Predicting detrusor overactivity using a physician-based scoring system

Women with lower urinary tract symptoms (LUTS) commonly present to primary care. Management is often based on a symptomatic diagnosis alone although LUTS correlate with urodynamic diagnosis in 65% of cases. The aim of this study was to develop a scoring system to discriminate between the symptoms of stress urinary incontinence (SUI) and overactive bladder (OAB). Physicians completed a specially developed questionnaire for all women complaining of LUTS. Women then underwent videocystourethrography. A scoring system based on the likelihood of each symptom for DO was developed using odds ratios and 95% confidence intervals (CI). This scoring system was subsequently used to discriminate those women with OAB from those with SUI. One hundred seventy one women were recruited to the study. This scoring system had a sensitivity of 79%, a specificity of 78% and a positive predictive value of 73% to identify detrusor overactivity (DO) This new OAB scoring system may be used in primary care to help discriminate between USI and DO.