Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence.
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 articleSubject
AnxietyFecal Incontinence
Female
Humans
Middle Aged
Patient Satisfaction
Prospective Studies
Quality of Life
Severity of Illness Index
Surveys and Questionnaires
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https://hdl.handle.net/10161/15393Published Version (Please cite this version)
10.1097/SPV.0000000000000078Publication 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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Show full item recordScholars@Duke
Matthew Don Barber
W. Allen Addison, M.D. Distinguished Professor of Obstetrics and Gynecology
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
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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