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Record W2026706274 · doi:10.1001/jama.299.12.1446

What Type of Urinary Incontinence Does This Woman Have?

2008· review· en· W2026706274 on OpenAlexaff
Jayna Holroyd‐Leduc

Bibliographic record

VenueJAMA · 2008
Typereview
Languageen
FieldMedicine
TopicPelvic floor disorders treatments
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsMedicineUrinary incontinenceContext (archaeology)Physical examinationConfidence intervalCohort studyCohortData extractionMEDLINEInternal medicineSurgery

Abstract

fetched live from OpenAlex

CONTEXT: Urinary incontinence is a prevalent condition and treatment options can depend on what type of incontinence is present. OBJECTIVE: To systematically review the evidence about the most accurate way to determine the type of urinary incontinence during an office assessment. DATA SOURCES: A search of MEDLINE using Ovid (1966-July 2007) and EMBASE (1980-July 2007), and the bibliographies of retrieved articles to identify relevant studies. Search terms included urinary incontinence, diagnostic tests, medical history taking, physical examination, cough stress test, and urodynamics. STUDY SELECTION: English-language articles were identified that addressed the office diagnosis of urinary incontinence in adults, in which data was not limited to case reports. Cohort studies of patients undergoing history, physical examination, and/or office procedures (excluding urodynamics) for diagnosing the type of urinary incontinence were included. Case-control studies were considered when there was insufficient data available from cohort studies. The accepted reference standard for categorization of incontinence type was diagnosis confirmed by an expert, urodynamic studies, or both. DATA EXTRACTION: Two investigators independently appraised study quality and extracted relevant data. Minimum inclusion criteria were completion of an appropriate reference standard in all patients and the ability to extract relevant data. DATA SYNTHESIS: Forty articles were identified for inclusion. A random-effects model was used for quantitative synthesis. Minimal data was available for men. In women, simple questions modestly helped diagnose stress urinary incontinence (summary positive likelihood ratio [LR], 2.2; 95% confidence interval [CI], 1.6-3.2; summary negative LR, 0.39; 95% CI, 0.25-0.61) but are more helpful in diagnosing urge urinary incontinence (summary positive LR, 4.2; 95% CI, 2.3-7.6; summary negative LR, 0.48; 95% CI, 0.36-0.62). A positive bladder stress test may help diagnose stress urinary incontinence (summary LR, 3.1; 95% CI, 1.7-5.5); however, a negative test is not as useful (summary LR, 0.36; 95% CI, 0.21-0.60). A systematic assessment combining the history, physical examination, and results of bedside tests to establish a clinical diagnosis appears to be of modest value in diagnosing stress urinary incontinence (summary positive LR, 3.7; 95% CI, 2.6-5.2; summary negative LR, 0.20; 95% CI, 0.08-0.51). The systematic assessment is less helpful in diagnosing urge urinary incontinence (summary positive LR, 2.2; 95% CI, 0.55-8.7; summary negative LR, 0.63; 95% CI, 0.34-1.17). CONCLUSIONS: The most helpful component for diagnosing urge urinary incontinence is a history of urine loss associated with urgency. A bladder stress test may be helpful for diagnosing stress urinary incontinence.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.973
Threshold uncertainty score0.975

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.039
GPT teacher head0.336
Teacher spread0.297 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations123
Published2008
Admission routes1
Has abstractyes

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