The total urgency and frequency score (TUFS) is a useful tool for assessing changes in major storage symptoms in patients with overactive bladder (OAB), researchers believe.
In a review article published in BJU International, Christopher Chapple (Royal Hallamshire Hospital, Sheffield, UK) and colleagues say that the TUFS tracks changes in patient-reported symptoms and correlates with several health-related quality-of-life (HRQoL) variables.
Chapple et al note that while the treatment of lower urinary tract symptoms (LUTS) in men tends to focus on voiding symptoms, patients typically find storage symptoms most bothersome. “The core storage symptom is urgency, which drives the other main storage symptoms of increased daytime frequency, nocturia and incontinence”, they write.
The TUFS tool, previously known as the “total urgency score”, is a validated measure that captures the two key storage measures – urgency and frequency – in a single assessment.
To use the tool, patients grade each void according to the patient perception of intensity of urgency scale (PPIUS), from no urgency (0 points) to urge incontinence (4 points). The score is calculated by adding the PPIUS sores of every void in a patient’s urinary diary and dividing this by the number of days recorded.
The TUFS has been validated in patients with OAB in several clinical trials. In the phase II BLOSSOM study, it was shown to have good psychometric properties, with high responsiveness, a link with the number of micturitions, high stability, and a low but significant correlation with the patients’ perception of bladder condition (PPBC) score.
It was also used to assess patients with OAB in the phase III SUNRISE study. Here, treatment-related changes in TUFS and PPIUS scores both correlated with changes in PPBC scores, leading the investigators to conclude that the TUFS is useful for assessment improvement in the major OAB symptoms of urgency and frequency.
In another phase III study, NEPTUNE, TUFS scores correlated with treatment-related changes in a range of HRQoL endpoints, including the Patient and Clinician Global Impression, the International Prostate Symptom Score HRQoL score and the OAB questionnaire symptom bother score, irrespective of treatment received.
Limitations of the TUFS include its reliance on patient self-report, the dichotomous classification of incontinence, and the time-limited nature of voiding diaries.
Nevertheless, Chapple and co-authors conclude: “[T]he TUFS appears to be a useful tool for the assessment of improvements in urgency and frequency in patients with storage symptoms attributable to LUTS or OAB.”
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