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

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Abstract

Introduction and hypothesis

St Mark’s incontinence score (SMIS) was originally designed and validated for use in an interview setting (iSMIS), and there is conflicting evidence for the validity of the self-administered SMIS (sSMIS). Our objective was to compare self-administered and interview-based reports of anal incontinence (AI) symptoms.

Methods

A total of 147 women reported symptoms of AI on a sSMIS before inclusion in a clinical study investigating the effect of conservative treatment for AI 1 year after delivery. After clinical investigations, an iSMIS was completed by one of two consultant surgeons blinded to the sSMIS results. The correlation and agreement among the individual items of the iSMIS and the sSMIS were assessed using Spearman’s rho and weighted kappa statistics, respectively.

Results

The mean iSMIS and sSMIS reported was 4.0 (SD: 3.6) and 4.3 (SD: 4.0), respectively. Spearman’s rho showed a strong relationship between the two total SMIS scores (r = 0.769, n = 147, p < 0.001), and explained variance was 59% (r2=0.591). Except for the individual item about gas incontinence, women reported more frequent AI symptoms on the sSMIS than on the iSMIS. The assessment of consistency among the individual items of the iSMIS and sSMIS showed substantial agreement (κ ≥ 0.60) for all items except for fair agreement for the item about formed stool incontinence (κ = 0.22), and moderate for the item about any change in lifestyle (κ = 0.5).

Conclusions

The level of consistency between the two methods of reporting anal incontinence symptoms suggests that the St Mark’s score may be used as both an interview-based and a self-administered incontinence score.

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Acknowledgements

The authors thank Clara Karoliussen for assembling the cohort, collecting background data, and contributing to the clinical investigations at St Olavs Hospital; Negin Sadati for collecting background data; and Leiv Sandvik for invaluable statistical advice throughout the study.

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Authors and Affiliations

  1. Department of Physiotherapy, Østfold Hospital Trust, Sarpsborg, Norway

    Hege Hølmo Johannessen

  2. Department of Research, Østfold Hospital Trust, P.O. Box 300, 1714, Grålum, Norway

    Hege Hølmo Johannessen

  3. Department of Gastroenterological Surgery, University Hospital of North Norway, Tromsø, Norway

    Stig Norderval

  4. Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway

    Stig Norderval

  5. Department of Surgery, Østfold Hospital Trust, Sarpsborg, Norway

    Arvid Stordahl

  6. Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway

    Ragnhild Sørum Falk

  7. Department of Surgery, St Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway

    Arne Wibe

  8. Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Arne Wibe

Authors
  1. Hege Hølmo Johannessen
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  2. Stig Norderval
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  3. Arvid Stordahl
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  4. Ragnhild Sørum Falk
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  5. Arne Wibe
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Corresponding author

Correspondence to Hege Hølmo Johannessen.

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Funding

This study was funded by the Norwegian Women’s Public Health Association/the Norwegian Extra Foundation for Health and Rehabilitation through EXTRA funds, Østfold Hospital Trust, St Olavs Hospital, Trondheim University Hospital, the Norwegian University of Science and Technology, and the Central Norway Regional Health Authority.

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Johannessen, H.H., Norderval, S., Stordahl, A. et al. Interview-based versus self-reported anal incontinence using St Mark’s incontinence score. Int Urogynecol J 29, 667–671 (2018). https://doi.org/10.1007/s00192-017-3363-y

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  • DOI: https://doi.org/10.1007/s00192-017-3363-y

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