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Obstetrics & Gynecology 2005;106:767-773
© 2005 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Validation of a Two-Item Quantitative Questionnaire for the Triage of Women With Urinary Incontinence

Alfred E. Bent, MD1, Angelo E. Gousse, MD2, Susan L. Hendrix, DO3, Carl G. Klutke, MD4, Ash K. Monga5, Chui Kin Yuen, MD6, Eric S. Meadows, PhD7, Ilker Yalcin, PhD7, David Muram, MD7 for the Duloxetine Mixed Urinary Incontinence Study Group*

From the 1Greater Baltimore Medical Center, Baltimore, Maryland; 2University of Miami, Miami, Florida; 3Wayne State University, Detroit, Michigan; 4Washington University School of Medicine, St. Louis, Missouri; 5Princess Anne Hospital, Southampton, United Kingdom; 6University of Manitoba, Winnipeg, Canada; and 7Lilly Research Laboratories, Indianapolis, Indiana.

OBJECTIVE: To evaluate the reproducibility, construct validity, and preferences for the 2-item Stress/Urge Incontinence Questionnaire.

METHODS: The questionnaire asks a patient to recall the number of stress urinary incontinence and urge urinary incontinence episodes she experienced during the preceding week. The 4-week prospective study included 3 office visits and enrolled women with stress, urge, or mixed urinary incontinence symptoms. The test–retest reproducibility was assessed after 3 days, and the construct validity of the questionnaire was evaluated against a diary and other measures of incontinence severity and effect. The bother associated with completing (patients) or analyzing (physicians) the diary was assessed. Both groups also reported their time requirements and preferences for the questionnaire or diary.

RESULTS: Reproducibility for the classification of symptoms was moderately strong ({kappa} = .536). Test–retest agreement was good (64–80%) for all but balanced mixed incontinence (38%). Intraclass correlations revealed good reproducibility for the number of stress (.694), urge (.703), and total (.726) incontinence episodes. Significant (P < .01) correlations with other measures of incontinence established construct validity. Patients and physicians reported it took less time to complete the questionnaire than the diary, but the majority said the completion or analysis of the diary was of little or no bother and preferred the diary.

CONCLUSION: The Stress/Urge Incontinence Questionnaire is a valid tool that can be used in clinical practice to differentiate between symptoms of stress and urge urinary incontinence to make an initial diagnosis, especially in primary care where incontinence is not a focus of the practice.

LEVEL OF EVIDENCE: III






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