Diagnostic classification of female urinary incontinence: an epidemiological survey corrected for validity.
Diagnostic questions about stress and urge incontinence were validated against a final diagnosis made by a gynecologist after urodynamic evaluation. Thereafter, an epidemiological survey was performed, using similar questions, and correcting the answers for lack of validity. Included were 250 incontinent women at the out-patient clinic and 535 women who reported incontinence in the epidemiological survey. The sensitivity for stress incontinence was 0.66 (95% confidence interval +/- 0.08), specificity 0.88 (+/- 0.06). The corresponding values for urge incontinence were 0.56 (+/- 0.15) and 0.96 (+/- 0.03), and for mixed incontinence 0.84 (+/- 0.10) and 0.66 (+/- 0.07). Using these indices of validity as corrective measures for the diagnostic distribution reported in the epidemiological survey, the percentage of stress incontinence increased from 51 to 77%, while mixed incontinence was reduced from 39 to 11%. Pure urge incontinence increased from 10 to 12%. Mixed incontinence will be overreported in epidemiological surveys. Correction for validity indicates that a larger majority than hitherto reported may have pure stress incontinence.
Sandvik
H
H
Department of Public Health and Primary Health Care, University of Bergen, Norway.
Hunskaar
S
S
Vanvik
A
A
Bratt
H
H
Seim
A
A
Hermstad
R
R
D000328:Adult; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014549:Urinary Incontinence / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D014563:Urodynamics