Assessing professional equipoise and views about a future clinical trial of invasive urodynamics prior to surgery for stress urinary incontinence in women: A survey within a mixed methods feasibility study

作者：Hilton Paul^*; Bryant Andy; Howel Denise; McColl Elaine; Buckley Brian S; Lucas Malcolm; Tincello Douglas G; Armstrong Natalie

来源：Neurourology and Urodynamics, 2012, 31(8): 1223-1230.

DOI：10.1002/nau.22328

• healthcare surveys
• interview studies
• randomized controlled trial
• urodynamics

Aims To determine surgeons%26apos; views on invasive urodynamic testing (IUT) prior to surgery for stress (SUI) or stress predominant mixed urinary incontinence (MUI). Methods Members of British Society of Urogynaecology (BSUG) and British Association of Urological Surgeons Section of Female, Neurological and Urodynamic Urology (BAUS-SFNUU) were sent an email invitation to complete an online SurveyMonkey (R) questionnaire regarding their current use of IUT prior to surgical treatment of SUI, their view about the necessity for IUT in various clinical scenarios, and their willingness to randomize patients into a future trial of IUT. A purposive sample of respondents was invited for telephone interview to explore further how they use IUT to inform clinical decisions, and to contextualize questionnaire responses. Results There were 176/517 (34%) responses, 106/332 (32%) from gynecologists/urogynecologists and 67/185 (36%) from urologists; all respondents had access to IUT, and 89% currently arrange IUT for most women with SUI or stress predominant MUI. For a variety of scenarios with increasingly complex symptoms the level of individual equipoise (undecided about IUT) was very low (16%) and community equipoise was, at best, 66:34 (IUT essential vs. unnecessary) even for the simplest scenario. Nevertheless, 70% rated the research question underlying the proposed studies very important or extremely important; 60% recorded a willingness to randomize score =8/10. Conclusions Most urogynecologists and urologists consider IUT essential before surgery in SUI with or without other symptoms. Most however recognize the need for further research, and indicated a willingness to recruit into multicenter trials addressing this question. Neurourol. Urodynam. 31:??, 2012.

• 出版日期2012-11