The "Aberdeen Home Continence Stress Test": A Novel Objective Assessment Tool for Female Stress Urinary Incontinence - Beyond the Abstract

The Aberdeen Home Continence Stress Test (HCST) is a novel patient-reported objective assessment tool invented by Professor Abdel-Fattah. Our team validated the test in the current study by evaluating its performance against the objective standard 24-hour pad test and the patient reported outcomes on the Patient Global Impression of Improvement (PGI-I).

The HCST is a standardized test in which participants cough loudly (three sets – each of three coughs) over a provided tissue paper and undress from the waist down in the privacy of their own homes. Each participant is asked to stand shoulder-width apart and drink until the sensation of bladder fullness. They report on the leakage appearing on the tissue paper, was there leakage? (yes or no), and secondly how much leakage was there? (none, small, moderate, or large).

The data used to analyze the HCST came from the SIMS randomized trial that provided 1063 HCST responses from 433 women from different time points.

The responders to the HCST showed a good understanding of the two questions of the HCST with minimum conflicting values across the two follow-up leakage questions.

The Cronbach’s alpha analysis revealed strong consistency between the two sets of HCST results repeated 24 hours apart (>0.7).
The comparison of diagnostic accuracy between the HCST to the 24-hour pad test (for positive/negative values), had recurring high levels of sensitivity, specificity, and NPV to show diagnostic accuracy.

When the leakage amount on the HCST saw a significant improvement (an improvement ≥ 2 groups, for example, large to small amount of leakage), it was associated with patient reported success on the PGI-I. This showed the HCST was able to detect when incontinence clinically improved.

Now that the HCST has been shown to be a valuable tool in surgical trials, the following steps will be to create prediction models using the HCST and validated questionnaires to further research how the HCST can diagnose women with SUI and predict the results of Urodynamics assessment.

Written by: Catriona Young, David Cooper, Alyaa Mostafa, Mohamed Abdel-Fattah

The Aberdeen Centre for Women's Health Research, University of Aberdeen, Foresterhill, Aberdeen, UK., Health Services Research Unit, University of Aberdeen, Aberdeen, UK., The Aberdeen Centre for Women's Health Research, University of Aberdeen, Foresterhill, Aberdeen, UK.

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