Selecting an outcome measure for evaluating treatment in fecal incontinence

被引:38
作者
Deutekom, M
Terra, MP
Dobben, AC
Dijkgraaf, MGW
Felt-Bersma, RJF
Stoker, J
Bossuyt, PMM
机构
[1] Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands
[2] Acad Med Ctr, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands
[3] Vrije Univ Amsterdam, Med Ctr, Dept Gastroenterol, Amsterdam, Netherlands
关键词
fecal incontinence; treatment outcome; review; patient perception; validity;
D O I
10.1007/s10350-005-0162-1
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: Various outcome measures exist to evaluate treatment in fecal incontinence, including descriptive, severity (fecal incontinence scoring systems), and impact (quality-of-life questionnaires) and diagnostic measures. We studied associations between changes after treatment for a number of outcome measures and compared them to patients' subjective perception of relief. METHODS: We analyzed data of 66 patients (92 percent female; mean age, 62 years) (Vaizey score, Wexner score, two impact scales, utility, resting pressure, and maximal incremental squeeze pressure) at baseline and after physiotherapy. In a standardized interview by phone, we asked patients to compare their situation before and after treatment. Correlations between changes in outcome measures were calculated. These changes were compared with patients' subjective perception. RESULTS: There was a high correlation between the changes in the Vaizey and the Wexner scores (r = 0.94, P < 0.01). Changes in Vaizey and Wexner scores correlated moderately with changes in maximum incremental squeeze pressure (r = -0.29, -0-30, both P < 0.05). Changes in utility and resting pressure were not correlated with changes in any of the other measurements (all r values between -0.086 and 0. 18). Average severity scores (Vaizey and Wexner) were I point lower for patients who rated their situation as worse or equal (62 percent), 4 points lower for patients who reported their situation to be better (21 percent), and 9 points lower in patients who rated their situation much better (17 percent) (P <.05). CONCLUSION: Severity measures are best related to patients' subjective perception of relief.
引用
收藏
页码:2294 / 2301
页数:8
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