Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
The Michigan incontinence symptom index (M-ISI): A clinical measure for type, severity, and bother related to urinary incontinence
Article first published online: 14 AUG 2013
© 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 33, Issue 7, pages 1128–1134, September 2014
How to Cite
Suskind, A. M., Dunn, R. L., Morgan, D. M., DeLancey, J. O.L., McGuire, E. J. and Wei, J. T. (2014), The Michigan incontinence symptom index (M-ISI): A clinical measure for type, severity, and bother related to urinary incontinence. Neurourol. Urodyn., 33: 1128–1134. doi: 10.1002/nau.22468
- Issue published online: 11 AUG 2014
- Article first published online: 14 AUG 2013
- Manuscript Accepted: 1 JUL 2013
- Manuscript Received: 27 MAR 2013
- Study was funded by the University of Michigan Department of Urology U010531 and Anne M. Suskind's efforts were funded by an NIH/NIDDK T32 DK07782
- Dr. John O.L. DeLancey was funded from Office for Research on Women's Health SCOR on Sex Differences in Women's Health P50 HD 44406 and has financial relationships with American Medical Systems, Kimberly Clark, Johnson & Johnson, and Proctor & Gamble
- quality of life;
- urge urinary incontinence;
- stress urinary incontinence;
- pad use
To develop a clinically relevant, easy to use, and validated instrument for assessing severity and bother related to urinary incontinence.
Survey items were piloted and refined following psychometric principles in five separate patient cohorts. Patient and expert endorsement of items, factor analyses, Spearman rank correlations and response distributions were employed for item selection. Formal reliability and validity evaluation were conducted for the final questionnaire items.
Expert physicians and patient focus groups confirmed face and content validity for the measure. A 10-item measure called the Michigan Incontinence Symptom Index (M-ISI) was developed with two domains: a Total M-ISI Domain consisting of subdomains for stress urinary incontinence, urgency urinary incontinence, and pad use, and a Bother Domain. High construct validity was demonstrated with a Cronbach's alpha for the Total M-ISI Domain (items 1-8) of 0.90 and for the Bother Domain (items 9-10) of 0.82. Cronbach's alpha for the subdomains were all > 0.85. Construct validity, convergent and divergent validity, internal discriminant validity, and predictive validity were all robust. The minimally important difference for the measure was determined to be 4 points (out of 32) for the Total M-ISI Severity Domain, and 1-2 points (out of 8-12) for the individual subdomains.
The M-ISI is a parsimonious measure that has established reliability and validity on several levels and complements current clinical evaluative methods for patients with urinary incontinence. Neurourol. Urodynam. 33:1128–1134 , 2014. © 2013 Wiley Periodicals, Inc.