Skip to main content
Erschienen in: International Urogynecology Journal 3/2013

01.03.2013 | Original Article

Responsiveness and interpretability of incontinence severity scores and FIQL in patients with fecal incontinence: a secondary analysis from a randomized controlled trial

verfasst von: E. M. J. Bols, H. J. M. Hendriks, L. C. M. Berghmans, C. G. M. I. Baeten, R. A. de Bie

Erschienen in: International Urogynecology Journal | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

This study aims to assess the responsiveness and interpretability of the Vaizey score, Wexner score, and the Fecal Incontinence Quality of Life Scale (FIQL) for use in the evaluation of patients with fecal incontinence (FI).

Methods

Eighty patients with FI with a mean age of 59.3 (SD ± 11.9) were enrolled in a randomized controlled trial. The patient-reported outcomes were tested for internal and external responsiveness, longitudinal construct validity, and interpretability.

Results

All total scores proved to have both adequate to excellent responsiveness and longitudinal construct validity, and changes were in agreement with subjective improvement. Due to variability in minimally important change estimates (Vaizey score −5 to −3, Wexner score −3 to −2, FIQL 1.1 to 1.2), they should be used as indicators. All patient-reported outcomes showed psychometric or practical limitations.

Conclusions

The instruments available to date to evaluate severity and quality of life in FI do not yet attain the highest levels of psychometric soundness. As the focus of patients may differ from that of physicians, it is recommended that several measures should be included for evaluation. So far, there are suggestions that the Wexner score is most suitable for severity assessment and the FIQL for evaluating quality of life.
Literatur
1.
Zurück zum Zitat Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26PubMedCrossRef Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26PubMedCrossRef
2.
Zurück zum Zitat Dunivan GC, Heymen S, Palsson OS et al (2010) Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol 202(5):493.e1–493.e6CrossRef Dunivan GC, Heymen S, Palsson OS et al (2010) Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol 202(5):493.e1–493.e6CrossRef
3.
Zurück zum Zitat Deutekom M, Terra MP, Dobben AC et al (2005) Selecting an outcome measure for evaluating treatment in fecal incontinence. Dis Colon Rectum 48:2294–2301PubMedCrossRef Deutekom M, Terra MP, Dobben AC et al (2005) Selecting an outcome measure for evaluating treatment in fecal incontinence. Dis Colon Rectum 48:2294–2301PubMedCrossRef
4.
Zurück zum Zitat Jaeschke R, Singer J, Guyatt GH (1989) Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 10:407–415PubMedCrossRef Jaeschke R, Singer J, Guyatt GH (1989) Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 10:407–415PubMedCrossRef
5.
Zurück zum Zitat Browning GG, Parks AG (1983) Postanal repair for neuropathic faecal incontinence: correlation of clinical result and anal canal pressures. Br J Surg 70:101–104PubMedCrossRef Browning GG, Parks AG (1983) Postanal repair for neuropathic faecal incontinence: correlation of clinical result and anal canal pressures. Br J Surg 70:101–104PubMedCrossRef
6.
Zurück zum Zitat Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97PubMedCrossRef Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97PubMedCrossRef
7.
Zurück zum Zitat Vaizey CJ, Carapeti E, Cahill JA et al (1999) Prospective comparison of faecal incontinence grading systems. Gut 44:77–80PubMedCrossRef Vaizey CJ, Carapeti E, Cahill JA et al (1999) Prospective comparison of faecal incontinence grading systems. Gut 44:77–80PubMedCrossRef
8.
Zurück zum Zitat Bols EMJ, Berghmans LCM, Hendriks HJM et al (2008) Physiotherapy and surgery in fecal incontinence: an overview. Phys Ther Rev 13:1–20CrossRef Bols EMJ, Berghmans LCM, Hendriks HJM et al (2008) Physiotherapy and surgery in fecal incontinence: an overview. Phys Ther Rev 13:1–20CrossRef
9.
Zurück zum Zitat Davis KJ, Kumar D, Poloniecki J (2004) Adjuvant biofeedback following anal sphincter repair: a randomized study. Aliment Pharmacol Ther 20:539–549PubMedCrossRef Davis KJ, Kumar D, Poloniecki J (2004) Adjuvant biofeedback following anal sphincter repair: a randomized study. Aliment Pharmacol Ther 20:539–549PubMedCrossRef
10.
Zurück zum Zitat Norton C, Chelvanayagam S, Wilson-Barnett J et al (2003) Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology 125:1320–1329PubMedCrossRef Norton C, Chelvanayagam S, Wilson-Barnett J et al (2003) Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology 125:1320–1329PubMedCrossRef
11.
Zurück zum Zitat Avery KN, Bosch JL, Gotoh M et al (2007) Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol 177:39–49PubMedCrossRef Avery KN, Bosch JL, Gotoh M et al (2007) Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol 177:39–49PubMedCrossRef
12.
Zurück zum Zitat Rockwood TH, Church JM, Fleshman JW et al (2000) Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 43:9–16, discussion 16-17PubMedCrossRef Rockwood TH, Church JM, Fleshman JW et al (2000) Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 43:9–16, discussion 16-17PubMedCrossRef
13.
Zurück zum Zitat Bols EM, Hendriks EJ, Deutekom M et al (2010) Inconclusive psychometric properties of the Vaizey score in fecally incontinent patients: a prospective cohort study. Neurourol Urodyn 29:370–377PubMed Bols EM, Hendriks EJ, Deutekom M et al (2010) Inconclusive psychometric properties of the Vaizey score in fecally incontinent patients: a prospective cohort study. Neurourol Urodyn 29:370–377PubMed
14.
Zurück zum Zitat Bols EM, Berghmans BC, Hendriks EJ et al (2007) A randomized physiotherapy trial in patients with fecal incontinence: design of the PhysioFIT-study. BMC Public Health 7:355PubMedCrossRef Bols EM, Berghmans BC, Hendriks EJ et al (2007) A randomized physiotherapy trial in patients with fecal incontinence: design of the PhysioFIT-study. BMC Public Health 7:355PubMedCrossRef
15.
Zurück zum Zitat Morkved S (2007) Physical therapy for fecal incontinence. In: Bo K, Berghmans B, Morkved S, Van Kampen M (eds) Evidence-based physical therapy for the pelvic floor. Elsevier, London, pp 309–315 Morkved S (2007) Physical therapy for fecal incontinence. In: Bo K, Berghmans B, Morkved S, Van Kampen M (eds) Evidence-based physical therapy for the pelvic floor. Elsevier, London, pp 309–315
16.
Zurück zum Zitat Mokkink LB, Terwee CB, Patrick DL et al (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737–745PubMedCrossRef Mokkink LB, Terwee CB, Patrick DL et al (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737–745PubMedCrossRef
17.
Zurück zum Zitat Husted JA, Cook RJ, Farewell VT et al (2000) Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 53:459–468PubMedCrossRef Husted JA, Cook RJ, Farewell VT et al (2000) Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 53:459–468PubMedCrossRef
18.
Zurück zum Zitat Crosby RD, Kolotkin RL, Williams GR (2003) Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 56:395–407PubMedCrossRef Crosby RD, Kolotkin RL, Williams GR (2003) Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 56:395–407PubMedCrossRef
19.
Zurück zum Zitat Terwee CB, Bot SD, de Boer MR et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42PubMedCrossRef Terwee CB, Bot SD, de Boer MR et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42PubMedCrossRef
20.
Zurück zum Zitat Salter K, Jutai JW, Teasell R et al (2005) Issues for selection of outcome measures in stroke rehabilitation: ICF Participation. Disabil Rehabil 27:507–528PubMedCrossRef Salter K, Jutai JW, Teasell R et al (2005) Issues for selection of outcome measures in stroke rehabilitation: ICF Participation. Disabil Rehabil 27:507–528PubMedCrossRef
21.
Zurück zum Zitat Hendriks EJ, Bernards AT, Berghmans BC et al (2007) The psychometric properties of the PRAFAB-questionnaire: a brief assessment questionnaire to evaluate severity of urinary incontinence in women. Neurourol Urodyn 26:998–1007PubMedCrossRef Hendriks EJ, Bernards AT, Berghmans BC et al (2007) The psychometric properties of the PRAFAB-questionnaire: a brief assessment questionnaire to evaluate severity of urinary incontinence in women. Neurourol Urodyn 26:998–1007PubMedCrossRef
22.
Zurück zum Zitat Terwee CB, Roorda LD, Dekker J et al (2010) Mind the MIC: large variation among populations and methods. J Clin Epidemiol 63:524–534PubMedCrossRef Terwee CB, Roorda LD, Dekker J et al (2010) Mind the MIC: large variation among populations and methods. J Clin Epidemiol 63:524–534PubMedCrossRef
23.
Zurück zum Zitat de Vet HC, Terwee CB, Ostelo RW et al (2006) Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes 4:54PubMedCrossRef de Vet HC, Terwee CB, Ostelo RW et al (2006) Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes 4:54PubMedCrossRef
25.
Zurück zum Zitat Terwee CB, Mokkink LB, Knol DL et al (2012) Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 21:659–670PubMedCrossRef Terwee CB, Mokkink LB, Knol DL et al (2012) Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 21:659–670PubMedCrossRef
26.
Zurück zum Zitat Revicki D, Hays RD, Cella D et al (2008) Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 61:102–109PubMedCrossRef Revicki D, Hays RD, Cella D et al (2008) Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 61:102–109PubMedCrossRef
27.
Zurück zum Zitat Maeda Y, Parés D, Norton C et al (2008) Does the St. Mark’s incontinence score reflect patients’ perceptions? A review of 390 patients. Dis Colon Rectum 51:436–442PubMedCrossRef Maeda Y, Parés D, Norton C et al (2008) Does the St. Mark’s incontinence score reflect patients’ perceptions? A review of 390 patients. Dis Colon Rectum 51:436–442PubMedCrossRef
28.
Zurück zum Zitat Bakx R, Sprangers MA, Oort FJ et al (2005) Development and validation of a colorectal functional outcome questionnaire. Int J Colorectal Dis 20:126–136PubMedCrossRef Bakx R, Sprangers MA, Oort FJ et al (2005) Development and validation of a colorectal functional outcome questionnaire. Int J Colorectal Dis 20:126–136PubMedCrossRef
29.
Zurück zum Zitat Olopade FA, Norman A, Blake P et al (2005) A modified Inflammatory Bowel Disease questionnaire and the Vaizey Incontinence questionnaire are simple ways to identify patients with significant gastrointestinal symptoms after pelvic radiotherapy. Br J Cancer 92:1663–1670PubMedCrossRef Olopade FA, Norman A, Blake P et al (2005) A modified Inflammatory Bowel Disease questionnaire and the Vaizey Incontinence questionnaire are simple ways to identify patients with significant gastrointestinal symptoms after pelvic radiotherapy. Br J Cancer 92:1663–1670PubMedCrossRef
30.
Zurück zum Zitat Bug GJ, Kiff ES, Hosker G (2001) A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG 108:1057–1067PubMed Bug GJ, Kiff ES, Hosker G (2001) A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG 108:1057–1067PubMed
31.
Zurück zum Zitat Rockwood TH (2004) Incontinence severity and QOL scales for fecal incontinence. Gastroenterology 126(1 Suppl 1):S106–S113PubMedCrossRef Rockwood TH (2004) Incontinence severity and QOL scales for fecal incontinence. Gastroenterology 126(1 Suppl 1):S106–S113PubMedCrossRef
32.
Zurück zum Zitat de Vet HC, Terluin B, Knol DL et al (2010) Three ways to quantify uncertainty in individually applied “minimally important change” values. J Clin Epidemiol 63:37–45PubMedCrossRef de Vet HC, Terluin B, Knol DL et al (2010) Three ways to quantify uncertainty in individually applied “minimally important change” values. J Clin Epidemiol 63:37–45PubMedCrossRef
33.
Zurück zum Zitat Gardener N, Avery K, Abrams P et al (2005) Methods of development of a symptom and quality of life assessment for bowel symptoms including anal incontinence-ICIQ-BS. Proceedings from the International Continence Society meeting, Montreal, Canada (abstract). Neurourol Urodyn 24:558–559 Gardener N, Avery K, Abrams P et al (2005) Methods of development of a symptom and quality of life assessment for bowel symptoms including anal incontinence-ICIQ-BS. Proceedings from the International Continence Society meeting, Montreal, Canada (abstract). Neurourol Urodyn 24:558–559
34.
Zurück zum Zitat Cotterill N, Norton C, Avery KN et al (2011) Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life: the ICIQ-B. Dis Colon Rectum 54:1235–1250PubMedCrossRef Cotterill N, Norton C, Avery KN et al (2011) Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life: the ICIQ-B. Dis Colon Rectum 54:1235–1250PubMedCrossRef
Metadaten
Titel
Responsiveness and interpretability of incontinence severity scores and FIQL in patients with fecal incontinence: a secondary analysis from a randomized controlled trial
verfasst von
E. M. J. Bols
H. J. M. Hendriks
L. C. M. Berghmans
C. G. M. I. Baeten
R. A. de Bie
Publikationsdatum
01.03.2013
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 3/2013
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-012-1886-9

Weitere Artikel der Ausgabe 3/2013

International Urogynecology Journal 3/2013 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.