Evidence map›Paper›PMID 26350343›Full record

Trial reportTrials2015

A mixed methods study to assess the feasibility of a randomised controlled trial of invasive urodynamic testing versus clinical assessment and non-invasive tests prior to surgery for stress urinary incontinence in women: the INVESTIGATE-I study.

Paul Hilton, Natalie Armstrong, Catherine Brennand, Denise Howel, Jing Shen, Andrew Bryant, Douglas G Tincello, Malcolm G Lucas, Brian S Buckley, Christopher R Chapple and 4 more

Open access · goldAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 2 countries.

Paul HiltonNewcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. paul.hilton@ncl.ac.uk.
Natalie ArmstrongDepartment of Health Sciences, University of Leicester, Leicester, UK. na144@le.ac.uk.
Catherine BrennandNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK. cath.brennand@newcastle.ac.uk.
Denise HowelInstitute of Health & Society, Newcastle University, Newcastle upon Tyne, UK. denise.howel@newcastle.ac.uk.
Jing ShenInstitute of Health & Society, Newcastle University, Newcastle upon Tyne, UK. jing.shen@newcastle.ac.uk.
Andrew BryantInstitute of Health & Society, Newcastle University, Newcastle upon Tyne, UK. andy.bryant@ncl.ac.uk.
Douglas G TincelloDepartment of Health Sciences, University of Leicester, Leicester, UK. dgt4@leicester.ac.uk.
Malcolm G LucasDepartment of Urology, Morriston Hospital, Swansea, UK. malcolm.lucas@wales.nhs.uk.
Brian S BuckleySchool of Medicine, National University of Ireland, Galway, Ireland. briansbuckley@gmail.com.
Christopher R ChappleDepartment of Urology, The Royal Hallamshire Hospital, Sheffield, UK. c.r.chapple@sheffield.ac.uk.
Tara HomerInstitute of Health & Society, Newcastle University, Newcastle upon Tyne, UK. tara.homer@newcastle.ac.uk.
Luke ValeInstitute of Health & Society, Newcastle University, Newcastle upon Tyne, UK. luke.vale@ncl.ac.uk.
Elaine McCollNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK. elaine.mccoll@newcastle.ac.uk.
INVESTIGATE Studies Group
Newcastle University · GBUniversity of Leicester · GBNational University of Ireland · IENewcastle College · GBOllscoil na Gaillimhe – University of Galway · IERoyal Hallamshire Hospital · GBRoyal Victoria Infirmary · GB

Funding

Department of Health 09/22/136Medical Research Council MR/K02325X/1
6 · The paper itself

Abstract

backgroundThe position of invasive urodynamic testing (IUT) in diagnostic pathways for urinary incontinence is unclear, and systematic reviews have called for further trials evaluating clinical utility. The objective of this study was to inform the decision whether to proceed to a definitive randomised trial of IUT compared to clinical assessment with non-invasive tests, prior to surgery in women with stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI).

methodsA mixed methods study comprising a pragmatic multicentre randomised pilot trial, a qualitative face-to face interview study with patients eligible for the trial, an exploratory economic evaluation including value of information study, a survey of clinicians' views about IUT, and qualitative telephone interviews with purposively sampled survey respondents. Only the first and second of these elements are reported here. Trial participants were randomised to either clinical assessment with non-invasive tests (control arm) or clinical assessment with non-invasive tests plus IUT (intervention arm). The main outcome measures of these feasibility studies were confirmation that units can identify and recruit eligible women, acceptability of investigation strategies and data collection tools, and acquisition of outcome data to determine the sample size for a definitive trial. The primary outcome proposed for a definitive trial was ICIQ-FLUTS (total score) 6 months after surgery or the start of nonsurgical treatment.

resultsOf 284 eligible women, 222 (78%) were recruited, 165/219 (75%) returned questionnaires at baseline, and 125/200 returned them (63%) at follow-up. Most women underwent surgery; management plans were changed in 19 (19%) participants following IUT. Participants interviewed were positive about the trial and the associated documentation.

conclusionsAll elements of a definitive trial were rehearsed. Such a trial would require between 232 and 922 participants, depending on the target difference in the primary outcome. We identified possible modifications to our protocol for application in a definitive trial including clarity over inclusion/exclusions, screening processes, reduction in secondary outcomes, and modification to patient questionnaire booklets and bladder diaries. A definitive trial of IUT versus clinical assessment prior to surgery for SUI or stress predominant MUI is feasible and remains relevant.

trial registrationCurrent Controlled Trials: ISRCTN 71327395, registered 7 June 2010.

Indexed as

Diagnostic Techniques, UrologicalUrodynamicsAdultCost-Benefit AnalysisEnglandFeasibility StudiesFemaleHealth Care CostsHumansInterviews as TopicMiddle AgedPatient SatisfactionPilot ProjectsPredictive Value of TestsPreoperative CareState Medicine

Identifiers

PMID26350343
PMCPMC4563900
OpenAlexW2146357929

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.