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Interview-based versus self-reported anal incontinence using St Mark's incontinence score.

Hege Hølmo Johannessen1,2, Stig Norderval3,4, Arvid Stordahl5

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International Urogynecology Journal
|May 27, 2017
PubMed
Summary

The St. Mark's Incontinence Score (SMIS) is reliable whether self-administered or used in an interview for assessing anal incontinence (AI) symptoms. This finding supports its use in both formats for patient evaluation.

Keywords:
Anal incontinenceInterviewScoringSelf-reporting

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Area of Science:

  • Urogynecology
  • Clinical Epidemiology

Background:

  • The St. Mark's Incontinence Score (SMIS) is a validated tool for assessing anal incontinence (AI).
  • Conflicting evidence exists regarding the validity of the self-administered SMIS (sSMIS) compared to the interview-based SMIS (iSMIS).

Purpose of the Study:

  • To compare self-administered and interview-based reports of anal incontinence (AI) symptoms using the St. Mark's Incontinence Score (SMIS).

Main Methods:

  • 147 women reporting AI symptoms completed a sSMIS.
  • Consultant surgeons blinded to sSMIS results administered an iSMIS.
  • Spearman's rho and weighted kappa statistics assessed correlation and agreement between sSMIS and iSMIS.

Main Results:

  • A strong correlation was found between total sSMIS and iSMIS scores (r=0.769, p<0.001), explaining 59% of the variance.
  • Women reported more frequent AI symptoms on the sSMIS than iSMIS, except for gas incontinence.
  • Substantial agreement (κ≥0.60) was observed for most items, with fair agreement for formed stool incontinence (κ=0.22) and moderate for lifestyle changes (κ=0.5).

Conclusions:

  • The St. Mark's Incontinence Score (SMIS) demonstrates significant consistency between self-administered and interview-based administration.
  • The findings suggest the SMIS is a valid tool for assessing anal incontinence symptoms in both self-administered and interview formats.