Suskind Anne M, Dunn Rodney L, Morgan Daniel M, DeLancey John O L, McGuire Edward J, Wei John T
University of Michigan, Department of Urology.
Neurourol Urodyn. 2014 Sep;33(7):1128-34. doi: 10.1002/nau.22468. Epub 2013 Aug 14.
To develop a clinically relevant, easy to use, and validated instrument for assessing severity and bother related to urinary incontinence.
Survey items were piloted and refined following psychometric principles in five separate patient cohorts. Patient and expert endorsement of items, factor analyses, Spearman rank correlations and response distributions were employed for item selection. Formal reliability and validity evaluation were conducted for the final questionnaire items.
Expert physicians and patient focus groups confirmed face and content validity for the measure. A 10-item measure called the Michigan Incontinence Symptom Index (M-ISI) was developed with two domains: a Total M-ISI Domain consisting of subdomains for stress urinary incontinence, urgency urinary incontinence, and pad use, and a Bother Domain. High construct validity was demonstrated with a Cronbach's alpha for the Total M-ISI Domain (items 1-8) of 0.90 and for the Bother Domain (items 9-10) of 0.82. Cronbach's alpha for the subdomains were all > 0.85. Construct validity, convergent and divergent validity, internal discriminant validity, and predictive validity were all robust. The minimally important difference for the measure was determined to be 4 points (out of 32) for the Total M-ISI Severity Domain, and 1-2 points (out of 8-12) for the individual subdomains.
The M-ISI is a parsimonious measure that has established reliability and validity on several levels and complements current clinical evaluative methods for patients with urinary incontinence.
开发一种临床适用、易于使用且经过验证的工具，用于评估与尿失禁相关的严重程度和困扰程度。
按照心理测量学原理，在五个不同的患者队列中对调查项目进行了预试验和完善。采用患者和专家对项目的认可、因素分析、斯皮尔曼等级相关性和反应分布来选择项目。对最终问卷项目进行了正式的信度和效度评估。
专家医生和患者焦点小组确认了该测量方法的表面效度和内容效度。开发了一种名为密歇根尿失禁症状指数（M-ISI）的10项测量方法，包括两个领域：一个总M-ISI领域，由压力性尿失禁、急迫性尿失禁和护垫使用的子领域组成，以及一个困扰领域。总M-ISI领域（项目1-8）的克朗巴赫α系数为0.90，困扰领域（项目9-10）的克朗巴赫α系数为0.82，证明了较高的结构效度。各子领域的克朗巴赫α系数均>0.85。结构效度、收敛效度和发散效度、内部判别效度和预测效度均很强。该测量方法的最小重要差异在总M-ISI严重程度领域确定为4分（满分32分），在各个子领域为1-2分（满分8-12分）。
M-ISI是一种简洁的测量方法，在多个层面上已确立了信度和效度，对当前尿失禁患者的临床评估方法起到了补充作用。
