Comparison of “subjective” and “objective” measures of severity of urinary incontinence in women

Abstract

The aims of this study were to compare "subjective" measures of severity of urinary incontinence to similar "objective" measures, establish their statistical correlation, and determine the effect of specific urodynamic diagnosis on such correlations. Baseline data was available from 265 women entered into a clinical trial studying pharmacologic and behavioral interventions for urinary incontinence. The "subjective" measures of incontinence were obtained by patient recall during history taking and included: the number of incontinent episodes in 1 week, the number of perineal pads used during 1 week, and the number of clothing changes required due to wetness. The "objective" measures of severity included: the number of incontinent episodes per week as recorded on a 7-day diary, the number of perineal pads used per week, also recorded on a diary, and the amount of fluid lost during a standardized pad test. Analysis consisted of Pearson correlations and linear regressions to determine equations for the prediction of objective measurement on the basis of the corresponding subjective measure. Significant positive correlations were seen between "subjective" and "objective" measurements for the comparisons of number of weekly incontinent episodes (R = 0.63), and for the weekly number of pads used (R = 0.81). The comparison between the number of clothing changes and the amount of fluid lost during pad testing was also significantly but less strongly correlated (R = 0.24). For the correlations between subjective and objective determinations of urinary incontinent episodes and for those between clothing changes and pad testing, the urodynamic diagnosis had no effect on the correlation coefficients, but did have a statistically significant effect on the intercept.(ABSTRACT TRUNCATED AT 250 WORDS)

Voiding and incontinence frequencies: Variability of diary data and required diary length

“…We also found that the gold standard highly correlated with the recall data and diary data regardless of diary length.Thus, if the diary length were to be determined solely on the basis of such correlation analysis, then no obvious diary length could be recommended, and perhaps the use of recall data would be justi¢ed [Elser et al, 1995]. In fact, previous investigations have recommended a diary length varying from anywhere from 1 day to 7 days [Robb, 1985;Wyman et al, 1988;Larsson and Victor, 1992;Barbara et al, 1994;Abrams and Klevmark, 1996;Lose et al, 1998;Gisolf et al, 2000;Groutz et al, 2000;Nygaard and Holcomb, 2000].…”

“…Recall data are not necessarily unreliable [Elser et al, 1995]; however, a frequency-volume chart or a frequency diary is nowadays recommended to accurately measure the symptom [Lose et al, 1998]. Diary recordings have been con¢rmed to be reproducible and more accurate compared with patient's recall [Wyman et al, 1988;Larsson and Victor, 1992;McCormack et al, 1992;Groutz et al, 2000;Nygaard and Holcomb, 2000;Blanker et al, 2000].…”

An exploratory study comparing psychological profiles and its congruence with clinical performance among patients with functional or motility digestive disorders

“…Incongruence of self-reported vs. clinician-reported measures of functionality or severity can be seldom found in the medical literature (Cowen, Wakefield, & Cloutier, 2007;Elser & Fantl, 1995;Schrader, 1997), but are rarely explored more in depth. To our knowledge, it is the first time this topic is analysed among patients with gastrointestinal pathologies.…”

Long–Term Effectiveness of Sacral Nerve Stimulation for Refractory Urge Incontinence

“…Use of diaries as an objective tool is strongly advocated by the medical community [17, 18]. Patients used diaries at baseline and at each follow–up visit to document the amount voided, leaked or catheterized for every episode for a minimum of 3 days.…”