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Neurourology and Urodynamics 26:456 (2007) EDITORIAL COMMENT Re: Burgio KL, Goode PS, Richter HE, et al. 2006. Global Ratings of Patient Satisfaction and Perceptions of Improvement With Treatment for Urinary Incontinence: Validation of Three Global Patient Ratings. Neurourol Urodynam 25:411–417 To the Editor: Although urinary incontinence is a major health concern, research measures of successful treatment are limited. As new surgical or pharmacologic treatments for incontinence are developed, it is important to have reliable and valid instru- ments to measure a broad range of outcomes. Outcome measures have evolved from urodynamic studies in a laboratory setting as the ‘‘gold standard’’ to the development of bladder diaries to measure change in frequency of incontinent episodes as the primary outcome used in most randomized controlled trials. More recently, a number of condition-specific measures have been developed that address symptom bothersomeness and the effect of urinary incon- tinence on health-related quality of life. These instruments have been shown to be reliable, responsive to change over time, and valid. However, measures from the patient’s perspective are limited. In this current article, Burgio et al. report a methodologically sound analysis of the validity of patient global ratings of treatments for urinary incontinence in three separate randomized controlled trials. The findings show persuasively that patient global ratings of satisfaction, perception of improvement, and estimated percent improve- ment are valid outcome measures. Expanding the dimensions of outcome measures to include patient global ratings is a significant addition to our research literature. Not all research tools are useful in clinical practice. These patient global ratings certainly are applicable and feasible in our clinical practices. The uniqueness of these tools are their simplicity and reflection of what we commonly ask our patients when assisting patients with management of their incontinence, ‘‘Are you satisfied, do you feel better, and how much better?’’. Congratulations to the Burgio group for their ongoing methodological work. Jeanette S. Brown, MD* UCSF Women’s Health Clinical Research Center San Francisco, California No conflict of interest reported by the author(s). *Correspondence to: Jeanette S. Brown, UCSF Women’s Health Clinical Research Center, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115. E-mail: [email protected] Published online 15 February 2007 in Wiley InterScience (www.interscience.wiley.com) DOI 10.1002/nau.20294 ß 2007 Wiley-Liss, Inc.

Re: Burgio KL, Goode PS, Richter HE, et al. 2006. Global ratings of patient satisfaction and perceptions of improvement with treatment for urinary incontinence: validation of three

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Neurourology and Urodynamics 26:456 (2007)

EDITORIAL COMMENT

Re: Burgio KL, Goode PS, Richter HE, et al. 2006. Global Ratings ofPatient Satisfaction and Perceptions of Improvement With Treatmentfor Urinary Incontinence: Validation of Three Global Patient Ratings.

Neurourol Urodynam 25:411–417

To the Editor:

Although urinary incontinence is a major health concern,research measures of successful treatment are limited. As newsurgical or pharmacologic treatments for incontinence aredeveloped, it is important to have reliable and valid instru-ments to measure a broad range of outcomes. Outcomemeasures have evolved from urodynamic studies in alaboratory setting as the ‘‘gold standard’’ to the developmentof bladder diaries to measure change in frequency ofincontinent episodes as the primary outcome used in mostrandomized controlled trials. More recently, a number ofcondition-specific measures have been developed that addresssymptom bothersomeness and the effect of urinary incon-tinence on health-related quality of life. These instrumentshave been shown to be reliable, responsive to change overtime, and valid. However, measures from the patient’sperspective are limited. In this current article, Burgio et al.report a methodologically sound analysis of the validity ofpatient global ratings of treatments for urinary incontinence

in three separate randomized controlled trials. The findingsshow persuasively that patient global ratings of satisfaction,perception of improvement, and estimated percent improve-ment are valid outcome measures. Expanding the dimensionsof outcome measures to include patient global ratings is asignificant addition to our research literature. Not all researchtools are useful in clinical practice. These patient globalratings certainly are applicable and feasible in our clinicalpractices. The uniqueness of these tools are their simplicityand reflection of what we commonly ask our patients whenassisting patients with management of their incontinence,‘‘Are you satisfied, do you feel better, and how much better?’’.Congratulations to the Burgio group for their ongoingmethodological work.

Jeanette S. Brown, MD*UCSF Women’s Health

Clinical Research CenterSan Francisco, California

No conflict of interest reported by the author(s).*Correspondence to: Jeanette S. Brown, UCSF Women’s Health Clinical ResearchCenter, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115.E-mail: [email protected] online 15 February 2007 in Wiley InterScience(www.interscience.wiley.com)DOI 10.1002/nau.20294

� 2007 Wiley-Liss, Inc.