Systematic review of cure rates in incontinence – role of clinical experts

Article type
Authors
Riemsma R1, Deshpande S1, Misso K1, Hutt E2, Huige N3, Kleijnen J1
1Kleijnen Systematic Reviews Ltd., York
2Medica Market Access Ltd., Tonbridge
3SCA, Gothenburg
Abstract
Background: We performed a systematic review of cure and success rates of treating incontinence in people with urinary or faecal incontinence.

Objectives: We were interested in cure and success rates of interventions and subsequent dependence on containment products, not in the relative effectiveness of interventions. Therefore, we used cure and success rates from individual study arms. We planned to calculate average cure and success rates.

Methods and Results: For comparability of cure rates across studies it was important that populations, outcomes and follow-up durations were similar. Therefore we reported cure rates by subgroup (people with stress urinary incontinence (SUI), urgency urinary incontinence (UUI) and mixed urinary incontinence (MUI); faecal incontinence (FI); people with disabilities or neurological diseases; and, elderly or cognitively impaired). We focused on ‘cure’ (no leakage), as this was the most unambiguous outcome. However, for faecal incontinence ‘cure’ is often not reported; therefore, success rates were collected together with a full description of the outcome reported. Only when outcome definitions were similar enough was combining results contemplated. Finally, outcomes were reported with follow-up ranging from 12 weeks to 10 years. Therefore, results were grouped by follow-up period (>12 weeks to