There has been a lack of uniformity in the literature in terms of how these questionnaires are scored. We score the questionnaires as described by the authors with assigned scores of 0 to 3 (not at all - 0, slightly - 1, moderately - 2, greatly - 3). The overall score for the IIQ and UDI is calculated by taking the average of all questions and multiplying by 33.3, for a total score of between 0 to 100.
We have found it very important to look at each individual question/domain addressed by the questionnaire and assess the impact score assigned by the patient for each domain. This is particularly useful in outcomes assessment.
We score the IIIQ differently, as: not at all - 0, rarely - 1, frequently - 2, all of the time - 3. Because this questionnaire includes questions regarding work (#7) and intimacy (#5), a global score will be dependent on a patient's own individual situation. A global score is calculated based on the following formula: Total points divided by total possible points (deleting "not applicable" questions) and multiplying by 100.
The score assigned to the individual activity that is impacted by the patient's incontinence is given particular importance. This will provide a greater value to that individual activity because other activities may not be as impacted and the overall assessment of outcome will be minimized. It also allows the patient to focus on that activity when assessing results of therapy.
We assess the UDI-6 with a global score as well as an assessment of its individual domains, as with the IIQ.
It is important to make sure that patients answer all of the included questions in the questionnaires, especially if global scores will be used for evaluation of impact/distress. When reviewing a questionnaire for completeness, we find that reviewing the unanswered questions with a patient to be particularly useful because they typically represent areas of variable impact, compared with the black and white nature of the "all of the time" or "never" responses. It is those unclear areas where patients may find less of a satisfactory result from therapy, as a result of other factors being involved, or greater clarity once a more significant factor has been corrected. Thus, those areas should not be ignored.
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Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.