title: An integrative review of standardized clinical evaluation tool utilization in anticholinergic drug trials for neurogenic lower urinary tract dysfunction.
abstract: METHODS
  To review prospective and randomized trials studying anticholinergic therapy for neurogenic bladder in SCI to identify whether trials included standardized clinical evaluation tools and reporting measures now recognized to enhance clinical trial data.
  
  
  METHODS
  A systematic search via EMBASE, MEDLINE, CENTRAL, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HTA (Health Technology Assessment), CMR (Comprehensive Microbial Resource), HAPI (Health and Psychosocial Instruments) and PsycINFO using the key term spinal cord injury crossed with oxybutynin, tolterodine, darifenacin, solifenacin, fesoterodine, trospium chloride, propiverine, propantheline and anticholinergic(s) for 1946-2015 inclusive. We then collated whether standardized clinical tools, measures and descriptors were used within each study identified: American Spine Injury Association (ASIA) impairment scale; symptom scores validated in SCI; technical methodology for urodynamics/video urodynamics; urinary diaries; and standardized urologic terminology.
  
  
  RESULTS
  A total of 1225 entries with 610 unique articles were identified, 14 randomized and 16 prospective studies. In 6/30 the population comprised SCI patients with neurogenic bladder alone; the remainder included mixed neurogenic etiologies. Classification using the ASIA impairment scale was used in <10% of studies; none used symptom scores validated in SCI; <50% reported urodynamic test methodology fully, incorporated urinary diaries or used International Continence Society Standardization Subcommittee urinary tract terminology.
  
  
  CONCLUSIONS
  Integrative review of trials from 1946 to 2015 identified infrequent use of standardized clinical evaluation tools and reporting measures. Data from future trials evaluating therapies for neurogenic bladder would likely be more applicable to specific SCI patients if current standardized classification and descriptors now available were used consistently: for example, the ASIA scale, symptom scores validated in SCI, standardized urodynamic methodology, urinary diaries and urinary tract terminology. Studies recruiting SCI patients exclusively would also provide additional benefit.
authors.affiliation: Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada.|International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.|Associate Member Department of Obstetrics and Gynaecology and School of Population and Public Health University of British Columbia, Vancouver, BC, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Stothers
authors.affiliation: St Andrews University, Fife, Scotland, UK.
authors.forename: B
authors.initials: B
authors.lastname: Tsang
authors.affiliation: Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada.|International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Nigro
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Lazare
authors.affiliation: Department of Urologic Sciences and Pediatrics, University of British Columbia, Vancouver, BC, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Macnab
mesh_terms: D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013119:Spinal Cord Injuries / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
chemical_list: D018680:Cholinergic Antagonists; D009465:Neuromuscular Agents