Changes in Self-Assessment of Continence Status Between Telephone Survey and Subsequent Clinical Visit

Aims: To explore variance in reporting continence information obtained by telephone survey with face-to-face clinician interview in a clinical setting. Methods: As part of a cross-sectional, epidemiologic study of incontinence prevalence among Black and White women aged 35-64 years, randomly selected households were contacted from geographic areas of known racial composition. Of 2,814 women who completed a 20-min, 137-item telephone interview, 1,702 were invited for future components of the study. A subset of these women was recruited for a clinical evaluation that was conducted within a mean of 82 days (SD 38 days) following the interviews. Prior to urodynamics testing, a clinician interview was conducted inquiring about continence status. The criterion for incontinence for both the telephone interview and the clinician interview was constant: 12 or more episodes of incontinence per year. Women whose subjective reports of continence information differed between telephone and clinician interviews were designated as "switchers." Results: Of the 394 women (222 Black and 172 White) who completed the clinical portion, 24.6% (n = 97) were switchers. Switchers were four times more likely to change from continent to incontinent (80.4%, N = 78) than from incontinent to continent (19.4%, N = 19; P=0.000) and nearly three times more likely to be Black (69%, N = 67) than White (31%, N = 30; P=0.001). Telephone qualitative interviews were completed with 72 of the switchers. The primary reason for switching was changes in women's life circumstances such as variation in seasons, activities of daily living, and health status followed by increased awareness of leakage secondary to the phone interview. Conclusion: One-time subjective telephone interviews assessing incontinence symptoms may underestimate the prevalence of incontinence especially among Black women. Neurourol. Urodynam. 29:734-740, 2010. (C) 2010 Wiley-Liss, Inc.