Systematic review of guidelines for urinary incontinence in women - 19/07/20

Doi : 10.1016/j.jogoh.2020.101842

A. Favre-Inhofer ^a,^b,⁎ , P. Dewaele ^c, P. Millet ^c, X. Deffieux ^c,^{^{1
Capital participation in following companies: SANOFI and NANOBIOTICS.},}^{^{2
Companies’ past contributions for one-off interventions (advice or conferences or travel funding): URGOTECH, ASTELLAS, ALLERGAN, LABORIE, MYLAN, PFIZER, BBRAUN, LEOPHARMA, GYNECARE, WELLSPECT, AMI.}}
^a Service de gynécologie-obstétrique et médecine de la reproduction, Hôpital Foch, Suresnes, France
^b Université de Versailles Saint Quentin en Yvelines, Versailles, France
^c Université Paris-Saclay & Assistance Publique Hôpitaux de Paris (APHP), GHU Sud, Hôpital Antoine Béclère, Service de Gynécologie-Obstétrique, F-92140 Clamart, France

^⁎Corresponding author at: Service de gynécologie-obstétrique et médecine de la reproduction, Hôpital Foch, Suresnes, France.Service de gynécologie-obstétrique et médecine de la reproductionHôpital FochSuresnesFrance

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 19 July 2020
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Highlights

•	Quality of methodologies of guidelines in urinary incontinence in women is quite different from one society to another.
•	The recommendations of urinary incontinence in women are quite consistent and their differences are mainly ones of grade.
•	Common sense over evidence-based medicine, publication chronology, semantics of grade and discrepancies of grades can explain grade differences in guidelines.

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Abstract

Introduction and objective

Urinary incontinence in women is the subject of multiple recommendations all over the world. The aim of our study was to compare methodologies and search for inconsistencies in texts and grades in these guidelines.

Methods

Seventeen recommendations from different medical societies in English, French and German were included. Their methodologies were analyzed, including writing methods, cyclicity, level of evidence (LE) and grades. The recommendations were synthesized and inconsistencies in texts and grades were studied. The quality of recommendations was evaluated with the Appraisal of Guidelines for Research and Evaluation (AGREE II) scale.

Results

Methods, rigour and cyclicity varied depending on societies. LE and grades are broadly consensual for higher LE and grades and less so for lower LE and grades. The Collège National des Gynécologues et Obstétriciens Français, the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, the European Association of Urology, the International Consultation on Urological Diseases and the National Institute for Health and Care Excellence have an AGREE score ≥ 80 % (third quartile). Grading and textual inconsistencies are explained by the order of studies or the absence of high LE.