The “Aberdeen Home Continence Stress Test”: a novel objective assessment tool for female stress urinary incontinence

Catriona Young; David Cooper; Alyaa Mostafa; Mohamed Abdel-Fattah

doi:10.1007/s00192-023-05530-4

The “Aberdeen Home Continence Stress Test”: a novel objective assessment tool for female stress urinary incontinence

Catriona Young^*, David Cooper, Alyaa Mostafa, Mohamed Abdel-Fattah

^*Corresponding author for this work

University of Aberdeen

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

3 Downloads (Pure)

Abstract

Introduction and hypothesis: Clinical trials for stress urinary incontinence (SUI) require a robust, reliable, and responsive tool for objective assessment of SUI post-intervention. The Aberdeen Home Continence Stress Test (HCST) is a novel patient-reported objective assessment tool, aimed to be patient-friendly and reduce attrition rates by avoiding hospital appointments and prolonged pad-wearing. We aim to describe the HCST for the first time and evaluate its reliability, diagnostic accuracy, and response to change. Methods: A secondary analysis of the Single-Incision Mini-Slings (SIMS) study (a prospective multicentre randomised control trial (RCT) comparing two surgical treatments of SUI was performed. In SIMS (n = 600 women), the objective outcome was assessed by the 24-h pad test, while the patient-reported success rates were assessed using the Patient Global Impression of Improvement (PGI-I) at 15 months, 2 years and 3 years post-randomisation. Participants were instructed to perform the HCST before and after the 24-h pad test. The HCST was analysed in relation to reliability, validity, and the relationship between the 24-h pad test and HCST results and finally with regard to its responsiveness to change in PGI-I. (Trial registration-number ISRCTN93264234, registration date 14/01/2014). Results: Compared to the 24-h pad test, the sensitivity of the HCST ranged from 0.81–0.95, specificity was 0.76–0.79, negative predictive value was 0.96–0.99 and positive predictive value was 0.32–0.43. Reliability was indicated by high-performing Cronbach’s alpha value (> 0.7). An improvement of ≥ 2 leakage groups on the HCST (for example from Large at baseline to Small leakage at follow-up) was strongly associated with patient-reported success on PGI-I (OR 4.38, 95% CI 2.31, 8.31). Conclusions: The HCST is a valid and reliable patient-reported objective assessment tool that can be used for assessing SUI in surgical trials with good specificity, sensitivity, and consistency.

Original language	English
Pages (from-to)	1961–1969
Number of pages	9
Journal	International Urogynecology Journal
Volume	34
Issue number	8
Early online date	13 Apr 2023
DOIs	https://doi.org/10.1007/s00192-023-05530-4
Publication status	Published - 1 Aug 2023

Bibliographical note

Funding Information:
This research of secondary analysis received no external funding. The original trial was funded by the UK National Institute for Health Research. The original funders were not involved in the analysis, interpretation of data, and preparation of the manuscript.

Acknowledgements
We acknowledge all the patients who participated in the original SIMS trial.

Keywords

Diagnostic accuracy
Incontinence
Measurement tool
Stress incontinence

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Cite this

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title = "The “Aberdeen Home Continence Stress Test”: a novel objective assessment tool for female stress urinary incontinence",

abstract = "Introduction and hypothesis: Clinical trials for stress urinary incontinence (SUI) require a robust, reliable, and responsive tool for objective assessment of SUI post-intervention. The Aberdeen Home Continence Stress Test (HCST) is a novel patient-reported objective assessment tool, aimed to be patient-friendly and reduce attrition rates by avoiding hospital appointments and prolonged pad-wearing. We aim to describe the HCST for the first time and evaluate its reliability, diagnostic accuracy, and response to change. Methods: A secondary analysis of the Single-Incision Mini-Slings (SIMS) study (a prospective multicentre randomised control trial (RCT) comparing two surgical treatments of SUI was performed. In SIMS (n = 600 women), the objective outcome was assessed by the 24-h pad test, while the patient-reported success rates were assessed using the Patient Global Impression of Improvement (PGI-I) at 15 months, 2 years and 3 years post-randomisation. Participants were instructed to perform the HCST before and after the 24-h pad test. The HCST was analysed in relation to reliability, validity, and the relationship between the 24-h pad test and HCST results and finally with regard to its responsiveness to change in PGI-I. (Trial registration-number ISRCTN93264234, registration date 14/01/2014). Results: Compared to the 24-h pad test, the sensitivity of the HCST ranged from 0.81–0.95, specificity was 0.76–0.79, negative predictive value was 0.96–0.99 and positive predictive value was 0.32–0.43. Reliability was indicated by high-performing Cronbach{\textquoteright}s alpha value (> 0.7). An improvement of ≥ 2 leakage groups on the HCST (for example from Large at baseline to Small leakage at follow-up) was strongly associated with patient-reported success on PGI-I (OR 4.38, 95% CI 2.31, 8.31). Conclusions: The HCST is a valid and reliable patient-reported objective assessment tool that can be used for assessing SUI in surgical trials with good specificity, sensitivity, and consistency.",

keywords = "Diagnostic accuracy, Incontinence, Measurement tool, Stress incontinence",

author = "Catriona Young and David Cooper and Alyaa Mostafa and Mohamed Abdel-Fattah",

note = "Funding Information: This research of secondary analysis received no external funding. The original trial was funded by the UK National Institute for Health Research. The original funders were not involved in the analysis, interpretation of data, and preparation of the manuscript. Acknowledgements We acknowledge all the patients who participated in the original SIMS trial.",

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AU - Mostafa, Alyaa

AU - Abdel-Fattah, Mohamed

N1 - Funding Information: This research of secondary analysis received no external funding. The original trial was funded by the UK National Institute for Health Research. The original funders were not involved in the analysis, interpretation of data, and preparation of the manuscript. Acknowledgements We acknowledge all the patients who participated in the original SIMS trial.

PY - 2023/8/1

Y1 - 2023/8/1

N2 - Introduction and hypothesis: Clinical trials for stress urinary incontinence (SUI) require a robust, reliable, and responsive tool for objective assessment of SUI post-intervention. The Aberdeen Home Continence Stress Test (HCST) is a novel patient-reported objective assessment tool, aimed to be patient-friendly and reduce attrition rates by avoiding hospital appointments and prolonged pad-wearing. We aim to describe the HCST for the first time and evaluate its reliability, diagnostic accuracy, and response to change. Methods: A secondary analysis of the Single-Incision Mini-Slings (SIMS) study (a prospective multicentre randomised control trial (RCT) comparing two surgical treatments of SUI was performed. In SIMS (n = 600 women), the objective outcome was assessed by the 24-h pad test, while the patient-reported success rates were assessed using the Patient Global Impression of Improvement (PGI-I) at 15 months, 2 years and 3 years post-randomisation. Participants were instructed to perform the HCST before and after the 24-h pad test. The HCST was analysed in relation to reliability, validity, and the relationship between the 24-h pad test and HCST results and finally with regard to its responsiveness to change in PGI-I. (Trial registration-number ISRCTN93264234, registration date 14/01/2014). Results: Compared to the 24-h pad test, the sensitivity of the HCST ranged from 0.81–0.95, specificity was 0.76–0.79, negative predictive value was 0.96–0.99 and positive predictive value was 0.32–0.43. Reliability was indicated by high-performing Cronbach’s alpha value (> 0.7). An improvement of ≥ 2 leakage groups on the HCST (for example from Large at baseline to Small leakage at follow-up) was strongly associated with patient-reported success on PGI-I (OR 4.38, 95% CI 2.31, 8.31). Conclusions: The HCST is a valid and reliable patient-reported objective assessment tool that can be used for assessing SUI in surgical trials with good specificity, sensitivity, and consistency.

AB - Introduction and hypothesis: Clinical trials for stress urinary incontinence (SUI) require a robust, reliable, and responsive tool for objective assessment of SUI post-intervention. The Aberdeen Home Continence Stress Test (HCST) is a novel patient-reported objective assessment tool, aimed to be patient-friendly and reduce attrition rates by avoiding hospital appointments and prolonged pad-wearing. We aim to describe the HCST for the first time and evaluate its reliability, diagnostic accuracy, and response to change. Methods: A secondary analysis of the Single-Incision Mini-Slings (SIMS) study (a prospective multicentre randomised control trial (RCT) comparing two surgical treatments of SUI was performed. In SIMS (n = 600 women), the objective outcome was assessed by the 24-h pad test, while the patient-reported success rates were assessed using the Patient Global Impression of Improvement (PGI-I) at 15 months, 2 years and 3 years post-randomisation. Participants were instructed to perform the HCST before and after the 24-h pad test. The HCST was analysed in relation to reliability, validity, and the relationship between the 24-h pad test and HCST results and finally with regard to its responsiveness to change in PGI-I. (Trial registration-number ISRCTN93264234, registration date 14/01/2014). Results: Compared to the 24-h pad test, the sensitivity of the HCST ranged from 0.81–0.95, specificity was 0.76–0.79, negative predictive value was 0.96–0.99 and positive predictive value was 0.32–0.43. Reliability was indicated by high-performing Cronbach’s alpha value (> 0.7). An improvement of ≥ 2 leakage groups on the HCST (for example from Large at baseline to Small leakage at follow-up) was strongly associated with patient-reported success on PGI-I (OR 4.38, 95% CI 2.31, 8.31). Conclusions: The HCST is a valid and reliable patient-reported objective assessment tool that can be used for assessing SUI in surgical trials with good specificity, sensitivity, and consistency.

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KW - Incontinence

KW - Measurement tool

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