Quality of Life Research

, Volume 27, Issue 8, pp 2189–2194 | Cite as

Measuring quality of life in patients with stress urinary incontinence: is the ICIQ-UI-SF adequate?

  • Zuzanna Kurzawa
  • Jason M. Sutherland
  • Trafford Crump
  • Guiping Liu



The International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) is a widely used four-item patient-reported outcome (PRO) measure. Evaluations of this instrument are limited, restraining user’s confidence in the instrument. This study conducts a comprehensive evaluation of the ICIQ-UI-SF on a sample of urological surgery patients in Canada.


One hundred and seventy-seven surgical patients with stress urinary incontinence completed the ICIQ-UI-SF pre-operatively. Methods drawing from confirmatory factor analysis (CFA), measures of reliability, item response theory (IRT), and differential item functioning were applied. Ceiling effects were examined.


Ceiling effects were identified. In the CFA, the factor loadings of items one and two differed significantly (p < 0.001) from item three indicating possible multidimensionality. The first two items reflect symptom severity not quality of life. Reliability was moderate as measured by Cronbach’s alpha (0.63) and McDonald’s coefficient (0.65). The IRT found the instrument does not discriminate between individuals with low incontinence-related quality of life.


Due to low/moderate reliability, the ICIQ-UI-SF can be used as a complement to other data or used to report aggregated surgical outcomes among surgical patients. If the primary objective is to measure quality of life, other PROs should be considered.


Ceiling effects Confirmatory factor analysis ICIQ-UI-SF Item response theory Patient-reported outcomes Urinary incontinence 



This study was funded by the Canadian Institutes of Health Research (CIHR) and in-kind support of the Vancouver Coastal Health (VCH) Authority.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Health Services and Policy Research, School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.Department of SurgeryUniversity of CalgaryCalgaryCanada

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