Relationship between patient report and physician assessment of urinary incontinence severity

• Published in: American journal of obstetrics and gynecology 2003-07, Vol.189 (1), p.76-80
• Main Authors: Melville, Jennifer L., Miller, Elizabeth A., Fialkow, Michael F., Lentz, Gretchen M., Miller, Jane L., Fenner, Dee E.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Female; Humans; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Perception; Quality of Life; Severity of Illness Index; Surveys and Questionnaires; symptom severity; Urinary incontinence; Urinary Incontinence - diagnosis; Urinary Incontinence - physiopathology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1067/mob.[phone]

Objective: The purpose of this study was to determine the relationship between patient report and physician assessment of urinary incontinence severity and to compare these assessments to a validated severity instrument. Study Design: A sequential sample of 153 women with urinary incontinence was enrolled over 12 months. Patients completed a detailed health questionnaire that included a medical comorbidity scale, 12-item short-form health survey (SF-12) the incontinence quality of life instrument, the PRIME-MD patient health questionnaire, and a patient incontinence severity assessment. The patient incontinence severity assessment is a single question that asks the patient to rate the severity of her incontinence symptoms on a 5-point Likert scale (range: 1 [mild] to 5 [severe]). After the physicians completed a detailed history, a physical examination, and a review of a 3-day voiding diary, they assigned a physician incontinence severity assessment score. The physician incontinence severity assessment is a physician rating of the severity of the patient's incontinence on a 5-point Likert scale (range: 1 [mild] to 5 [severe]). A validated severity index was computed and used for comparison. This is a multiplicative index that is based on frequency (4 levels) and amount of leakage (2 levels), which yields an index value of 1 to 8. Spearman correlation coefficients were calculated for patient incontinence severity assessment, the physician incontinence severity assessment scores, and the severity index values. Chi-square tests were used to determine differences between patient incontinence severity assessment and physician incontinence severity assessment ratings. Results: Spearman correlation coefficients for patient incontinence severity assessment and physician incontinence severity assessment were 0.62 (P