Urinary symptom screening tool validated for female OAB

Jun 9 2014

By Joanna Lyford, Senior medwireNews Reporter

The Actionable Bladder Symptom Screening Tool (ABSST) is a reliable, valid and sensitive instrument in women with incontinence due to non-neurogenic overactive bladder (OAB), researchers report.

The ABSST, which was originally developed for use by people with multiple sclerosis, may thus be useful in screening women with urinary symptoms and identifying those who might benefit from treatment, say the researchers.

Linda Cardozo (King’s College Hospital, London, UK) and colleagues evaluated the ABSST in 100 women attending six gynaecology clinics in the USA. The women also completed the OAB questionnaire Short Form (OAB-q SF) and a patient global impression of severity (PGI-S) scale.

Fifty-three women had a pre-existing diagnosis of urgency urinary incontinence (UUI) or OAB while the other 47 served as controls. The majority of women were Caucasian and working full- or part-time. Women with urinary symptoms tended to be older than control women (mean age 54.6 vs 40.4 years), have a higher body mass index (31.1 vs 26.4 kg/m²) and a greater prevalence of comorbidities.

The mean duration of urinary symptoms was 6.8 years and 77.4% of symptomatic women were not receiving treatment.

Mean scores on each of the screening tools differed significantly between symptomatic women and controls. Mean scores were 3.3 versus 0.6 on the ABSST, 3.0 versus 1.2 on the PGI-S, 46.1 versus 11.2 on the OAB-q SF symptom bother subscale and 66.2 versus 95.6 on the OAB-q SF healthcare-related quality-of-life subscale.

Further analysis indicated that the ABSST was internally consistent and reliable, with a Cronbach’s alpha of 0.90, and had moderate-to-high concurrent validity versus the OAB-q SF.

The ABSST comprises eight statements about the nature and impact of bladder symptoms over the past 7 days. Analysis of individual items showed no floor effect, which suggests that all were perceived by women as relevant and important problems associated with OAB/UUI, say the researchers.

Finally, receiver operating characteristic curve analysis suggested that an ABSST score of 3 or higher would be optimal for identifying women with OAB/UUI, and best matching the clinician’s own assessment of whether the patient should be treated.

A cutoff score of 3 or higher had a sensitivity of 79.1% and specificity of 98.2%, which was similar to the tool’s performance in the neurogenic population (sensitivity 82.0%, specificity 95.0%).

Writing in the International Urogynecology Journal, Cardozo and team conclude: “[T]he ABSST is a reliable, valid, and sensitive tool that can be used to identify women who may benefit from treatment and to facilitate discussions between patients and healthcare providers regarding lower urinary tract problems.”

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