Fedorkow D M, Sand P K, Retzky S S, Johnson D C
Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.
J Reprod Med. 1995 Jan;40(1):42-6.
The purpose of this prospective, cohort study was to perform a receiver-operating characteristic (ROC) analysis of the cotton swab test and its ability to predict stress incontinence. The study was performed in a tertiary care gynecologic urology clinic over a period of 3.5 years. Two hundred sixty-three women presenting with the complaint of urinary incontinence formed the basis of the cohort. Subjects were classified as having genuine stress urinary incontinence or incontinence secondary to another factor following urodynamic testing. The cotton swab test was performed as part of the standard urogynecologic assessment. Measurement was made of the resting, straining and calculated resultant change in angle. ROC curves were calculated for each of the angles measured. The resultant ROC curves demonstrated that straining angle has the best discriminatory power in the diagnosis of genuine stress urinary incontinence. The optimum cut-off point for this discrimination is a deflection of 40 degrees from the horizontal, with a resultant sensitivity of 83%. Despite the diagnostic trend, the sensitivity of the straining angle does not allow one to confidently make a diagnosis of genuine stress urinary incontinence without a confirmatory evaluation. The test, however, can be beneficial in the counseling and triage of women with lower urinary tract complaints.
这项前瞻性队列研究的目的是对棉拭子试验及其预测压力性尿失禁的能力进行受试者操作特征（ROC）分析。该研究在一家三级医疗妇科泌尿科诊所进行，为期3.5年。263名主诉尿失禁的女性构成了该队列的基础。在进行尿动力学测试后，受试者被分类为患有真性压力性尿失禁或继发于其他因素的尿失禁。棉拭子试验作为标准泌尿妇科评估的一部分进行。测量静息、用力时的角度以及计算得出的角度变化。为每个测量角度计算ROC曲线。所得的ROC曲线表明，用力时的角度在诊断真性压力性尿失禁方面具有最佳的鉴别能力。这种鉴别的最佳临界点是与水平方向偏离40度，灵敏度为83%。尽管有诊断趋势，但仅用力时的角度的灵敏度并不足以让人在没有确诊评估的情况下自信地诊断真性压力性尿失禁。然而，该测试在对下尿路症状女性的咨询和分诊中可能是有益的。
