The minimum important differences for the urinary scales of the pelvic floor distress inventory and pelvic floor impact questionnaire

Barber, Matthew D.; Spino, Cathie; Janz, Nancy K.; Brubaker, Linda; Nygaard, Ingrid; Nager, Charles W.; Wheeler, Thomas L.

doi:10.1016/j.ajog.2009.02.007

Cited by 155Pelvic floor disorders treatmentsUrinary Bladder and Prostate ResearchHealth Systems, Economic Evaluations, Quality of Life

The minimum important differences for the urinary scales of the pelvic floor distress inventory and pelvic floor impact questionnaire

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Barber, Matthew D., Spino, Cathie, Janz, Nancy K., Brubaker, Linda, Nygaard, Ingrid, Nager, Charles W., Wheeler, Thomas L.·2009·American Journal of Obstetrics and Gynecology

DOI 10.1016/j.ajog.2009.02.007PMC PMC2680021

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Abstract

Objective We sought to estimate the minimum important difference (MID) for the Urinary Distress Inventory (UDI), UDI-stress subscale of the Pelvic Floor Distress Inventory, and Urinary Impact Questionnaire (UIQ) of the Pelvic Floor Impact Questionnaire.Study design We calculated MID using anchor- and distribution-based approaches from a randomized trial for nonsurgical stress incontinence treatment. Anchors included a global impression of change, incontinence episodes from a urinary diary, and the Incontinence Severity Index. Effect size and standard error of measurement were the distribution methods used.Results Anchor-based MIDs ranged from -22.4 to -6.4 points for the UDI, -16.5 to -4.6 points for the UDI-stress, and -17.0 to -6.5 points for the UIQ. These data were supported by 2 distribution-based estimates.Conclusion Reasonable estimates of MID are 11, 8, and 16 points for the UDI, UDI-stress subscale, and UIQ, respectively. Statistically significant improvements that meet these thresholds should be considered clinically important.

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The minimal clinically important change was -45 for the PFDI-20 and -15 for the POPDI-6.
“Differences in the symptom scores of the two groups between baseline and 1 year postoperatively were compared (a score of −45 was the minimal clinically important change [MCIC] for the PFDI‐20) [17]. We examined only one domain, Pelvic Organ Prolapse Distress Inventory‐6 (POPDI‐6), of the PFDI‐20 questionnaire (a score of −15 was the MCIC).”
From Composite Failure Associated With Sacrohysteropexy and Sacrocolpopexy With Supracervical Hysterectomy for Advanced Pelvic Organ Prolapse (2025) · cites this paper as [17]
The Discussion (page unavailable) recommends minimum important differences of 11, 8, and 16 points for the urinary scales UDI, UDI-stress, and UIQ—not −45 for PFDI-20. It explicitly says the study determined values only for urinary scales and that prolapse-scale values require further study, contrary to attributing a −15 POPDI-6 threshold to it. (LLM, conf=0.88)
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The statistically significant difference in the urinary subscale of PFIQ favoring uterine-preserving surgery was smaller than published minimum important differences and thus unlikely to be clinically meaningful.
“Although we observed statistically significant group differences one urinary symptom subscale which favored UP surgery, the effect size was smaller than published minimum important differences and thus unlikely to be clinically meaningful.64”
From Hysterectomy versus uterine preservation for pelvic organ prolapse surgery: a prospective cohort study (2025) · cites this paper as [64]

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Authors: Barber, M. D., Spino, C., Janz, N. K., Brubaker, L., Nygaard, I., Nager, C. W., & Wheeler, T. L.
Affiliations: Cleveland Clinic (US)
University of Michigan (US)
Loyola University Chicago (US)
University of Utah (US)
University of California San Diego (US)
University of Alabama at Birmingham (US)
ORCID: Spino, Cathie
Brubaker, Linda
Nygaard, Ingrid
Nager, Charles W.
Venue: American Journal of Obstetrics and Gynecology
Publisher: Elsevier BV
Published: 2009-05
Volume: 200
Issue: 5
Pages: 580.e1-580.e7
ISSN: 0002-9378 (ISSN-L)
DOI: 10.1016/j.ajog.2009.02.007
PMC: PMC2680021
OpenAlex: W2055558574
Cited by: 155
References: 28
Citations by year: 2026: 9 · 2025: 10 · 2024: 15 · 2023: 12 · 2022: 13 · 2021: 14 · 2020: 9 · 2019: 10 · 2018: 7 · 2017: 3 · 2016: 12 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 10
FWCI: 5.44
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: American Journal of Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Eunice Kennedy Shriver National Institute of Child Health and Human Development (U10 HD 54215, U10 HD54241, U10 HD41267, U10 HD41261, U01-HD41249, U10 HD 54214, U10HD041261, U10HD054136, U10HD054214, U10 HD 41250, U01HD041249, U10HD054215, U10 HD 54136, U10HD041267, U10HD054241, U10HD041250, UG1HD041267)
Topics: Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords: minimal clinically important difference, stress urinary incontinence, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, patient-reported outcome measures, anchor-based estimation, distribution-based estimation, standard error of measurement
MeSH terms: Adult, Affective Symptoms, Female, Humans, Middle Aged, Psychometrics, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Urinary Incontinence, Stress, Pelvic Floor

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The minimum important differences for the urinary scales of the pelvic floor distress inventory and pelvic floor impact questionnaire

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