Jeanette S. Brown, MD; Eric Vittinghoff, PhD; Leslee L. Subak, MD
Potential Financial Conflicts of Interest: Dr. Brown has received research support through contracts with University of California, San Francisco, from the National Institute of Diabetes and Digestive and Kidney Diseases and Pfizer Inc.
Brown J., Vittinghoff E., Subak L.; Questionnaire to Distinguish between Stress and Urge Urinary Incontinence. Ann Intern Med. 2006;145:935-936. doi: 10.7326/0003-4819-145-12-200612190-00018
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Published: Ann Intern Med. 2006;145(12):935-936.
We appreciate the opportunity to respond to the comments by Drs. Kalantri, Moons, and Rich. We agree that the accuracy of the 3IQ is modest. However, Dr. Kalantri considerably overstates the proportion of women with urge incontinence (43%, which is not two thirds) and stress incontinence (23%, which is not three fifths) who are misclassified by the 3IQ (see our Table 3). As we stated in our conclusions, the modest accuracy of the 3IQ is acceptable given that the risk for misclassification and inappropriate treatment by primary care is low.
In response to Dr. Moons, the 3IQ is meant to be a diagnostic test applied in women with urinary incontinence and is not meant to be a screening tool for case finding. We included the first question of the questionnaire because some women may have incontinence that occurs less than monthly, and current incontinence in the last 3 months seemed a reasonable threshold for continuing onto the next 2 questions to determine the type of incontinence.
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