Case-finding tools for the diagnosis of OAB in women: A narrative review

Overactive bladder (OAB) remains underdiagnosed with many patients never seeking medical help. Methods to aid early identification and treatment of OAB will be hugely beneficial, and to this end several case-finding tools have been developed. The aim of this review is to critically analyse the literature regarding case-finding tools that have been validated specifically for the detection of OAB in women.

A literature search of the PubMed database was performed until July 2019 using the search terms screening and OAB or lower urinary tract symptoms (LUTS). Names of individual case-finding tools included in the sixth International Consultation on Incontinence were also searched on the PubMed database. Original articles on the validation of patient-reported screening questionnaires for the detection of OAB in women were included.

A total of 22 studies met the inclusion criteria and were included in this review. The validation studies of 11 case-finding tools were assessed. All demonstrated good sensitivity and specificity for OAB or incontinence symptoms, and five tools have been most extensively validated for this condition (bladder control self-assessment questionnaire [B-SAQ], OAB-V8, OAB-V3, OAB symptom score, and questionnaire for urinary incontinence diagnosis). B-SAQ and OAB-V8 demonstrated high sensitivity whilst actionable bladder symptom screening tool was the most specific. B-SAQ was the only tool in this review to encompass screening for "red-flag" symptoms (hematuria, pain), and it has also been validated in a primary care setting.

Several case-finding tools have been demonstrated to have high accuracy for diagnosing OAB in women. B-SAQ encompasses other LUTS as well as "red-flag" symptoms; its use should be promoted in primary care.