Validity of utility measures for women with urge, stress, and mixed urinary incontinence.
OBJECTIVE
We sought to evaluate the construct validity of 3 health status classification system instruments-Health Utilities Index Mark 3 (HUI-3), EuroQol (EQ-5D), and Short Form 6D (SF-6D)-and a visual analog scale (VAS) for measuring utility scores in women with urge, stress, and mixed urinary incontinence.


METHODS
Utility scores were measured in 202 women with urinary incontinence. Pelvic floor symptom severity and quality of life were measured using the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire, respectively. Construct, discriminant, and concurrent validity were evaluated.


RESULTS
Significant correlations were noted between utility scores and the Pelvic Floor Distress Inventory (r = -0.22 to -0.42, P < .05) and the Pelvic Floor Impact Questionnaire (r = -0.32 to -0.50, P < .05). Mean utility scores were significantly lower for women with urge or mixed incontinence compared to stress incontinence for the EQ-5D (0.71 ± 0.23, 0.73 ± 0.26, and 0.81 ± 0.16, respectively, P = .02) and the SF-6D (0.76 ± 0.12, 0.74 ± 0.12, and 0.81 ± 0.11, respectively, P = .02) but not the HUI-3 or the VAS. There was a clinically important difference in utility scores (>0.03) between women with urge or mixed incontinence as compared to stress incontinence for the HUI-3, EQ-5D, and SF-6D but not the VAS. Utility preference scores were significantly lower for women with combined urinary and fecal incontinence (0.69-0.73) than urinary incontinence alone (0.77-0.84, P < .01).


CONCLUSIONS
The HUI-3, EQ-5D, and SF-6D, but not the VAS, provide valid measurements for utility scores in women with stress, urge, and mixed urinary incontinence.
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Heidi S
HS
Harvie
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
Judy A
JA
Shea
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Uduak U
UU
Andy
Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA.
Kate
K
Propert
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
J Sanford
JS
Schwartz
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Lily A
LA
Arya
D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D010414:Pennsylvania; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*; D053202:Urinary Incontinence, Urge / Q000503:physiopathology*
EuroQol; Health Utilities Index Mark 3; Short Form 6D; health-related quality of life; urinary incontinence; utility score