The Neurogenic Bladder Symptom Score (NBSS): a secondary assessment of its validity, reliability among people with a spinal cord injury

• Published in: Spinal cord 2018-03, Vol.56 (3), p.259-264
• Main Authors: Welk, Blayne, Lenherr, Sara, Elliott, Sean, Stoffel, John, Presson, Angela P., Zhang, Chong, Myers, Jeremy B.
• Format: Article
• Language: English
• Subjects: 692/308/409; 692/699/375/1824; Adult; Anatomy; Biomedical and Life Sciences; Biomedicine; Bladder; Cohort Studies; Complications; Correlation coefficient; Correlation coefficients; Cross-Sectional Studies; Disability Evaluation; Female; Human Physiology; Humans; Male; Middle Aged; Neurochemistry; Neuropsychology; Neurosciences; Quality of life; Reliability analysis; Reproducibility of Results; Severity of Illness Index; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - epidemiology; Surveys and Questionnaires; United States - epidemiology; Urinary bladder; Urinary Bladder, Neurogenic - diagnosis; Urinary Bladder, Neurogenic - epidemiology; Urinary Bladder, Neurogenic - etiology; Validity
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/s41393-017-0028-0

Study design Prospective cross-sectional study. Objectives Validate the Neurogenic Bladder Symptom Score (NBSS) for people with spinal cord injury (SCI). Setting United States (recruitment from community/tertiary neurourology clinics). Methods We used data from a prospective observational study of people with a SCI who enrolled during December 2015–September 2016. Participants completed the NBSS and other measurement tools (SF-12 and SCI-QOL Bladder Management Complications tool). Data were used to determine the internal consistency (Cronbach’s alpha), validity (hypothesis testing), and test–re-test reliability (using an intraclass correlation coefficient). Results 609 people with a SCI had complete data. The median NBSS total score was 22 (IQR 15–30), and median quality of life was “mixed”. The Cronbach’s alpha of the total and the incontinence, storage/voiding, and consequences domains was 0.85, 0.93, 0.76, and 0.49 respectively. All item to domain correlations were ≥0.3, aside from 3/7 of the items from the consequences domain. Appropriate correlations between the NBSS domains and external variables and other questionnaires were observed, such as a moderate correlation between the SCI-QOL Bladder Management complications tool and the NBSS total score. For the reliability assessment, 174 people had 3 month followup data and did not have a significant change to their urologic health. The intraclass correlation coefficients were >0.75 for all subdomains and the overall score. Conclusions The NBSS demonstrated good validity and reliability in a large cohort of people with a SCI, and is a suitable tool to assess neurogenic bladder symptoms. Sponsorship Patient-Centered Outcomes Research Institute (PCORI) Award CER14092138.