Department of Obstetrics and Gynecology, Guy's and St Thomas' Hospitals, London, UK.
Department of Urology, The Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK.
Neurourol Urodyn. 2018 Jun;37(5):1701-1710. doi: 10.1002/nau.23479. Epub 2018 Jan 23.
To develop a comprehensive patient-reported bladder assessment tool (BAT) for assessing overactive bladder (OAB) symptoms, bother, impacts, and satisfaction with treatment.
Subjects were consented and eligibility was confirmed by a recruiting physician; subjects were then scheduled for in-person interviews. For concept elicitation and cognitive interviews, 30 and 20 subjects, respectively, were targeted for recruitment from US sites. All interviews were conducted face-to-face, audio-recorded, transcribed verbatim, anonymized, and analyzed using a qualitative data analysis software program. A draft BAT was created based on the results of the concept elicitation interviews and further revised based on cognitive interviews as well as feedback from an advisory board of clinical and patient-reported outcome (PRO) experts.
Nocturia, daytime frequency, and urgency were reported by all subjects (n = 30, 100.0%), and incontinence was reported by most subjects (n = 25, 83.3%). The most frequently reported impacts were waking up to urinate (n = 30, 100.0%), embarrassment/shame (n = 24, 80.0%), stress/anxiety (n = 23, 76.7%), and lack of control (n = 23, 76.7%). Following analysis, item generation, cognitive interviews, and advisory board feedback, the resulting BAT contains four hypothesized domains (symptom frequency, symptom bother, impacts, and satisfaction with treatment) and 17 items with a 7-day recall period.
The BAT has been developed in multiple stages with input from both OAB patients and clinical experts following the recommended processes included in the FDA PRO Guidance for Industry. Once fully validated, we believe it will offer a superior alternative to use of the bladder diary and other PROs for monitoring OAB patients in clinical trials and clinical practice.
开发一种全面的患者报告膀胱评估工具(BAT),用于评估膀胱过度活动症(OAB)症状、困扰、影响和治疗满意度。
通过招募医生获得患者同意并确认其符合入选标准;然后安排患者进行面对面访谈。为了进行概念发掘和认知访谈,分别有 30 名和 20 名符合条件的患者从美国的研究中心招募入组。所有访谈均面对面进行,录音、逐字转录、匿名,并使用定性数据分析软件进行分析。根据概念发掘访谈的结果制定了 BAT 草案,并根据认知访谈以及临床和患者报告结局(PRO)专家咨询委员会的反馈进一步修订。
所有患者(n=30,100.0%)均报告有夜尿、白天尿频和尿急,多数患者(n=25,83.3%)报告有尿失禁。最常报告的影响是半夜醒来排尿(n=30,100.0%)、尴尬/羞愧(n=24,80.0%)、压力/焦虑(n=23,76.7%)和缺乏控制感(n=23,76.7%)。经过分析、项目生成、认知访谈和咨询委员会反馈,最终的 BAT 包含四个假设的领域(症状频率、症状困扰、影响和治疗满意度)和 17 个项目,采用 7 天回顾期。
该 BAT 是在 OAB 患者和临床专家的共同参与下,按照 FDA PRO 指导原则中包含的推荐流程分多个阶段开发而成。一旦充分验证,我们相信它将为监测临床试验和临床实践中的 OAB 患者提供优于膀胱日记和其他 PRO 的替代方法。