Pelvic Floor Distress Inventory-20

Women with Pelvic Floor Symptoms:(Barber et al, 2005; n = 100 women evaluated at the Pelvic Floor Disorders Clinic at the Duke University Medical Center; mean age = 56(15) years)

• MCID for the short form: 45 or more point change on summary score

Women with Pelvic Organ Prolapse: (Kaplan et al, 2012; n = 248 women, 103 prolapse participants and 145 non-prolapse participants; mean age for prolapse participants = 59.9 (11.4) years; mean age for non-prolapse participants = 53.4 (9.5) years)

• Cut-Off Score of <135.4 has a sensitivity of 62.7% and specificity of 51.0%

Pelvic Floor Distress: (Barber et al, 2005; n = 45 women with pelvic floor disorders scheduled to undergo surgery to evaluate the correlation between short and long forms in a second independent population; the short forms were re-administered 3 to 6 months postoperatively to assess the responsiveness of the instruments; mean age = 59(12) years)

Baseline Characteristics of the Two Study Populations

 

 

 

 

Group 1 (n = 100)

Group 2 (n = 45)

P value

Age*

56 (15)

59 (12)

.23

Caucasian (%)

83%

95%

.30

BMI*

29 (7)

27 (6)

.10

Parity**

2 (0-5)

2 (1-7)

.50

Insurance Status (%)

 

 

.001

Private HMO

44

71

 

Medicaid/Medicare

56

29

 

Previous Hysterectomy (%)

68

51

.08

Previous Pelvic Reconstructive Surgery (%)

32

20

.19

Pelvic Floor Disorders (%)

 

 

 

Urodynamic Stress Incontinence

30

40

.32

Detrusor Overactivity

16

16

.95

Voiding Dysfunction

24

40

.75

Pelvic Organ Prolapse (Stage 3 or 4)

27

58

.0007

Fecal Incontinence

13

11

.96

Defecatory Dysfunction

28

40

.21

Rectal Prolapse

4

6

.96

Number of Pelvic Floor Disorders Per Patient (%)

 

 

<.0001

0***

24

0

 

1

44

34

 

2

26

40

 

3+

6

26

 

*Mean +/- SD, **Median (range), *** In group 1, 24% of patients did not meet the study definition of any pelvic floor diagnoses listed above but all had some symptom of pelvic floor dysfunction.  In contrast, all patients in group 2 met the criteria for one or more pelvic floor disorders

 

 

 

 

Surgical Procedures Performed on Group 2

 

Procedure

Percent

Hysterectomy

38

Trachelectomy

4

Anterior Colporrhaphy

60

Posterior Colporrhaphy

67

Paravaginal Repair (Abdominal or Laparoscopic)

22

Vaginal Vault Suspension

55

Sacral Colpopexy (Abdominal or Laparoscopic)

13

Sling Procedure (Including TVT)

40

Retropubic Urethropexy (Burch)

20

Urethrolysis

2

Anal Sphincteroplasty

4

Rectopexy

2

TVT = Tension-free Vaginal Tape

 

 

Women with Pelvic Floor Symptoms:(Barber et al, 2001)

• 83% white
• Median parity was 2(0-5)
• Mean weight = 78(21) kg

Pelvic Floor Distress: (Barber et al, 2005)

• PFDI-20:  Excellent test-retest reliability (ICC = 0.93) 
• UDI-6:  Excellent test-retest reliability (ICC = 0.82) 
• POPDI-6:  Excellent test-retest reliability (ICC= 0.91) 
• CRADI-8:  Excellent test-retest reliability (ICC = 0.84)

 

Women with Pelvic Floor Symptoms:(Barber et al, 2001)

• Excellent test-retest reliability (ICC = 0.87)

 

Women with Pelvic Floor Disorders: (Toprak et al, 2012; n = 128 women with pelvic floor disorders including pelvic organ prolapse, urinary incontinence, and anal incontinence; mean age = 51.91 (9.82) years; Turkish sample)

• Excellent test-retest reliability (ICC = 0.98)

Pelvic Floor Distress: (Barber et al, 2005) 

• PFDI-20:  Excellent (r =.93) 
• UDI-6:  Excellent (r =.86) 
• POPDI-6:  Excellent (r =.92) 
• CRADI-8:  Excellent (r =.93)

Pelvic Floor Distress: (Barber et al, 2005) 

• Excellent internal consistency (Chronbach alpha = 0.88)

 

Women with Pelvic Floor Symptoms:(Barber et al, 2001)

• Excellent internal consistency (Chronbach alpha = 0.88)

 

Women with Pelvic Floor Disorders: (Toprak et al, 2012)

• Adequate internal consistency (Chronbach's alpha = 0.79)

 

Pelvic Floor Disorders: (Barber et al, 2011; n = 1006 participants in 4 prospective studies of pelvic floor disorders, including pelvic organ prolapse, stress urinary incontinence, and fecal incontinence at baseline, 3-months, and 12-months; mean age = 58.4 (14.7) years)

Subscale to Total Measure Correlations

 

Subscale

PFDI -20

UDI

0.88 (Excellent)

POPDI

0.90 (Excellent)

CRADI

0.93 (Excellent)

 

Women with Pelvic Organ Prolapse: (Kaplan et al, 2012)

Internal Consistency of PFDI-20

 

 

Chronbach's Alpha

PFDI 20

0.908 (Excellent)

Subscale

 

UDI

0.965 (Excellent)

POPDI

0.952 (Excellent)

CRADI

0.964 (Excellent)

Pelvic Floor Distress: (Barber et al, 2005)

• The scales of the PFDI and PFIQ demonstrate significant association with appropriate measures of symptom severity and pelvic floor diagnoses, thereby demonstrating construct validity

 

Women with Pelvic Floor Disorders: (Toprak et al, 2012)

• Construct validity demonstrated that the PFDI-20 and each subscale displayed significant correlation with other clinical methods used (p<0.05)

 

Women with Pelvic Organ Prolapse: (Kaplan et al, 2012)

• Adequate correlation between PFDI-20 and POP-Q (r  = 0.387)
• Poor correlation between UDI (PFDI-20 subscale) and POP-Q (r  = 0.134)
• Excellent  correlation between POPDI (PFDI-20 subscale) and POP-Q (r  = 0.608)
• Poor  correlation between CRADI (PFDI-20 subscale) and POP-Q (r  = 0.043)

• After the item content for the short forms was determined, a multidisciplinary expert panel that included urogynecologists, female urologists, a colorectal surgeon, a pelvic floor physical therapist, and a psychometrician reassessed content validity (Barber et al, 2005).

• After the item content for the short forms was determined, a multidisciplinary expert panel that included urogynecologists, female urologists, a colorectal surgeon, a pelvic floor physical therapist, and a psychometrician reassessed face validity (Barber et al, 2005).

Pelvic Floor Distress: (Barber et al, 2005) 

• Small change for sensitivity (ES = 1.48)

• Standardized response mean (SRM = 1.09)

 

Women with Pelvic Organ Prolapse: (Kaplan et al, 2012)

Responsiveness of PFDI-20 and PDFI-20 Subscales

 

 

 

Effect Size (ES)

SRM

PFDI-20

1.38 (Large change)

1.42

UDI

0.88 (Large change)

0.91

POPDI

1.48 (Large change)

1.39

CRADI

0.61 (Moderate change)

0.54