Quantification of vaginal support: are continuous summary scores better than POPQ stage? - 19/08/11

Doi : 10.1016/j.ajog.2010.06.071

Linda Brubaker, MD, MS ^a, Matthew D. Barber, MD, MHS ^b, Ingrid Nygaard, MD, MS ^c, Charlie W. Nager, MD ^d, Edward Varner, MD ^e, Joseph Schaffer, MD ^f, Anthony Visco, MD ^g, Susan Meikle, MD ^h, Cathie Spino, DSc ⁱ
Pelvic Floor Disorders Network
^a Department of Obstetrics and Gynecology and Urology, Loyola University, Chicago, IL
^b Department of Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH
^c Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT
^d Department of Reproductive Sciences, University of California, San Diego, CA
^e Department of Obstetrics and Gynecology, University of Alabama–Birmingham, Birmingham, AL
^f Department of Obstetrics and Gynecology, University of Texas–Southwestern, Dallas, TX
^g Department of Obstetrics and Gynecology, Duke University, Durham, NC
^h Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
ⁱ Department of Biostatistics, University of Michigan, Ann Arbor, MI

Résumé

Objective

This analysis compared 3 continuous variables as summary support loss (SL) scores with pelvic organ prolapse (POP) quantification (POPQ) ordinal stages.

Study Design

We used pooled baseline data from 1141 subjects in 3 randomized trials (CARE, n = 322; OPUS, n = 380; ATLAS, n = 439) to test 3 SL measures. The relative responsiveness was assessed using the standardized response mean of 2-year outcome data from the CARE trial.

Results

Each SL measure was strongly correlated with POPQ ordinal staging; the single most distal POPQ point had the strongest correlation. Improvements in anatomic support were weakly correlated with improvements in POP Distress Inventory (r = 0.17–0.24; P < .01 for each) but not with changes in POP Impact Questionnaire for all measures of SL or POPQ stage.

Conclusion

While continuous, single number summary measures compared favorably to ordinal POPQ staging system, the single most distal POPQ point may be preferable to POPQ ordinal stages to summarize or compare group data.

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Key words : outcome measures, pelvic organ prolapse, pelvic surgery, prolapse, quantification of prolapse

Plan

Materials and Methods

Results

Comment

	Supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Diabetes and Digestive and Kidney Diseases, and the National Institutes of Health Office of Research on Women's Health (U01 HD41249, U10 HD41250, U10 HD41261, U10 HD41267, U10 HD54136, U10 HD54214, U10 HD54215, and U10 HD54241).
	Cite this article as: Brubaker L, Barber MD, Nygaard I, et al. Quantification of vaginal support: are continuous summary scores better than POPQ stage? Am J Obstet Gynecol 2010;203:512.e1-6.
	Reprints not available from the authors.

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Vol 203 - N° 5

P. 512.e1-512.e6 - novembre 2010 Retour au numéro

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Quantification of vaginal support: are continuous summary scores better than POPQ stage? - 19/08/11

Résumé

Objective

Study Design

Results

Conclusion

Plan

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