EuroQol EQ-5D and condition-specific measures of health outcome in women with urinary incontinence: reliability, validity and responsiveness
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To evaluate the measurement properties of the EuroQoL EQ-5D and two condition-specific patient-reported outcome measures—the Symptom Severity Index (SSI) and the Urinary Incontinence-Specific Quality of Life instrument (I-QoL)—in women with urinary incontinence.
A questionnaire comprising all instruments was completed by women taking part in a clinical trial of physiotherapy for urinary incontinence. Follow-up questionnaires were at 6 weeks and 5 months. Data quality, internal consistency reliability, validity and responsiveness were assessed.
One hundred and seventy-four patients taking part in the clinical trial completed the questionnaire. Instruments had low levels of missing data. The EQ-5D had a large ceiling effect and poor responsiveness. The SSI had poor validity and responsiveness. The I-QoL had levels of reliability that supported application in group assessment, and in some cases, individual assessment, and good evidence of validity. The I-QoL was the most responsive instrument at both 6 weeks and 5 months.
The I-QoL was the best performing instrument and is recommended as a continence-specific measure of quality of life in a clinical trial setting. The SSI and EQ-5D are not recommended. Alternative generic instruments, which support economic evaluation, require further evaluation in trials of female urinary incontinence.
KeywordsQuality of life Health status Female urinary incontinence Reliability Validity
We are very grateful to all of the patients who so willingly gave of their time to complete the various questionnaires, and the healthcare practitioners taking part in the trial. This study was funded by the Physiotherapy Research Foundation.
- 3.Martin, J. L., Williams, K. S., Abrams, K. R., et al. (2006). Systematic review and evaluation of methods of assessing urinary incontinence. Health Technology Assessment, 10(6), 1–132.Google Scholar
- 4.Abrams, P., Cardozo, L., Fall, M., Griffiths, D., Rosier, P., et al. (2002). The standardisation of terminology of lower urinary tract function: Report from the Standardisation Sub-committee of the International Continence Society. Neurourology and Urodynamics, 21, 167–178.PubMedCrossRefGoogle Scholar
- 6.Ross, S., Soroka, D., Karahalios, A., Glazener, C. M., Hay-Smith, E. J., & Drutz, H. P. (2005). Incontinence-specific quality of life measures used in trials of treatments for female urinary incontinence: A systematic review. International Urogynecology Journal and Pelvic Floor Dysfunction, 17(3), 272–285.PubMedGoogle Scholar
- 12.Scottish-Intercollegiate-Guidelines-Network. (2004). SIGN 79: Management of urinary incontinence in primary care. A national clinical guideline. Edinburgh: Scottish-Intercollegiate-Guidelines-Network.Google Scholar
- 13.Department-of-Health. (2000). Good practice in continence services, UK. Department of Health. www.doh.gov.uk/continenceservices.htm.
- 14.Lose, G., Fantl, J. A., Victor, A., Walter, S., Wells, T. L., et al. (2001). Outcome measures for research in adult women with symptoms of lower urinary tract dysfunction. Standardization Committee of the International Continence Society. Acta Obstetrica et Gynecologica Scandinavia, 80, 981–985.CrossRefGoogle Scholar
- 21.Marra, C. A., Woolcott, J. C., Kopec, J. A., Shojania, K., Offer, R., et al. (2005). A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Social Science and Medicine, 60, 1571–1582.PubMedCrossRefGoogle Scholar
- 22.Donovan, J. L., Kay, H. E., Peters, T. J., Abrams, P., Coast, J., et al. (1997). Using the ICSOoL to measure the impact of lower urinary tract symptoms on quality of life: Evidence from the ICS-‘BPH’ Study. International Continence Society–Benign Prostatic Hyperplasia. British Journal of Urology, 80, 712–721.PubMedGoogle Scholar
- 23.Kobelt, G. (1997). Economic considerations and outcome measurement in urge incontinence. Urology, 50, 100–7; discussion 8–10.Google Scholar
- 24.Fuertes, M. E., Garcia Matres, M. J., Gonzalez Romojaro, V., de la Rosa, S., Anguera Vila, A., et al. (2000). Clinical trial to evaluate trospium chloride (Uraplex) effectiveness and tolerance in patients with detrusor instability incontinence and its impact on quality of life. Archivos Españoles de Urologia, 53, 125–136.PubMedGoogle Scholar
- 25.Hawthorne, G. (2006). Measuring incontinence in Australia 2006 (153 pp). Canberra: Commonwealth of Australia. ISBN: 0 642 82980 2. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ageing-continence-measure.htm
- 26.Streiner, D., & Norman, G. (2003). Health measurement scales: A practical guide to their development and use (3rd ed.). Oxford: Oxford University Press.Google Scholar
- 27.Jolliffe, I. (1986). Principal component analysis. New York: Springer-Verlag.Google Scholar
- 28.Nunnally, J., & Bernstein, I. (1994). Psychometric theory. New York: McGraw-Hill.Google Scholar
- 31.Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1995). Multivariate data analysis: With readings (4th ed.). New Jersey: Prentice Hall.Google Scholar