Electronic bladder diaries of differing duration versus a paper diary for data collection in overactive bladder

AIMS: This observational study compared data values, reliability, consistency and compliance collected by electronic and paper diaries of differing durations.

METHODS: Subjects ≥18 years with overactive bladder (OAB) on stable antimuscarinic treatment for ≥12 weeks were assigned to one of five, 15-week diary schedules in this randomized, parallel-group observational study. Sample size was sufficient to assess reliability and consistency of diary data with adequate precision. Reliability was assessed via intraclass correlation coefficients, variability with ANCOVAs, and consistency using Cronbach's alpha.

RESULTS: Demographic characteristics of randomized subjects were representative of OAB trial populations. For mean volume voided, reliability was comparable across diary groups. For incontinence, reliability improved with increasing diary duration. For micturition frequency, electronic 7-day diary results had highest reliability and lowest variability. Lowest overall reliability was observed in the 3-day paper diary. Consistency was highest in the electronic continuous groups; Cont A (daily measurements throughout the study period [fully Continuous]) and Cont B (daily measurements for some but not all endpoints of interest [Partially Continuous]). Compliance was generally high; across groups ≥90% of diaries had at least one entry per day. There was no significant change in average micturition frequency with diary duration, suggesting no diary fatigue. One-third of subjects in the electronic Cont B group also reported micturitions as incontinence when they only needed to report incontinence; they also reported lowest satisfaction with the study. The electronic 7-day and electronic Cont A schedules (who reported incontinence and micturitions throughout the study) had lowest residual errors.

CONCLUSIONS: For future OAB trials, 7-day or continuous electronic diaries may improve accuracy and reliability of micturition and incontinence frequency data compared with shorter collection periods and paper diaries. 

Neurourol Urodyn. 2015 Jul 14. doi: 10.1002/nau.22800. [Epub ahead of print]

Abrams P1, Paty J2, Martina R3, Newgreen DT4, van Maanen R4, Paireddy A4, Kuipers-deGroot T4, Ridder A4.

1 Southmead Hospital, Bristol Urological Institute, Southmead Road, Bristol, United Kingdom.
2 Quintiles, Skyline Drive, Hawthorne, New York.
3 University of Leicester, University Road, Leicester, United Kingdom, (formerly of Astellas Pharma Europe BV, Netherlands).
4 Astellas Pharma BV, Leiden, Netherlands.