Department of Urogynaecology, King's College Hospital, London, UK.
BJU Int. 2011 May;107(10):1612-7. doi: 10.1111/j.1464-410X.2010.09684.x. Epub 2010 Nov 11.
• To assess the measurement characteristics of the Patient Perception of Intensity of Urgency Scale (PPIUS) in patients with overactive bladder (OAB).
• Adult women with at least a 3-month history of OAB. The design was a 4-week, double-blind, randomized, placebo-controlled trial of transdermal oxybutynin, with a 2-week placebo run-in and 8-week, open-label extension. • Symptom improvement was assessed using 3-day bladder diaries incorporating the PPIUS, and disease-specific health-related quality of life was assessed using the King's Health Questionnaire (KHQ). Convergent validity was shown by correlation with the KHQ, and other bladder diary variables. Known groups validity was assessed by comparison of baseline mean urge ratings, and urgency episode frequency for continent and incontinent patients, and by comparison with the same measures from a historical control group of 40 asymptomatic female volunteers. • Between- and within-groups responsiveness was assessed using standardized effect sizes (Cohen's d and effect size r). Reliability was assessed for the two arms of the trial at different time points and intervals, using intraclass correlation (ICC) and a t-test for the difference between mean scores.
• In total, 96 women were randomized. Urgency episode frequency showed moderate correlation with total KHQ score (r = 0.500, P < 0.001) and with daytime and night-time voiding frequency. • There were significant differences in continent and incontinent subgroups for mean urge ratings (difference in means, -0.61/void, P < 0.001), and urgency episodes (difference in means, -2.67 episodes/day, P < 0.001), as well as between OAB patients and normal controls (mean urge rating: difference in means 1.22 per void, P < 0.001; urgency episodes: difference in means 2.93 episodes/day, P < 0.001). • Between-groups analysis of effect size found that urgency episode frequency (d = 0.679, r = 0.321) was more responsive than mean urge rating (d = 0.480, r = 0.233). In both subgroups, urgency episode frequency (d = 0.421-0.454, r = 0.206-0.222) had better within-groups responsiveness than mean urge rating. • Urgency episodes (ICC, 0.65-0.81) were measured more reliably than urgency urinary incontinence episodes (ICC, 0.50-0.65).
• Assessment of urgency episodes using the PPIUS shows good reliability, excellent known groups validity, high responsiveness and convergence with subjective measures of severity. • PPIUS is freely available, and should be useful in both clinical practice and research studies when assessing women with urgency, with or without urgency urinary incontinence.
评估膀胱过度活动症（OAB）患者急迫感强度量表（PPIUS）的测量特性。
至少有 3 个月 OAB 病史的成年女性。设计为为期 4 周的双盲、随机、安慰剂对照的透皮奥昔布宁试验，包括 2 周的安慰剂导入期和 8 周的开放标签扩展期。使用 3 天膀胱日记评估症状改善，使用 King's 健康问卷（KHQ）评估疾病特异性健康相关生活质量。通过与 KHQ 的相关性以及其他膀胱日记变量来证明收敛效度。通过比较有尿失禁和无尿失禁患者的基线平均急迫感评分和急迫感发作频率，以及与 40 名无症状女性志愿者的历史对照组的相同测量值进行比较，来评估已知组有效性。使用标准化效应大小（Cohen's d 和效应大小 r）评估组间和组内反应性。使用组内相关系数（ICC）和均值得分之间的 t 检验评估试验的两个臂在不同时间点和间隔的可靠性。
共有 96 名女性被随机分配。急迫感发作频率与总 KHQ 评分（r = 0.500，P < 0.001）和白天和夜间排尿频率具有中度相关性。在有尿失禁和无尿失禁亚组中，平均急迫感评分（差异均值，-0.61/次，P < 0.001）和急迫感发作（差异均值，-2.67 次/天，P < 0.001）存在显著差异，以及 OAB 患者与正常对照组之间（平均急迫感评分：差异均值 1.22 次/次，P < 0.001；急迫感发作：差异均值 2.93 次/天，P < 0.001）。组间效应大小分析发现，急迫感发作频率（d = 0.679，r = 0.321）比平均急迫感评分（d = 0.480，r = 0.233）更具反应性。在两个亚组中，急迫感发作频率（d = 0.421-0.454，r = 0.206-0.222）比平均急迫感评分具有更好的组内反应性。急迫感发作（ICC，0.65-0.81）比急迫性尿失禁发作（ICC，0.50-0.65）测量更可靠。
使用 PPIUS 评估急迫感发作具有良好的可靠性、优异的已知组有效性、高反应性和与严重程度的主观测量的一致性。PPIUS 是免费提供的，在评估有或没有急迫性尿失禁的急迫症女性时，无论是在临床实践还是研究中都应该是有用的。
