Measures of quality of life of people with neurogenic overactive bladder: A systematic review of psychometric properties.

OBJECTIVE: To identify psychometrically robust quality-of-life (QOL) outcome measures for evaluating QOL among people with neurogenic overactive bladder (OAB). STUDY DESIGN: Electronic databases (CINAHL, EMBASE, MEDLINE, Scopus and Web of Science) were searched from inception to January 2023. Two independent reviewers participated in study screening, data extraction and quality appraisal. Studies were included if they validated at least one psychometric property of a QOL outcome measure among adults (age ≥ 18 years) with neurogenic OAB. The COnsensus-based Standards for selecting health status Measurement INstruments (COSMIN) checklist and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool were used to evaluate the methodological quality and quality of evidence, respectively, for each included study. RESULTS: Database searches identified 47 studies that tested the psychometric properties of 15 QOL measures in a total of 19,994 participants with stroke, spinal cord injury, Parkinson's disease or multiple sclerosis. The Incontinence Quality of Life Questionnaire (I-QOL), King's Health Questionnaire, Overactive Bladder Questionnaire and Qualiveen were the best validated measures, with strong reliability, validity and responsiveness. I-QOL was the most robust, cross-culturally administered and psychometrically strong measure. The COSMIN checklist indicated sufficient methodological quality for 70% of measures, and the modified GRADE tool indicated quality of evidence ranging from moderate (67%) to high (33%). CONCLUSIONS: This review identified the I-QOL as a culturally diverse measure with robust reliability, validity and responsiveness for assessing QOL among people with neurogenic OAB. These findings are supported by studies with good methodological quality (COSMIN) and high-quality evidence (GRADE).

Quantitative Anatomical Differences in the Shoulder.

This study explored the radiographic and anatomical differences in normal shoulders between men and women, as well as factors such as race, height, weight, and age. A total of 205 patients with documented normal anatomical radiographs comprised the study population. Five fellowship-trained orthopedic surgeon reviewers measured head diameter, humeral head size, head to tuberosity distance, greater tuberosity width, neck-shaft angle, surface-arc angle, glenoid neck length, and distance from the lateral acromion process to the greater tuberosity on anteroposterior radiographs with the shoulder in external rotation. After the reviewers identified and marked defined anatomical landmarks, a comprehensive automated calculator was used to compute all parameters. Between men and women, head diameter (P<.001), humeral head size (P<.001), greater tuberosity width (P<.001), distance from the lateral acromion process to the greater tuberosity (P<.001), and glenoid neck length (P<.001) were significantly different, whereas race was not significantly different for any anatomical parameter. Using Spearman's rho, there was a strong correlation between head diameter/humeral head height and height (rs=0.77/rs=0.68), weight (rs =0.62), and greater tuberosity width (rs=0.66/rs= 0.61); there also was a strong negative correlation between head to tuberosity distance and neck-shaft angle (rs=-0.80). This study demonstrated precisely defined proximal humeral anatomical relationships and sizes using an advanced standardized imaging software program. With these data, orthopedic surgeons and implant designers can better understand the anatomy and glenohumeral relationships to re-create when performing total shoulder arthroplasty. [Orthopedics. 2017; 40(3):155-160.].