The sensitivity and specificity of a simple test to distinguish between urge and stress urinary incontinence.
BACKGROUND
Urinary incontinence is common in women. Because treatments differ, urge incontinence should be distinguished from stress incontinence. To make this distinction, current guidelines recommend an extensive evaluation that is too time-consuming for primary care practice.


OBJECTIVE
To test the accuracy of a simple questionnaire to categorize type of urinary incontinence in women.


METHODS
Multicenter, prospective study of the accuracy of the 3 Incontinence Questions (3IQ) compared with an extended evaluation to distinguish between urge incontinence and stress incontinence.


METHODS
5 academic medical centers in the United States.


METHODS
301 women enrolled from April to December 2004 who were older than 40 years of age (mean age, 56 years [SD, 11]) with untreated incontinence for an average of 7 years (SD, 7) and a broad range of incontinence severity.


METHODS
All participants included in the analyses answered the 3IQ questionnaire, and a urologist or urogynecologist who was blinded to the responses performed the extended evaluation. Sensitivity, specificity, and likelihood ratios were determined for the 3IQ.


RESULTS
For classification of urge incontinence and with the extended evaluation as the gold standard, the 3IQ had a sensitivity of 0.75 (95% CI, 0.68 to 0.81), a specificity of 0.77 (CI, 0.69 to 0.84), and a positive likelihood ratio of 3.29 (CI, 2.39 to 4.51). For classification of stress incontinence, the sensitivity was 0.86 (CI, 0.79 to 0.90), the specificity was 0.60 (CI, 0.51 to 0.68), and the positive likelihood ratio was 2.13 (CI, 1.71 to 2.66).


CONCLUSIONS
Participants were enrolled by urologists and urogynecologists at academic medical centers.


CONCLUSIONS
The 3IQ questionnaire is a simple, quick, and noninvasive test with acceptable accuracy for classifying urge and stress incontinence and may be appropriate for use in primary care settings. Similar studies are needed in other populations. We also need a clinical trial comparing the outcomes of treatments based on the 3IQ and the extended evaluation.
Brown
Jeanette S
JS
University of California, San Francisco, and San Francisco Veterans Affairs Medical Center, San Francisco, California 94115, USA. brownj@obgyn.ucsf.edu
Bradley
Catherine S
CS
Subak
Leslee L
LL
Richter
Holly E
HE
Kraus
Stephen R
SR
Brubaker
Linda
L
Lin
Feng
F
Vittinghoff
Eric
E
Grady
Deborah
D
D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States; D014549:Urinary Incontinence / Q000145:classification / Q000175:diagnosis*; D014550:Urinary Incontinence, Stress / Q000145:classification / Q000175:diagnosis*