title: Rating improvements in urinary incontinence: do patients and their physicians agree?
abstract: OBJECTIVE
  to determine whether patients' perceptions of improvement following behavioural interventions for urinary incontinence (UI) correspond with physicians' global ratings of change, and to compare both these ratings with more objective UI outcome measures.
  
  
  METHODS
  consecutive new female patients aged 65 years and older recruited from outpatient UI clinics in Quebec received a behavioural management protocol for UI. At 3-month follow-up, patients and physicians were independently asked for their global impression of change in UI status. Patients completed 3-day voiding diaries and a UI-specific quality-of-life index before and after treatment.
  
  
  RESULTS
  108 patients (mean age 73 +/- 5 years, range 65-86 years) with stress, urge and mixed UI participated. There was concordance between patients' and physicians' ratings of change in 57% of cases. Among the remaining cases, patients were 1.6 times as likely to report significant improvements compared to physicians. Patients' ratings correlated more strongly with improvements in UI episodes in the voiding diary (r = 0.4, P = 0.002 versus r = 0.3, P = 0.004 for physicians) and on the quality-of-life index (r = -0.5, P < 0.0001 versus r = -0.4, P < 0.0001 for physicians).
  
  
  CONCLUSIONS
  physicians underestimate clinically meaningful changes in UI in older women following behavioural interventions.
authors.affiliation: Department of Geriatric Medicine, Institut universitaire de gériatrie de Montreal, Montreal, Quebec H3 W1 W5, Canada. cara.tannenbaum@umontreal.ca
authors.forename: Cara
authors.initials: C
authors.lastname: Tannenbaum
authors.forename: Judith
authors.initials: J
authors.lastname: Brouillette
authors.forename: Jacques
authors.initials: J
authors.lastname: Corcos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001521:Behavior Therapy; D005260:Female; D006801:Humans; D008499:Medical Records; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy