title: Tablet-based screening improves continence management in multiple sclerosis.
abstract: OBJECTIVE
  To investigate whether electronic continence questionnaires aid early identification and optimizes management of sphincter dysfunction in a multiple sclerosis clinic.
  
  
  METHODS
  A custom designed, tablet-based cross-platform software tool was designed to capture validated multiple sclerosis (MS) patient-reported outcomes. An unselected cohort of MS patients from a tertiary referral clinic completed electronic tablet-based versions of the Bladder Control Scale (BLCS) and the Bowel Control Scale in the waiting room. Data were captured wirelessly "on-the-fly" and stored in a deidentified, secure database; and individual questionnaire results were immediately available to the treating neurologist in the electronic medical record. Scores of ≥2 on either questionnaire generated an automated electronic referral to the clinic MS continence nurse (MS CN).
  
  
  RESULTS
  One hundred and fifty-seven MS patients completed a total of 184 electronic continence test sets and on two occasions only the BLCS was completed. An automatic electronic referral for formal continence review was generated 128 times in 108 patients. Fifty-seven formal continence assessments were undertaken by the MS CN following automated referral. All reviews resulted in at least one clinical intervention being made.
  
  
  CONCLUSIONS
  Tablet-based data capture and automated continence referral using this software tool is an efficient, sensitive, and feasible method of screening MS patients for bladder and bowel dysfunction. Concordance with the results of formal continence assessment in this pilot study validates the use of this technology as a screening tool.
authors.affiliation: Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Department of Neurology, Royal Prince Alfred Hospital Sydney, New South Wales, Australia.
authors.forename: Heidi N
authors.initials: HN
authors.lastname: Beadnall
authors.affiliation: Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Australia Sydney, New South Wales, Australia.
authors.forename: Kushi E
authors.initials: KE
authors.lastname: Kuppanda
authors.affiliation: Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Australia Sydney, New South Wales, Australia.
authors.forename: Annmaree
authors.initials: A
authors.lastname: O'Connell
authors.affiliation: Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Neuroimmunology Clinic, Concord Hospital and University of Sydney Sydney, New South Wales, Australia.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Hardy
authors.affiliation: Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Department of Neurology, Concord Repatriation General Hospital Sydney, New South Wales, Australia ; Concord Clinical School, University of Sydney Sydney, New South Wales, Australia.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Reddel
authors.affiliation: Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Department of Neurology, Royal Prince Alfred Hospital Sydney, New South Wales, Australia.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Barnett