Validity of a scored urological history in detecting detrusor instability in female urinary incontinence

Background. Kauppila and co-workers published in 1982 a detrusor instability score (DIS) for women with urinary incontinence. The aim of this study was to determine the validity of the DIS in an outpatient clinic for urogynecology.Methods. The DIS questionnaire was incorporated as part of an independent history at the first consultation. The DIS was compared with clinical diagnosis in 250 patients consecutively referred for evaluation. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of the DIS in diagnosing genuine stress incontinence (GSI) were calculated using the gynecologist's clinical diagnosis based on urodynamic findings as the gold standard. An ROC-curve was constructed for determining the optimum cut-off point for the DIS for women with GSI.Results. A cut-off point at 7 for the DIS, yielded sensitivity=0.77, specificity=0.52, PPV=0.74, NPV=0.52 and an overall accuracy=0.68. Optimum cut-off point for GSI according to the ROC-curve was...