title: Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic-prolapse surgery.
abstract: OBJECTIVE
  In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation on Incontinence has initiated the development and evaluation of disease-specific questionnaires (ICIQ) to compare the patient's degree of improvement. Alternatively, the Patient's Global Impression of Improvement (PGI-I score) with an inherent before-after assessment has been widely accepted in recent studies. The aim of this study was to compare the PGI-I versus the ICIQ score for women undergoing UI or POP surgery.
  
  
  METHODS
  This study is based on self-administered pre- and postoperative questionnaires, completed by women undergoing surgery for UI or POP in Denmark in 2013. Weighted Kappa statistics and 95 % limits of agreement method were used when comparing the PGI-I and ICIQ scores.
  
  
  RESULTS
  Among the 3,310 women included the PGI-I score showed a higher improvement than the IQIC score, for UI 0.83 (CI 95 %: 0.80-0.85) vs 0.62 (0.60-0.64) and for POP 0.77 (0.75-0.78) vs 0.66 (0.65-0.67).
  
  
  CONCLUSIONS
  The PGI-I score renders higher satisfaction than the ICIQ score and the PGI-I score overestimates the improvement following UI and POP surgery.
authors.affiliation: Center for Clinical Epidemiology, Odense University Hospital, Sønderboulevard 29, Opg. 101, Odense, 5000, Denmark. michael.due.larsen@rsyd.dk.
authors.forename: Michael Due
authors.initials: MD
authors.lastname: Larsen
authors.affiliation: Gynaecology and Obstetrics Department, Herlev Hospital & University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Lose
authors.affiliation: Center for Clinical Epidemiology, Odense University Hospital, Sønderboulevard 29, Opg. 101, Odense, 5000, Denmark.|Gynaecology and Obstetrics Department, Hospital Lillebaelt, Kolding, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Guldberg
authors.affiliation: Center for Clinical Epidemiology, Odense University Hospital, Sønderboulevard 29, Opg. 101, Odense, 5000, Denmark.|Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Kim Oren
authors.initials: KO
authors.lastname: Gradel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000601:surgery*; D055815:Young Adult
keywords: Patient-reported outcome measures; Patient’s Global Impression of Improvement; Pelvic organ prolapse; Questionnaires; Surgery; Urinary incontinence