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International Urogynecology Journal

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01-10-2014 | Original Article

The minimum important difference for the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire

Authors: M. M. Mamik, R. G. Rogers, C. R. Qualls, J. D. Morrow

Published in: International Urogynecology Journal | Issue 10/2014

Abstract

Introduction and hypothesis

Although the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ) is widely used to assess sexual function in women, the minimum important difference (MID) (defined as the smallest difference in scores of a patient-reported outcome measure that is perceived by patients as beneficial or harmful and which would lead the clinician to consider a change in treatment) is not known. The objective was to estimate the MID for the PISQ.

Methods

Two study populations, one of women with overactive bladder (OAB) and urgency UI (UUI) treated with tolterodine in a placebo-controlled trial (cohort I), and one of women treated surgically for prolapse and/or UI (cohort II) were used. Cohort I anchors were the Overactive Bladder Questionnaire (OAB-q), the Patient Perception of Bladder Condition (PPBC), the Patient Perception of Treatment Benefit Questionnaire (PPTBQ), and the change in number of UUI episodes in bladder diaries. Distribution MIDs were also calculated.

Results

In the anchor-based analysis, the MID values for changes in PISQ total scores at 3 months in cohort I were 5 points using the UUI anchor (diary-dry women), 5 points using the PPBC anchor, 5 points with the PPTBQ, and 9 points with the OAB-q. In cohort II, the MID at week 12 in PISQ total scores was 7 points in women with improved IIQ-7 scores. The distribution-based MID in PISQ total scores was 5.3 points in cohort I and 5.8 points in cohort II.

Conclusion

A reasonable estimate of MID for the PISQ total score is 6 points. Improvements that meet these thresholds may be considered clinically important.

Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ, Pelvic Floor Disorders Network (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300(11):1311–1316PubMedCrossRefPubMedCentral

Rogers RG, Kammerer-Doak D, Darrow A, Murray K, Qualls C, Olsen A, Barber M (2006) Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study. Am J Obstet Gynecol 195(5):e1–e4PubMedCrossRef

Handa VL, Cundiff G, Chang HH, Helzlsouer KJ (2008) Female sexual function and pelvic floor disorders. Obstet Gynecol 111(5):1045–1052PubMedCrossRefPubMedCentral

Rogers RG, Kammerer-Doak D, Villarreal A, Coates K, Qualls C (2001) A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse. Am J Obstet Gynecol 184(4):552–558

Crosby RD, Kolotkin RL, Williams GR (2003) Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 56(5):395–407PubMedCrossRef

Barber MD, Spino C, Janz NK, Brubaker L, Nygaard I, Nager CW, Wheeler TL; Pelvic Floor Disorders Network (2009) The minimum important differences for the urinary scales of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. 200(5):580.e1–580.e7

Rogers R, Bachmann G, Jumadilova Z, Sun F, Morrow JD, Guan Z, Bavendam T (2008) Efficacy of tolterodine on overactive bladder symptoms and sexual and emotional quality of life in sexually active women. Int J Urogynecol Pelvic Floor Dysfunct 19(11):1551–1557CrossRef

Rogers RG, Kammerer-Doak D, Olsen A, Thompson PK, Walters MD, Lukacz ES, Qualls C (2004) A randomized, double-blind, placebo-controlled comparison of the effect of nitrofurantoin monohydrate macrocrystals on the development of urinary tract infections after surgery for pelvic organ prolapse and/or stress urinary incontinence with suprapubic catheterization. Am J Obstet Gynecol 191(1):182–187PubMedCrossRef

Cohen J (1977) Statistical power analysis for the behavioural sciences. Academic Press, New York

10.

Revicki D, Hays RD, Cella D, Sloan J (2008) Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 61(2):102–109PubMedCrossRef

11.

Leidy NK, Wyrwich KW (2005) Bridging the gap: using triangulation methodology to estimate minimal clinically important differences (MCIDs). COPD 2(1):157–165PubMedCrossRef

12.

Pleil AM, Coyne KS, Reese PR, Jumadilova Z, Rovner ES, Kelleher CJ (2005) The validation of patient-rated global assessments of treatment benefit, satisfaction, and willingness to continue—the BSW. Value Health 8 [Suppl 1]:S25–S34PubMedCrossRef

13.

Coyne KS, Matza LS, Kopp Z, Abrams P (2006) The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol 49(6):1079–1086PubMedCrossRef

14.

Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379PubMedCrossRef

15.

Coyne KS, Matza LS, Thompson CL, Kopp ZS, Khullar V (2006) Determining the importance of change in the overactive bladder questionnaire. J Urol 176(2):627–632PubMedCrossRef

16.

Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn 14(2):131–139PubMedCrossRef

17.

Jaeschke R, Singer J, Guyatt GH (1989) Ascertaining the minimal clinically important difference. Control Clin Trials 10:407–415PubMedCrossRef

Title: The minimum important difference for the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire
Authors: M. M. Mamik
R. G. Rogers
C. R. Qualls
J. D. Morrow
Publication date: 01-10-2014
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 10/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-014-2342-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The minimum important difference for the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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