Zoe S. Kopp

Objectives: Hepatitis C virus (HCV) is highly curable with antiviral therapy, and traditionally, treatment adherence has been critical for treatment success. We sought to determine whether assessing HCV treatment readiness with a structured treatment readiness tool was associated with increased rates of adherence and cure among patients at a safety-net HCV clinic. Methods: We administered the...

Aim To linguistically validate the translation of the Lower Urinary Tract Symptoms (LUTS) Tool from English to 10 European languages and assess whether the translations adequately reflected the concepts in the original version and if urological terms and the individual items were readily understood. Methods Residents of the target countries who spoke the native language and had LUTS were asked to evaluate a harmonized translation of the LUTS Tool, which was developed in 10 languages: Danish (Denmark), Dutch (Belgium, Netherlands), Finnish (Finland), French (Belgium, France, Luxembourg, and Switzerland), German (Germany, Switzerland), Greek (Greece), Icelandic (Iceland), Italian (Italy), Norwegian (Norway), and Spanish (Spain). After reviewing the language‐appropriate version, participants were asked to explain why any words were difficult to understand and to paraphrase each sentence during a standardized cognitive debriefing interview. Linguistic validation teams (original translators, back translator, project manager, interviewer, and survey research expert) conducted a qualitative analysis of the cognitive debriefing findings. Results The terminology and concepts in the English‐language version of the LUTS Tool were adequately captured in all language translations. The overall item comprehension rate, across languages, was 98.5%. Terms related to storage, voiding, and post‐micturition LUTS were comprehensible. Minor difficulties with comprehension were identified in 9 of 10 translations, and those changes were made to improve clarity. Conclusions Individuals with LUTS from 10 countries understood the individual items captured in translated versions of the LUTS Tool. The overall comprehension rate was high. Most changes were made to improve conceptual clarity based on country‐specific linguistic and cultural nuances. Neurourol. Urodynam. 32: 75–81, 2013.

A think tank was convened at the third ICI‐RS meeting held in the UK, June 2011, to consider the best outcome measures when assessing treatments for lower urinary tract dysfunction (LUTD). Given the vast array of measures available a focus on questionnaires was decided upon, which continued to highlight a plethora of available tools. The decision was therefore taken to approach this topic from an alternative perspective and instead ask the audience of gathered experts in this field to consider, “What we need to ask as a minimum in order to capture the most fundamental parameters when evaluating new treatments for LUTD?” Discussions highlighted the need for inclusion of a global measure in all outcome evaluations in order to increase comparability between different treatment evaluations and different populations. More specific categories of evaluation identified were: treatment satisfaction, symptom quantification, health related quality of life and adverse events. Further optional components were identified for inclusion where relevant, such as health economic, goal setting and psychosocial evaluation. A “Minimum Outcome Set for Testing (MOST)” was therefore proposed by selecting a health outcome measure from each category while not being prescriptive about specific outcome measurement selection. The ‘MOST’ toolkit is therefore proposed to promote standardized evaluation in this field and represents a useful starting point for further consideration of this concept. Neurourol. Urodynam. 31:400–403, 2012.

Aims: To evaluate the utility of the International Prostate Symptom Score (IPSS) and the LUTS Tool when assessing lower urinary tract symptoms (LUTS). Secondary objectives were to examine associations of LUTS and treatment seeking.Methods: Analyses were performed using EpiLUTS data, a population‐based, cross‐sectional, Internet survey of men and women (aged ≥40) in Sweden, UK, and US with a sample of 30,000 participants. Participants completed the IPSS and the LUTS Tool. Prevalence rates of symptoms captured by the LUTS Tool were compared using IPSS summary scores: 0, 1–7, 8–19, and ≥20. LUTS Tool subscale scores were calculated. Pearson correlations between the LUTS Tool symptoms and subscales and IPSS symptoms were performed. Logistic regressions evaluated the associations of IPSS scores and LUTS Tool subscales with treatment seeking for LUTS.Results: The IPSS did not assess some symptoms (i.e., incontinence) for which there was a high prevalence among participants. Correlations between the 7 symptoms assessed by the IPSS and LUTS Tool were moderate to high ranging between 0.37 (nocturia women) and 0.77 (weak stream men), indicating concordance. While the LUTS Tool subscales and the total IPSS score were all significantly associated with treatment seeking, the LUTS Tool OAB subscale in men and Voiding subscale in women most strongly predicted treatment seeking.Conclusion: LUTS that are excluded from the IPSS, most notably incontinence, were prevalent even among mildly symptomatic participants. Since storage symptoms appear to drive treatment seeking, identifying, and treating these symptoms is essential when caring for patients with LUTS. Neurourol. Urodynam. 31:448–454, 2012.

Study Type – Outcomes (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Short‐term (12‐week) trials have demonstrated that subjects with OAB who receive treatment with fesoterodine 4‐ and 8‐mg, either in fixed‐dose or flexible‐dose regimens, show significant improvements in measures of HRQL and other patient‐reported outcomes. The results of this long‐term, open‐label study show that treatment with fesoterodine for up to 24 months resulted in sustained improvement in measures of HRQL and severity of bladder‐related problems in subjects with OAB symptoms. Throughout the study, a high percentage of subjects reported satisfaction with fesoterodine treatment. The results were similar in men and women and across age groups (n = 182; women, n = 682; aged n = 134; 45–64 years, n = 432; 65–74 years, n = 204; ≥75 years, n = 94); most subjects (77%) who continued treatment maintained the 8‐mg dose. Among subjects in the overall population, there were significant improvements in all KHQ domains, ICIQ‐SF scores, and bladder‐related problems at open‐label baseline vs double‐blind baseline ( P < 0.05); additional significant improvements were observed at months 12 and 24 vs open‐label baseline in all outcomes ( P < 0.05) except for the KHQ General Health Perception domain. When data were stratified by gender or age, significant improvements at open‐label baseline vs double‐blind baseline were further significantly enhanced or sustained at months 12 and 24 for most KHQ domains, and for ICIQ‐SF scores and bladder‐related problems for all groups. Women had significantly greater improvements than men in the KHQ Emotion ( P = 0.0173) and Severity/Coping ( P = 0.0112) domains and ICIQ‐SF scores ( P = 0.0276) during open‐label treatment. Subjects aged P = 0.0357) and in the Sleep/Energy domain compared with all other groups (all P < 0.02). Treatment satisfaction was high (≥92%) throughout open‐label treatment regardless of gender or age. CONCLUSIONS: Long‐term fesoterodine treatment was associated with sustained improvement in measures of health‐related quality of life and bladder‐related problems and with high treatment satisfaction in subjects with overactive bladder symptoms. Effects of gender and age were minimal.