Variation in surgical treatment advice for women with stress urinary incontinence: a study using clinical case vignettes
| Autor: | Jil B Mamza, Philip Toozs-Hobson, Dina El-Hamamsy, Rebecca S Geary, Andrew Wilson, Ash Monga, Jonathan Duckett, Jan van der Meulen, Ipek Gürol, Tahir Mahmood, Douglas G Tincello |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Urology Urinary Incontinence Stress Case vignette Female urinary incontinence Urinary incontinence Computer-assisted web interviewing Case vignettes Body Mass Index Interquartile range Surveys and Questionnaires medicine Humans Surgical treatment business.industry Obstetrics and Gynecology Latent class model Gynecology Physical therapy Original Article Female Clinical case medicine.symptom business Body mass index Decision-making |
| Zdroj: | International Urogynecology Journal |
| ISSN: | 1433-3023 0937-3462 |
| Popis: | Introduction The aim of this study was to determine how recommendations of gynaecologists on surgical treatment for stress urinary incontinence (SUI) were influenced by patient characteristics. Methods Two hundred forty-five gynaecologists in the UK fully responded to an online questionnaire including 18 vignettes describing 7 clinical characteristics of women with SUI (age, body mass index, SUI type, previous SUI surgery, frequency of leakage, bother, physical status). The gynaecologists scored recommendations for surgery ranging from 1 ‘certainly not’ to 5 ‘certainly yes’. Mean scores were used to calculate the relative impact (‘weight’) of each clinical characteristic. Latent class analysis was used to distinguish groups of gynaecologists with a particular practice style because they responded to the patient characteristics captured in the case vignettes in a similar way. Results The gynaecologists’ overall average recommendation score was 2.9 (interquartile range 2 to 4). All patient characteristics significantly influenced the recommendation scores (p always < 0.001) but their impact was relatively small. SUI type was most important (weight 23%), followed by previous SUI surgery (weight 21%). Latent class analysis identified five groups of gynaecologists with practice styles that differed mainly with respect to their mean recommendation score, ranging from 1.3 to 4.0. Conclusions Surgical treatment advice in response to case vignettes was only minimally influenced by patient characteristics. There were five groups of gynaecologists whose inclination to recommend surgical treatment varied. This suggests that there is lack of consensus on the role of surgery as a treatment for SUI. A considerable number of gynaecologists were reluctant to recommend surgery. |
| Databáze: | OpenAIRE |
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