Table 5Diagnostic tools to assess clinical importance and monitor effectiveness of treatments of UI

Tools*References (all that mentioned)ConditionsDomainMinimal important differencesWorst to bestValidity/reliability
Symptom Bother
ISI
Sandvik, 1993334
Sandvik, 2000335
Any/not specifiedFrequency
Severity
1993 version*
6–8 as severe UI (pad test mean 56–63g/24 hours)
3–4 as moderate UI (pad test 17g/24 hours)
2000 version
8–9 as severe UI(pad test mean 52g/24 hours)
12 as very severe UI (pad test mean 122g/24 hrs)
1993 version 8 to 1
2000 version 12 to 1
Yes/No
Symptom Bother PGI-IYalcin, 2003331Stress UI1 item for improvementChange incontinence episode frequency*
−92% in very much better group
−63% in much better group
7 to 1 for improvementYes/No
Symptom Bother PGI-SYalcin, 2003331Stress UI1 item for severityMean incontinence episode frequency*
32.8 per week for severe cases
4 to 1 for severityYes/No
Symptom Bother
POSQ
Matza, 2005333Urgency UI or OAB4 bother scales for OAB symptoms
1 item to indicate the most bother symptom
Not available5 to 1 for first 4 itemsYes/Yes
Symptom Bother PPBCCoyne, 2005338
Capo, 2008339
Matza, 2005333
Any/not specifiedSingle-Item Global MeasureIncontinence episodes/7days diary*
7.4 in many severe cases
3.3 in very severe cases
2.0 in moderate severe cases
6 to 1Yes/Yes
Symptom Bother
SSI/SII
Black, 1996338Stress UISeverity
Incontinence impact
Not available20 to 0 for SSI
16 to 0 for SII
Yes/Yes
Symptom Bother
SUIQQ
Kulseng-Hanssen, 2003252Stress UI or Urgency UI (OAB)Total QoLNot available12 to 0 for the stress incontinence index
8 to 0 for the urgency incontinence index
16 to 0 for the QoL index
Yes/Yes
Symptom Bother UDIUebersax, 1995336
Shumaker, 1994222
Barber,2009337
Dyer, 2010349
Stress UI or Urgency UI (OAB)Symptom: irritative, stress, obstructive−6.4 to −22.4
−35 to −43 (anchor-based) or −10 to −25 (distribution-based) for UUI
−4.6 to −16.5 for UDI-stress subscale
100 to 0 for each subscaleYes/Yes
Symptom Bother UDI-6Uebersax, 1995336Any/not specifiedSymptom: irritative, stress, obstructiveNot available18 to 0Yes/Yes
Screening 3IQBrown, 2006266Any/not specified3 questions to classify UUI and SUINot availableCategorical variablesNo/No
Screening B-SAQBasra, 2007299Any/not specifiedSymptoms BotherSymptom score 7–9: significant problem*
Symptom score 10–12: very significant problem
Bother score 7–9: significant problem
Bother score 10–12: major problem
12 to 0Yes/Yes
Screening ISQGunthorpe, 20002240Any/not specifiedFive items for predicting UI
Three items for concerns
Not availableAlgorism for predicting UI
12 to 3 for concerns of UI
Yes/Yes
Screening LUSQShaw, 2002296Any/not specifiedPresence of incontinence
Severity
Urgency
Frequency
Nocturia
Not availableCategorical variablesYes/Yes
Screening MESADiokno, 1986297Any/not specifiedGeneral medical
Urological: severity (frequency and quantity) and nature (stress, urge, or mixed)
Social
Mental health
Not availableCategorical variablesYes/Yes
Screening OAB-V8Yalcin, 2003331Urgency UI or OAB8 items for screeningNot available40 to 0Yes/No
Screening QUIDBradley, 2005259Any/not specifiedStress score
Urge score
Not available15 to 0 for each scoreYes/Yes
Screening USPHaab, 2008298Any/not specifiedStress urinary incontinence
Overactive bladder
Low stream
Not available9 to 0 for SUI
21 to 0 for OAB
9 to 0 for low stream
Yes/Yes
Quality of Life
BFLUTS-SF
Jackson, 1996
227 Brookes, 2004350
Reid, 2007351
Any/not specifiedSymptom
Severity
Bothersome
Sexual function
Total QoL
Not available20 to 0 for the incontinence score
12 to 0 for the voiding score
15 to 0 for the filling score
6 to 0 for the sexual function score
18 to 0 for the QoL score
Yes/Yes
Quality of Life
CONTLIFE
Amarenco, 2003248Any/not specifiedGlobal health and quality of life
Daily Activities
Emotions
Sexual function
Effort Activities
Self-Image
Well-Being
−7 to −20 (graph only), depending on the domain, in improved population defined by decrease of at least 50% in the number of urinary leaks under treatment0 to 100Yes/Yes
Quality of Life
EPIQ
Lukacz, 2005262Any/not specifiedQoL
Defecatory dysfunction
Pelvic organ prolapse
Stress urinary incontinence
Overactive bladder
Pain and difficult voiding
Anal incontinence
Not availableNot availableYes/Yes
Quality of Life
IBS
Abdel-Fattah, 2007352Any/not specifiedSimple visual analogue scaleNot available100 to 0No/No
Quality of Life
ICIQ
Avery, 2004353Any/not specifiedFrequency
Severity
Bothersome
Social limitation
Sexual function
Interference with everyday life
Total QoL
Not available21 to 0Yes/Yes
Quality of Life
ICIQ-SF
Klovning, 2009354Any/not specifiedFrequency
Severity
Total QoL
With QoL*
Mean 16.3 for very severe UI (defined by 2000 ISI)
12.3 for severe UI
Without QoL
9.4 for very severe UI
6.8 for severe UI
21 to 0 with QoL
11 to 0 without QoL
Yes/Yes
Quality of Life
ICS
Stothers, 2004355Any/not specifiedGlobal health and quality of life
Social interaction
Sexual function
Financial impact
Satisfaction
Personal strain
Not available45 to 0Yes/Yes
Quality of Life
IHI
Rai, 1994356Urgency UI or OABHealth/function
Emotion
Not available68 to 0Yes/No
Quality of Life
IIQ
Shumaker, 1994222
Uebersax, 1995336
Hagen, 2002357
Barber, 2009337
Dyer, 2010349
Any/not specifiedTravel
Physical activity
Social
Emotional
Total QoL
−6.5 to −22 for stress UI
−18 to −50 for UUI
100 to 0 for each domainYes/Yes
Quality of Life
IIQ-7
Uebersax, 1995336Any/not specifiedTravel
Physical activity
Social
Emotional
Total QoL
Not available21 to 0Yes/No
Quality of Life
IOQ
Bjelic-Radisic, 2007358Stress UISymptom
Complication
Satisfaction
QoL
Not available2100 to 0Yes/Yes
Quality of Life
I-QOL
Patrick, 1999359
Bushnell, 2005360
Wagner, 1996361
Oh, 2007362
Schurch, 2007363
Yalcin, 2006364
Yalcin, 2010321
Hollingworth, 2010365
Any/not specified
Neurogenic UI
Avoidance and Limiting behavior
Psychological impact
Social embarrassment
Total QoL
2 to 5 for UI
6.3 for the within-group MCID: Patients appear to recognize important clinical value at reductions of 50–70% or more incontinence episode frequency
2.5 for the between-group MCID
4 to 11 for neurogenic UI
A ≥10-point increase was associated with a 0.05
SF- 6D increase in patients with neurogenic UI
0 to 100Yes/Yes
Quality of Life
KHQ
Kelleher, 1997366
Reese, 2003367
Sand, 2007368
Kelleher, 2004369
Mostafa, 2010370
Any/not specified
Urgency UI or OAB
Severity
Incontinence impact
Role limitation
Physical limitation
Social limitation
Personal relationship
Emotions
Sleep and energy
General health
−3 to −4 for general health and severity domains
−5 to −6 for other domains
“Very Much improved or Much improved” in PGI-I corresponds to a mean change in KHQ of 46 & 35 points (Range 17 – 60 points) with clear demarcation from those reporting “no change and/or worse condition” (mean 2 & −21; Range −25 – 10)*
100 to 0 for each domainYes/Yes
Quality of Life
LIS
Shaw, 2 004371Any/not specifiedImpact on activities
Impact on feelings
Not available22 to 0 for activities
20 to 10 on feelings
Yes/Yes
Quality of Life
Quality of Life
OAB-q
Coyne, 2002372
Coyne, 2006373
Urgency UI or OABBothersome
Social interaction
Sleep and energy
Concern/worry
Coping
Total QoL
Bothersome: 16–19
Social interaction: 4.5–9.3
Sleep and energy: 13–20)
Concern/worry: 12–19
Coping: 11–19
Total QoL: 12–16 (within-treatment
0 to 100 for bother score
100 to 0 for QoL
Yes/Yes
Quality of Life
PISQ
Rogers, 2001374Any/not specifiedBehavioral/emotive
Physical activity
Partner-related
Total score
Not available0 to 125Yes/Yes
Quality of Life
PRAFAB
Hendriks, 2007375
Hendriks, 2008376
Hendriks, 2008377
Any/not specifiedProtection
Amount
Frequency
Adjustment
Body image
>14 points for severe UI (>2 g/hour urine loss)*
SUI: 2.5–3.1
Urgency UI: 3.0–4.0
20 to 5. 4 points/item (1–4) with a total PRAFAB-Q score of 20 pointsYes/Yes
Quality of Life
UISS
Stach-Lempinen, 2001245Any/not specifiedThe amount of leakage the degree to which UI affects aspects of women’s daily lives>11.02 points for severe UI (>30 g/24 hour urine loss)*100 to 0Yes/Yes
Quality of Life
UQ
Matza, 2005333Stress UI or Urgency UI (OAB)15 Likert-scale items nocturia
Fear of incontinence
Time to control urge
Impact on daily activities
4 visual analog scales
Urinary urgency’s severity
Intensity
Impact
Discomfort
Not available1 (or 5) to 5 ( or 1) for Likert-scale 10 to 1 for visual analog scalesYes/Yes
Quality of Life
YIPS
Lee, 1995378Any/not specifiedEight-item seven-point rating scales a unidimensional measure
Three single-item measures of self-perceptions of change in continence status, health status, amount of leakage
Not available0 to 7 for eight rating scales
Categorical variables for three single-item measures
Yes/Yes
Patient Satisfaction
OAB-SS
Blaivas, 2007300Urgency UI or OAB5 items for urgency
2 items for frequency
Not available5 points Likert scalesYes/Yes
Satisfaction
BSW
Pleil, 2005301Urgency UI or OABBenefit
Satisfaction
Willingness to continue
−2.21 mean number of incontinence episodes per 24 hours for much benefit populationCategorized for each domainYes/No
Satisfaction
EPI
Burgio, 2006302Any/not specifiedOne item for estimated percent improvementNot available0 to 100Yes/No
Satisfaction
GPI
Burgio, 2006302Any/not specifiedOne item for global perception of improvementNot available5 categoriesYes/No
Satisfaction
PSQ
Burgio, 2006302Any/not specifiedOne item for patient satisfactionA 70% improvement in the frequency of incontinence episodes on bladder diary as a critical threshold3 categoriesYes/No
Satisfaction
TBS
Colman, 2008303Urgency UI or OABOne item for patient-reported benefitsUUI episodes/24 hours
+1.31 in “4” group
−0.52 in “3” group
−1.62 in “2” group
−2.38 in “1” group
4 to 1Yes/Yes
*

Abbreviations: 3IQ: Three Incontinence Questions Questionnaire; BFLUTS: Bristol Female Lower Urinary Tract Symptoms Questionnaire; B-SAQ: Bladder Self-Assessment Questionnaire or Bladder Control Self-Assessment Questionnaire (BCSQ); BSW: Benefit, Satisfaction with treatment, and Willingness; Contilife: Quality of Life Assessment Questionnaire Concerning Urinary Incontinence; EPI: Estimated Percent Improvement; EPIQ: Epidemiology of Prolapse and Incontinence Questionnaire; GPI: Global Perception of Improvement; IBS: Incontinence Bothersome Scale; ICIQ: International Consultation on Incontinence Modular Questionnaire; ICS: Incontinence Classification System; IHI: Urinary Incontinence Handicap Inventory; IIQ: Incontinence Impact Questionnaire; IIQ-7: Incontinence Impact Questionnaire - short form; IOQ: Incontinence Outcome Questionnaire; I-QOL: Urinary Incontinence- Specific Quality of Life Instrument; ISI: Incontinence Severity Index; ISQ: Incontinence Screening Questionnaire; KHQ: King’s Health Questionnaire; LIS: Leicester Impact Scale; LUSQ: The Leicester Urinary Symptom Questionnaire; MESA: Medical, Epidemiological, and Social Aspects of Aging Questionnaire; OAB-q: Overactive Bladder Questionnaire; OAB-S: Overactive Bladder Satisfaction Questionnaire; OAB-SS: Overactive Bladder Symptom Score; OAB-V8: OAB Awareness Tool; PGI-I and PGI-S: Patient Global Impression of Improvement and of Severity; PISQ: Pelvic Organ Prolapse–Urinary Incontinence Sexual Function Questionnaire; POSQ: Primary OAB Symptom Questionnaire; PPBC: Patient Perception of Bladder Condition; PRAFAB: Protection, Amount, Frequency, Adjustment, Body image tool; PSQ: Patient Satisfaction Question; PUF: patient symptom scale (Pelvic Pain, Urgency, and Frequency; QUID: Questionnaire for Urinary Incontinence Diagnosis; SF: Short Form; SSI and SII: Symptom Severity Index and Symptom Impact Index for stress incontinence in women; SUIQQ: Stress and Urge Incontinence and Quality of Life Questionnaire; TBS: Treatment Benefit Scale; UDI: Urogenital Distress Inventory; UDI-6: Urogenital Distress Inventory-6; UISS: Urinary Incontinence Severity Score; UI: Urinary Incontinence Score; UQ: Urgency Questionnaire; USP: Urinary Symptom Profile; YIPS: York Incontinence perceptions scale.

*

clinically important cut-off values

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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