Conflict of interest: none.
Development of quality indicators for women with urinary incontinence
Article first published online: 16 SEP 2013
© 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 32, Issue 8, pages 1058–1063, November 2013
How to Cite
Anger, J. T., Scott, V. C.S., Kiyosaki, K., Khan, A. A., Weinberg, A., Connor, S. E., Roth, C. P., Wenger, N., Shekelle, P. and Litwin, M. S. (2013), Development of quality indicators for women with urinary incontinence. Neurourol. Urodyn., 32: 1058–1063. doi: 10.1002/nau.22353
Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
- Issue published online: 24 OCT 2013
- Article first published online: 16 SEP 2013
- Manuscript Accepted: 30 OCT 2012
- Manuscript Received: 10 SEP 2012
- Patient-Oriented Research Career Development Award. Grant Number: 1 K23 DK080227
- American Recovery and Reinvestment Act (ARRA) Supplement Award from the National Institute of Diabetes and Digestive and Kidney Diseases. Grant Number: 5RC1EB010649
- quality indicators;
- RAND appropriateness method;
- stress urinary incontinence;
- urge urinary incontinence
To develop a means to measure the quality of care provided to women treated for urinary incontinence (UI) through the development of quality-of-care indicators (QIs).
We performed an extensive literature review to develop a set of potential quality indicators for the management of UI. QIs were modeled after those previously described in the Assessing the Care of Vulnerable Elders (ACOVE) project. Nine experts ranked the indicators on a nine-point scale for both validity and feasibility. We analyzed preliminary rankings of each indicator using the RAND Appropriateness Method. A forum was then held in which each indicator was thoroughly discussed by the panelists as a group, after which the indicators were rated a second time individually using the same nine-point scale.
QIs were developed that addressed screening, diagnosis, work-up, and both non-surgical and surgical management. Areas of controversy included whether routine screening for incontinence should be performed, whether urodynamics should be performed before non-surgical management is initiated, and whether cystoscopy should be part of the pre-operative work-up of uncomplicated stress incontinence. Following the expert panel discussion, 27 of 40 potential indicators were determined to be valid for UI with a median score of at least seven on a nine-point scale.
We identified 27 quality indicators for the care of women with UI. Once these QIs are pilot-tested for feasibility, they will be applied on a larger scale to measure the quality of care provided to women with UI in the United States. Neurourol. Urodynam. 32:1058–1063, 2013. © 2013 Wiley Periodicals, Inc.