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Non-surgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness

Slide: 25 of 50

Results of the Systematic Review: Evaluation of Diagnostic Methods (2 of 4)

Diagnostic methods under evaluation were compared with a reference standard, either clinical diagnosis or urodynamics, to determine the sensitivity, specificity, positive likelihood ratio, and positive predictive value relative to the reference standard.

To evaluate stress UI symptoms for correct diagnosis of stress UI, symptoms of stress UI were compared with the complete clinical diagnosis. The sensitivity of stress UI symptoms was 0.88 (statistically valid range of 0.68 to 0.96). Specificity was 0.67 (statistically valid range of 0.54 to 0.78). The positive likelihood ratio was 2.35, which is defined as small diagnostic value. The positive predictive value was calculated at 0.80 (statistically valid range from 0.66 to 0.89).

To evaluate urgency UI symptoms for the correct diagnosis of detrusor overactivity UI, symptoms of urgency UI were compared with the complete clinical diagnosis. The sensitivity of urgency UI symptoms was 0.82 (statistically valid range of 0.73 to 0.89). Specificity was 0.67 (statistically valid range of 0.53 to 0.89). The positive likelihood ratio was 2.52, which is defined as small diagnostic value. The positive predictive value was calculated at 0.79 (statistically valid range from 0.54 to 0.92).

To evaluate stress and urgency UI symptoms for the correct diagnosis of mixed UI, symptoms were compared with the complete clinical diagnosis. The sensitivity of stress and urgency UI symptoms was 0.65 (statistically valid range of 0.36 to 0.86). Specificity was 0.54 (statistically valid range of 0.21 to 0.84). The positive likelihood ratio was 1.6, which is defined as small diagnostic value. The positive predictive value was calculated at 0.80 (statistically valid range from 0.43 to 0.96).

To evaluate stress UI symptoms for the correct diagnosis of stress UI, symptoms were compared with diagnosis by multichannel urodynamics. The sensitivity of stress symptoms was 0.93 (statistically valid range of 0.90 to 0.95). Specificity was 0.41 (statistically valid range of 0.34 to 0.49). The positive likelihood ratio was 1.54, which is defined as small diagnostic value. The positive predictive value was calculated at 0.74 (statistically valid range from 0.67 to 0.81).

To evaluate urgency UI symptoms for the correct diagnosis of detrusor overactivity UI, symptoms were compared with diagnosis by multichannel urodynamics. The sensitivity of urgency symptoms was 0.82 (statistically valid range of 0.76 to 0.87). Specificity was 0.51 (statistically valid range of 0.44 to 0.59). The positive likelihood ratio was 1.54, which is defined as minimal diagnostic value. The positive predictive value was calculated at 0.80 (statistically valid range from 0.73 to 0.86).

To evaluate stress and urgency UI symptoms for the correct diagnosis of mixed UI, symptoms were compared with diagnosis by multichannel urodynamics. The sensitivity of stress and urgency symptoms was 0.73 (statistically valid range of 0.61 to 0.82). Specificity was 0.53 (statistically valid range of 0.40 to 0.66). The positive likelihood ratio was 1.45, which is defined as minimal diagnostic value. The positive predictive value was calculated at 0.89 (statistically valid range from 0.85 to 0.92).