Urgency Questionnaire validated for use in overactive bladder

By Joanna Lyford, Senior medwireNews Reporter

The symptom of urinary urgency experienced by people with overactive bladder (OAB) is a pathological sensation distinctive from the normal urge to void, US researchers believe.

Karin Coyne (Evidera, Bethesda, Maryland, USA) and co-authors propose that a new tool, the Urgency Questionnaire (UQ), may be a valuable for evaluating urgency in people with OAB.

Urinary urgency is the cardinal symptom of OAB, the researchers say, yet there is no single validated instrument to assess this symptom in daily practice. In previous work, Coyne and team conducted qualitative interviews with 16 patients with OAB and used their responses to develop a 24-item tool, the UQ.

In their latest research, Coyne et al conducted three psychometric validation studies in which they sought to refine the questionnaire items and test their content validity.

The three studies included 974, 163 and 47 participants with OAB, respectively, with one study including 30 continent individuals as controls. The majority of participants in the studies were White females with mean ages ranging from 49 to 66 years.

Writing in the International Urogynecology Journal, the researchers say that they deleted some items from the UQ, leaving 19 items covering four key areas: nocturia, fear of incontinence, time to control urgency and impact on daily activities.

The final version of the UQ showed moderate-to-high internal consistency and scores significantly correlated with patient-completed diary variables such as micturition frequency, nocturia, incontinence episodes, number of incontinence pads used and urgency episodes.

UQ scores discriminated between levels of symptom severity, as measured by various clinical indicators, and between continent and incontinent OAB patients. Importantly, the tool was also able to differentiate between OAB patients and healthy controls, with scores on all UQ subscales differing significantly between these groups.

Finally, the team found that most of the UQ subscales had strong reproducibility and all were sensitive to change over time, leading them to conclude that the instrument’s psychometric performance is “robust” and that the UQ is “a reliable, valid, and responsive measure to assess the context, severity, intensity, and daily life impact of [urinary urgency].”

The researchers remark that one of their most important findings was the ”striking“ degree of differentiation between patients with and without OAB.

Indeed, they say that the ability of the UQ to clearly differentiate between these two groups provides quantitative and consistent evidence that urinary urgency episodes are abnormal bladder sensations that usually persist until voiding, regardless of whether this is done voluntarily or not.

Coyne et al conclude: “Future research is needed to replicate these findings and to evaluate the performance of the UQ in relation to other [patient-reported outcomes] that have been validated for use in evaluating OAB symptoms and other urinary conditions.”

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