title: Determining health-related quality of life and health state utility values of urinary incontinence in women.
abstract: OBJECTIVE
  : Health-related quality-of-life estimates currently available for urinary incontinence have largely been derived from population-based studies without physician confirmation of diagnosis. The purpose of this study was to compare the health state utility values for urinary incontinence in women derived from EQ-5D questionnaires and visual analog scale (VAS) with the economic gold standard method, the Standard Gamble (SG) interview.
  
  
  METHODS
  : Subjects were approached for study participation after a diagnosis of stress or urge urinary incontinence was made by the attending urogynecologist. Twenty-eight patients completed the Sandvik Severity Index (SSI), EQ-5D, and VAS. They then participated in the SG conversation.
  
  
  RESULTS
  : The median utility (interquartile range) for stress incontinence varied based on the methods: EQ-5D, 0.83 (0.23); VAS, 0.85 (0.15); and SG, 1.00 (0.01). There was a statistically significant difference between the SG assessment and the other 2 methods of assessing utility values, the EQ-5D and VAS in women with urodynamically demonstrated stress urinary incontinence (P = 0.0003 and P < 0.0001, respectively). In the combined group of women with urodynamically proven stress, urge, and mixed urinary incontinence, there was also a statistically significant difference between the SG and the generic methods of assessing utility values, the EQ-5D and VAS (P < 0.0001). Mean SSI scores were similar in women with stress incontinence (6.6 [23.5]) and in the combined group (7.9 [3.8]).
  
  
  CONCLUSIONS
  : Previous studies may have underestimated the health-related quality of life of urinary incontinence.
authors.affiliation: From the *UMass Memorial Medical Center, Division of Urogynecology, Worcester; and †Brigham and Women's Hospital, Division of Urogynecology, Boston, MA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Patterson
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Geisler
authors.forename: Abraham
authors.initials: A
authors.lastname: Morse