaire/Uro dynamic test	1¹⁹⁷ 161	0.68	0.79	3.23	0.40	0.82	0.63
Detrusor overactivity	Self reported questionnaire/UD	1¹⁹⁷ 166	0.67	0.66	1.94	0.51	0.13	0.96
Detrusor overactivity	Bristol Female Lower Urinary Tract Symptoms Questionnaire, interview/Urodynamic test	1²⁵³ 72	0.85	0.16	1.01	0.94
Detrusor overactivity	Bristol Female Lower Urinary Tract Symptoms Questionnaire, self report/Urodynamic test	1²⁵³ 72	0.81	0.12	0.92	1.58
Urodynamic stress UI	Bristol Female Lower Urinary Tract Symptoms Questionnaire, interview/Urodynamic test	1²⁵³ 72	0.89	0.30	1.27	0.37
Urodynamic stress UI	Bristol Female Lower Urinary Tract Symptoms Questionnaire, self report/Urodynamic test	1²⁵³ 72	0.88	0.29	1.24	0.41
Urodynamic stress UI	Discriminant score/Urodynamic test	1²⁵³ 252	0.78	0.84	4.97	0.26	0.81	0.81
Urodynamic stress UI^*	Gaudenz- Incontinence- questionnaire score predominant stress UI symptoms/Urodynamic test	1²⁵³ 198	0.83	0.92	10.12	0.18	0.95	0.76
Urodynamic stress UI^*	3IQ predominant stress UI symptoms/clinical diagnosis	1²⁶⁶ 301	0.77	0.79	3.63	0.29	0.74	0.82
Urodynamic stress UI^*	Clinical algorithm of predominant stress UI symptoms based on UITN/Urodynamic test	1²⁶⁷ 655	0.91
Detrusor overactivity^*	3IQ predominant stress UI symptoms/clinical diagnosis	1²³⁸ 301	0.57	0.87	4.52	0.49	0.75	0.76
Urodynamic stress UI	3IQ predominant stress UI symptoms/clinical diagnosis	1²³⁸ 301	0.68	0.85	4.57	0.37	0.86	0.66
Detrusor overactivity	3IQ predominant stress UI symptoms/clinical diagnosis	1²³⁸ 301	0.48	0.91	5.22	0.57	0.86	0.60
Detrusor overactivity^*	Gaudenz- Incontinence- questionnaire score predominant urgency UI symptoms/Urodynamic test	1²³⁸ 198	0.86	0.96	24.28	0.14	0.81	0.98
Mixed UI	Gaudenz- Incontinence- questionnaire score mixed UI symptoms/Urodynamic test	1²³⁸ 198	0.61	0.87	4.56	0.45	0.54	0.89
Urodynamic stress UI	Gaudenz- Incontinence- questionnaire score predominant stress UI symptoms/Urodynamic test	1²³⁸ 198	0.98	0.55	2.18	0.03	0.79	0.95
Detrusor overactivity	Gaudenz- Incontinence- questionnaire score predominant urgency UI symptoms/Urodynamic test	1²³⁸ 198	0.90	0.70	2.97	0.15	0.34	0.98
Urodynamic stress UI	Symptoms, Q- tip, and cough test/Urodynamic test	1³⁴⁷ 87	0.94	0.84	5.85	0.08	0.94	0.84
Detrusor overactivity	Symptoms, Q- tip, and cough test/Urodynamic test	1³⁴⁷ 87	0.78	0.87	5.98	0.25	0.84	0.82
Urodynamic stress UI^*	Symptoms, Q- tip, and cough test/Urodynamic test	1³⁴⁷ 87	0.92	0.45	1.67	0.18	0.56	0.88
Detrusor overactivity^*	Symptoms, Q- tip, and cough test/Urodynamic test	1³⁴⁷ 87	0.88	0.67	2.69	0.18	0.39	0.96
Mixed UI	Symptoms, Q- tip, and cough test/Urodynamic test	1³⁴⁷ 87	0.67	0.89	6.00	0.38	0.70	0.88
Urodynamic stress UI	Ultrasound (perineal, BND)/Urodynamic test	1²⁸⁹ 102	0.73	0.77	3.16	0.35	0.64	0.83
Urodynamic stress UI	Ultrasound (perineal, BND)/Urodynamic test	1²⁹⁰ 38	0.72
Urodynamic stress UI	Ultrasound (transrectal, drop of UV junction)/Urodynamic test	1²⁹¹ 91	0.86	0.96	20.30	0.14	0.95	0.88
Urodynamic stress UI	Ultrasound (transrectal, drop of UV junction)/Urodynamic test	1²⁹² 85	0.94	0.87	7.10	0.07	0.81	0.96
Urodynamic stress UI	Ultrasound (vaginal, opening of bladder neck/proximal urethral with leakage during cough)/Urodynamic test	1²⁹³ 124	0.96	0.82	5.33	0.05
Detrusor overactivity	Symptoms and pad test/Urodynamic test	1³⁴⁸ 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 Ratio	Interpretation
>10	Large and often conclusive increase in the likelihood of disease
5 – 10	Moderate increase in the likelihood of disease
2 – 5	Small increase in the likelihood of disease
1 – 2	Minimal increase in the likelihood of disease
1	No 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.

Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Apr.

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