Diagnosing daytime bladder symptoms in children with nocturnal enuresis: a comparison of brief parental questionnaire with in-depth, physician-elicited, assessment.
OBJECTIVE
To assess the accuracy of brief parental questionnaire reporting of daytime bladder symptoms in children with nocturnal enuresis and compare with in-depth reporting elicited by physician assessment, for diagnosing monosymptomatic and non-monosymptomatic nocturnal enuresis.


METHODS
A cross-sectional study of consecutive children attending an outpatient nocturnal enuresis clinic at a tertiary paediatric hospital participated in the study. Parents were asked to complete a questionnaire as part of routine assessment at their first visit which was compared with a detailed clinical assessment by the physician involving eliciting a thorough history from the parent and child.


RESULTS
Parents of 585 children participated in the study (mean age 9.2 years, range 5.0-17.5 years). Sixty percent of children were males. There was poor agreement between initial parental reporting and physician diagnosis of monosymptomatic and non-monosymptomatic nocturnal enuresis (Kappa = 0.3, 95% confidence interval 0.21-0.37), mainly because parents underreport daytime incontinence and urgency compared with physician-elicited information (43% vs. 69% and 66% vs. 87%, respectively).


CONCLUSIONS
Parents underreport daytime symptoms by 20-25%. Reliance on a brief parental history without prompting by physicians for daytime symptoms for diagnosing type of nocturnal enuresis may be misleading and result in suboptimal management.
Sureshkumar
Premala
P
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. premalas@chw.edu.au
Caldwell
Patrina H Y
PH
Craig
Jonathan C
JC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D053207:Diurnal Enuresis / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D009517:New South Wales; D053206:Nocturnal Enuresis / Q000145:classification / Q000175:diagnosis*; D010290:Parents; D010808:Physical Examination; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires