Sandvik H, Hunskaar S, Vanvik A, Bratt H, Seim A, Hermstad R
Department of Public Health and Primary Health Care, University of Bergen, Norway.
J Clin Epidemiol. 1995 Mar;48(3):339-43. doi: 10.1016/0895-4356(94)00147-i.
Diagnostic questions about stress and urge incontinence were validated against a final diagnosis made by a gynecologist after urodynamic evaluation. Thereafter, an epidemiological survey was performed, using similar questions, and correcting the answers for lack of validity. Included were 250 incontinent women at the out-patient clinic and 535 women who reported incontinence in the epidemiological survey. The sensitivity for stress incontinence was 0.66 (95% confidence interval +/- 0.08), specificity 0.88 (+/- 0.06). The corresponding values for urge incontinence were 0.56 (+/- 0.15) and 0.96 (+/- 0.03), and for mixed incontinence 0.84 (+/- 0.10) and 0.66 (+/- 0.07). Using these indices of validity as corrective measures for the diagnostic distribution reported in the epidemiological survey, the percentage of stress incontinence increased from 51 to 77%, while mixed incontinence was reduced from 39 to 11%. Pure urge incontinence increased from 10 to 12%. Mixed incontinence will be overreported in epidemiological surveys. Correction for validity indicates that a larger majority than hitherto reported may have pure stress incontinence.
针对压力性尿失禁和急迫性尿失禁的诊断性问题，与妇科医生在尿动力学评估后做出的最终诊断进行了验证。此后，使用类似问题进行了一项流行病学调查，并对答案的有效性不足进行了校正。纳入了门诊的250名尿失禁女性以及在流行病学调查中报告有尿失禁的535名女性。压力性尿失禁的敏感性为0.66（95%置信区间±0.08），特异性为0.88（±0.06）。急迫性尿失禁的相应值为0.56（±0.15）和0.96（±0.03），混合性尿失禁的相应值为0.84（±0.10）和0.66（±0.07）。将这些有效性指标用作流行病学调查中报告的诊断分布的校正措施后，压力性尿失禁的百分比从51%增加到77%，而混合性尿失禁从39%降至11%。单纯急迫性尿失禁从10%增加到12%。在流行病学调查中，混合性尿失禁会被过度报告。有效性校正表明，可能有比迄今报告的更大比例的人患有单纯压力性尿失禁。
