RELIABILITY OF THE MESA QUESTIONNAIRE AS A SCREENING TOOL FOR URINARY INCONTINENCE
S.T. Mahajan, M.P. FitzGerald, K. Kenton, L. Brubaker
Loyola University, Maywood, IL
OBJECTIVE: To determine the reliability of the MESA questionnaire as a screening tool for urinary incontinence in female pelvic medicine and reconstructive surgery patients.
MATERIALS AND METHODS: After IRB approval was obtained, 100 patients who were new to our referral center were asked to complete a second MESA questionnaire in addition to one completed before entering the examination room. Both questionnaires were completed before talking to a healthcare provider. Previous responses were not available to the patient. Demographics and responses were analyzed using SPSS (SPSS, Inc, Chicago, IL). Percentage scores were calculated separately for the stress and urge section of each MESA questionnaire. An assignment was made for each completed MESA questionnaire to one of four categories of continence: mixed, stress only, urge only, and no incontinence. A response of at least ‘Sometimes’ to at least one MESA item in the stress or urge category indicated incontinence. Agreement between the category assignments of the two MESA questionnaires was assessed using kappa statistics.
RESULTS: One hundred patients completed 2 MESA questionnaires a median of 1 hour apart. The study population was predominantly Caucasian (79%), vaginally parous (median parity 2.0) and middle-aged (mean age 53 years). Incontinence categories of at the time of initial and repeat testing are listed in Table 1. The kappa value for agreement between the diagnoses was 0.7 (p < 0.0001). However, 24 patients would have had their initial diagnosis changed at the time of completion of the second questionnaire. Of 80 patients who had stress incontinence by MESA #2, 75 had stress incontinence by MESA #1. Similarly, 68 patients had urge incontinence symptoms by MESA #1, and 71 had urge incontinence by MESA #2. Twelve patients had ‘no incontinence’ by MESA #1, and 16 had ‘no incontinence’ by MESA #2.
CONCLUSIONS: The MESA questionnaire is a useful screening tool for urinary incontinence symptoms among tertiary urogynecologic patients. Its reliability in the categorization of urinary incontinence subtype will depend on the cutoff values used to define incontinence. Currently, no recommended cutoff value has been defined.
Table 1. Diagnoses based on incontinence scores for 100 patients completing 2 MESA questionnaires a median of 1 hour apart. Kappa value was 0.7, p<0.001.
|
|
MESA 2 |
|
|||
|
|
Mixed |
Stress only |
Urge only |
No incontinence |
|
|
MESA 1 |
|
|
|
|
|
|
Mixed |
56 |
0 |
3 |
1 |
60 |
|
Stress only |
5 |
12 |
0 |
3 |
20 |
|
Urge only |
1 |
0 |
6 |
1 |
8 |
|
No Incontinence |
0 |
1 |
0 |
11 |
12 |
|
Total |
62 |
13 |
9 |
16 |
100 |
Key Words: MESA, reliability, screening, questionnaire
Disclosure - Speakers Bureau: S. Mahajan, Indevus Pharm, Inc.; K. Kenton, Lilly; Grant/Research: M.P. Fitzgerald, Lifetec Inc.; K. Kenton, Lifetech Inc., Pfizer; L. Brubaker, Lifetech Inc.;
Consultant: Linda Brubaker, Pfizer, Yamanouchi, Novartis, Lilly.