Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic- prolapse surgery

• Published in: International Urogynecology Journal 2016-04, Vol.27 (4), p.537-543
• Main Authors: Larsen, Michael Due, Lose, Gunnar, Guldberg, Rikke, Gradel, Kim Oren
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Female; Gynecology; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Reported Outcome Measures; Patient Satisfaction; Pelvic Organ Prolapse - surgery; Surveys and Questionnaires; Urinary Incontinence - surgery; Urology; Young Adult
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-015-2840-4

Introduction and hypothesis In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation on Incontinence has initiated the development and evaluation of disease-specific questionnaires (ICIQ) to compare the patient’s degree of improvement. Alternatively, the Patient’s Global Impression of Improvement (PGI-I score) with an inherent before–after assessment has been widely accepted in recent studies. The aim of this study was to compare the PGI-I versus the ICIQ score for women undergoing UI or POP surgery. Methods This study is based on self-administered pre- and postoperative questionnaires, completed by women undergoing surgery for UI or POP in Denmark in 2013. Weighted Kappa statistics and 95 % limits of agreement method were used when comparing the PGI-I and ICIQ scores. Results Among the 3,310 women included the PGI-I score showed a higher improvement than the IQIC score, for UI 0.83 (CI 95 %: 0.80–0.85) vs 0.62 (0.60–0.64) and for POP 0.77 (0.75–0.78) vs 0.66 (0.65–0.67). Conclusions The PGI-I score renders higher satisfaction than the ICIQ score and the PGI-I score overestimates the improvement following UI and POP surgery.