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Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence.

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Date
2014-11
Authors
Jelovsek, John Eric
Chen, Zhen
Markland, Alayne D
Brubaker, Linda
Dyer, Keisha Y
Meikle, Susie
Rahn, David D
Siddiqui, Nazeema Y
Tuteja, Ashok
Barber, Matthew D
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Abstract
OBJECTIVES: The objective of this study was to estimate the minimum important difference (MID) for the Fecal Incontinence Severity Index (FISI), the Colorectal-Anal Distress Inventory (CRADI) scale of the Pelvic Floor Distress Inventory, the Colorectal-Anal Impact Questionnaire (CRAIQ) scale of the Pelvic Floor Impact Questionnaire, and the Modified Manchester Health Questionnaire (MMHQ). METHODS: We calculated the MIDs using anchor-based and distribution-based approaches from a multicenter prospective cohort study investigating adaptive behaviors among women receiving nonsurgical and surgical management for fecal incontinence (FI). Patient responses were primarily anchored using a Global Impression of Change scale. The MID was defined as the difference in mean change from baseline between those who indicated they were "a little better" and those who reported "no change" on the Global Impression of Change scale 3 months after treatment. The effect size and SE of measurement were the distribution methods used. RESULTS: The mean changes (SD) in FISI, CRADI, CRAIQ, and MMHQ scores from baseline to 3 months after treatment were -8.8 (12.0), -52.7 (70.0), -60.6 (90.0), and -12.6 (19.2), respectively. The anchor-based MID estimates suggested by an improvement from no change to a little better were -3.6, -11.4 and -4.7, -18.1 and -8.0, and -3.2 for the FISI, CRADI (long and short version), CRAIQ (long and short version), and MMHQ, respectively. These data were supported by 2 distribution-based estimates. CONCLUSIONS: The MID values for the FISI are -4, CRADI (full version, -11; short version, -5), CRAIQ (full version, -18; short version, -8), and MMHQ -3. Statistically significant improvements that meet these thresholds are likely to be clinically important.
Type
Journal article
Subject
Anxiety
Fecal Incontinence
Female
Humans
Middle Aged
Patient Satisfaction
Prospective Studies
Quality of Life
Severity of Illness Index
Surveys and Questionnaires
Permalink
https://hdl.handle.net/10161/15393
Published Version (Please cite this version)
10.1097/SPV.0000000000000078
Publication Info
Jelovsek, John Eric; Chen, Zhen; Markland, Alayne D; Brubaker, Linda; Dyer, Keisha Y; Meikle, Susie; ... Barber, Matthew D (2014). Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence. Female Pelvic Med Reconstr Surg, 20(6). pp. 342-348. 10.1097/SPV.0000000000000078. Retrieved from https://hdl.handle.net/10161/15393.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Barber

Matthew Don Barber

W. Allen Addison, M.D. Distinguished Professor of Obstetrics and Gynecology
Jelovsek

John E Jelovsek

F. Bayard Carter Distinguished Professor of Obstetrics and Gynecology
Dr. Jelovsek is the F. Bayard Carter Distinguished Professor of OBGYN at Duke University and serves as Director of Data Science for Women’s Health. He is Board Certified in OBGYN by the American Board of OBGYN and in Female Pelvic Medicine & Reconstructive Surgery by the American Board of OBGYN and American Board of Urology. He has an active surgical practice in urogynecology based out of Duke Raleigh. He has expertise as a clinician-scientist in developing and evaluating clini
Siddiqui

Nazema Yusuf Siddiqui

Associate Professor of Obstetrics and Gynecology
Research on pelvic floor disorders. Specific interests include: 1) studying the urinary microbiome in aging, recurrent urinary tract infections, and overactive bladder; 2) pathophysiology of overactive bladder with particular emphasis on translational biology.
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