Department of Rehabilitation Science, Bangladesh Health Professions Institute (BHPI), Savar, Bangladesh.
Health Services Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Int Urogynecol J. 2023 Dec;34(12):3033-3040. doi: 10.1007/s00192-023-05657-4. Epub 2023 Oct 11.
To establish, for the first time, the clinically important differences for the ICIQ-UI-SF and ICIQ-FLUTS questionnaires following surgical and conservative treatments for stress-predominant urinary incontinence in women.
Data from the SIMS and OPAL randomised controlled trials were analysed using an anchor-based method. Clinically important difference (CID; score change indicating a successful outcome) and minimal important difference (MID; score change indicating the smallest noticeable difference) were estimated using the PGI-I scale as the anchor.
For ICIQ-UI-SF, following surgical management, CIDs were 5.0 (95%CI 4.3, 5.6) at 1 year and 4.9 points (95%CI 4.2, 5.5) at 3 years, while following conservative management, CIDs were 4.0 (95%CI 3.4, 4.5) at 1 year and 4.6 points (95%CI 4.0, 5.2) at 2 years. For ICIQ-FLUTS, the CID was 3.4 points (95%CI 2.9, 4.0) at 1 year for both surgical and conservative management. MIDs for ICIQ-UI-SF, after surgical treatment, were 4.7 (95% CI 3.2, 6.1) at 1 year and 1.6 points (95%CI -0.2, 3.0) at 3 years, and after conservative treatment they were 1.7 (95% CI 1.0, 2.5) at 1 year and 1.9 points (95%CI 1.1, 2.7) at 2 years. For ICIQ-FLUTS, MIDs were 1.8 (95% CI 0.6, 3.1) at 1 year and 3.2 points (95%CI 2.0, 4.4) at 2 years after surgical treatment, and 1.3 (95%CI 0.6, 1.9) at 1 year and 1.9 points (95%CI 1.1, 2.6) at 2 years after conservative treatment.
Our study is the first to establish the CID for the ICIQ-UI-SF and ICIQ-FLUTS that women would associate with a successful outcome 3-years post-surgery and 2-years post-conservative treatment of stress-predominant urinary incontinence. The MID was lower following conservative compared to surgical treatment.
首次建立女性压力性尿失禁手术和保守治疗后,国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-UI-SF)和国际尿失禁咨询委员会尿失禁问卷-短表(ICIQ-FLUTS)的临床重要差异。
使用基于锚定的方法分析 SIMS 和 OPAL 随机对照试验的数据。使用患者总体印象改善(PGI-I)量表作为锚定物来估计临床重要差异(CID;表示治疗成功的评分变化)和最小重要差异(MID;表示可察觉的最小差异的评分变化)。
对于 ICIQ-UI-SF,手术治疗后 1 年 CID 为 5.0(95%CI 4.3, 5.6),3 年 CID 为 4.9 分(95%CI 4.2, 5.5),而保守治疗后 1 年 CID 为 4.0(95%CI 3.4, 4.5),2 年 CID 为 4.6 分(95%CI 4.0, 5.2)。对于 ICIQ-FLUTS,手术和保守治疗后 1 年的 CID 均为 3.4 分(95%CI 2.9, 4.0)。ICIQ-UI-SF 术后治疗 1 年 MID 为 4.7(95%CI 3.2, 6.1),3 年 MID 为 1.6 分(95%CI -0.2, 3.0),而保守治疗后 1 年 MID 为 1.7(95%CI 1.0, 2.5),2 年 MID 为 1.9 分(95%CI 1.1, 2.7)。对于 ICIQ-FLUTS,手术治疗后 1 年 MID 为 1.8 分(95%CI 0.6, 3.1),2 年 MID 为 3.2 分(95%CI 2.0, 4.4),而保守治疗后 1 年 MID 为 1.3 分(95%CI 0.6, 1.9),2 年 MID 为 1.9 分(95%CI 1.1, 2.6)。
本研究首次建立了女性压力性尿失禁术后 3 年和保守治疗后 2 年的 CID,认为这与治疗成功相关。与手术治疗相比,保守治疗后的 MID 更低。