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Urinary incontinence-85: an expanded prostate cancer composite (EPIC) score cutoff value for urinary incontinence determined using long-term functional data by repeated prospective EPIC-score self-assessment after radical prostatectomy


Bossert, Karolin; Ramakrishnan, Venkat M; Seifert, Burkhardt; Lehmann, Kurt; Hefermehl, Lukas J (2017). Urinary incontinence-85: an expanded prostate cancer composite (EPIC) score cutoff value for urinary incontinence determined using long-term functional data by repeated prospective EPIC-score self-assessment after radical prostatectomy. International Neurourology Journal, 21(4):302-308.

Abstract

PURPOSE: To determine an objective cutoff value (COV) for urinary incontinence (UI) using the Expanded Prostate Cancer Composite (EPIC) score after radical prostatectomy (RP).
METHODS: From 2004-2013, all RP patients at our institution completed the EPIC urinary domain (EPIC-UD) questionnaire preoperatively and 6 weeks; 3, 6, 9, 12, and 18 months postoperatively; and yearly thereafter. The EPIC-UD is composed of several questions, 4 of which address UI qualitatively (EPIC-UI). Furthermore, patients were asked to complete a global quality of life (QoL) questionnaire regarding continence. The EPIC COV was calculated using receiver operating characteristic (ROC) analysis. Correlations between the EPIC-UI and quantitative QoL were evaluated using the Kendall-Tau test.
RESULTS: We analyzed 239 patients with a median age of 63 years (interquartile range [IQR], 59-66 years), a median follow-up of 48 months (IQR, 30-78 months) and a median preoperative EPIC-UI score of 100 (IQR, 91.75-100). The ROC analysis for the distinction between EPIC-UI and the use of ≤1 pad/day yielded an EPIC-UI COV of >85, which we termed the UI-85, with an area under the curve of 0.857 (P<0.0001). A stronger correlation was seen between QoL scores and the UI-85 (1 year postoperatively: correlation coefficient [CC], 0.592; P<0.0001) than between QoL and not using a pad (CC, 0.512; P<0.0001).
CONCLUSIONS: The calculated COV of the EPIC-UI for continence was 85. UI is a multidimensional condition that cannot be adequately characterized by a single piece of information, such as pad usage only. Hence, the UI-85 represents a nuanced and straightforward tool for monitoring and comparing continence between different time points and cohorts in a multidimensional and objective manner.

Abstract

PURPOSE: To determine an objective cutoff value (COV) for urinary incontinence (UI) using the Expanded Prostate Cancer Composite (EPIC) score after radical prostatectomy (RP).
METHODS: From 2004-2013, all RP patients at our institution completed the EPIC urinary domain (EPIC-UD) questionnaire preoperatively and 6 weeks; 3, 6, 9, 12, and 18 months postoperatively; and yearly thereafter. The EPIC-UD is composed of several questions, 4 of which address UI qualitatively (EPIC-UI). Furthermore, patients were asked to complete a global quality of life (QoL) questionnaire regarding continence. The EPIC COV was calculated using receiver operating characteristic (ROC) analysis. Correlations between the EPIC-UI and quantitative QoL were evaluated using the Kendall-Tau test.
RESULTS: We analyzed 239 patients with a median age of 63 years (interquartile range [IQR], 59-66 years), a median follow-up of 48 months (IQR, 30-78 months) and a median preoperative EPIC-UI score of 100 (IQR, 91.75-100). The ROC analysis for the distinction between EPIC-UI and the use of ≤1 pad/day yielded an EPIC-UI COV of >85, which we termed the UI-85, with an area under the curve of 0.857 (P<0.0001). A stronger correlation was seen between QoL scores and the UI-85 (1 year postoperatively: correlation coefficient [CC], 0.592; P<0.0001) than between QoL and not using a pad (CC, 0.512; P<0.0001).
CONCLUSIONS: The calculated COV of the EPIC-UI for continence was 85. UI is a multidimensional condition that cannot be adequately characterized by a single piece of information, such as pad usage only. Hence, the UI-85 represents a nuanced and straightforward tool for monitoring and comparing continence between different time points and cohorts in a multidimensional and objective manner.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2017
Deposited On:08 Jan 2018 20:23
Last Modified:08 Jan 2018 20:33
Publisher:Korean Continence Society
ISSN:2093-4777
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.5213/inj.1735000.500
PubMed ID:29298473

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