title: The impact of multichannel urodynamics upon treatment recommendations for female urinary incontinence.
abstract: The aim of this study was to evaluate whether multichannel urodynamic testing changes a physician's treatment recommendations when managing women with urinary incontinence. In this prospective reader study, four fellowship-trained urogynecologists reviewed 39 abstracted cases of urinary incontinence on two occasions: first without and subsequently with urodynamic data. Treatment recommendations were made for each case after each review. The probability of urodynamic data modifying treatment recommendations was estimated for each reader and for the population of readers using a random effects logistic regression to account for reader variability. The overall probability that urodynamic data would change treatment was 26.9% (95% confidence interval (CI), 18.6%, 37.2%) for medical treatments and 45.5% (95% CI, 37.8%, 53.4%) for surgical treatments. Reader-to-reader differences accounted for 3% and <1% of the total variance for medical and surgical treatments, respectively. Multichannel urodynamic evaluations are significantly associated with changes in medical and surgical treatment recommendations in a referral population.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstet/Gynecol, Women and Infants' Hospital/Warren Alpert Medical School of Brown University, 695 Eddy Street, Providence, RI, 02903, USA. rward@wihri.org
authors.forename: Renée M
authors.initials: RM
authors.lastname: Ward
authors.forename: Brittany Star
authors.initials: BS
authors.lastname: Hampton
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Blume
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Sung
authors.forename: Charles R
authors.initials: CR
authors.lastname: Rardin
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Myers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014549:Urinary Incontinence / Q000503:physiopathology* / Q000628:therapy; D014563:Urodynamics