Evidence map›Paper›PMID 37871326›Full record

ArticleThe Journal of urology2024

Longitudinal Fluctuations in Treatment Response After OnabotulinumToxinA and Sacral Neuromodulation for Refractory Urgency Incontinence.

Whitney K Hendrickson, Chong Zhang, J Eric Jelovsek, Ingrid E Nygaard, Angela P Presson

Open access · greenAbstract read
In one paragraph

Article in The Journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 19% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Whitney K HendricksonDivision of Urogynecology, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah.ORCID 0000-0003-4603-2879
Chong ZhangDivision of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
J Eric JelovsekDivision of Urogynecology, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina.
Ingrid E NygaardDivision of Urogynecology, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah.
Angela P PressonDivision of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
University of Utah · USDuke University · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
CTSA UM1 Program at University of UtahUM1TR004409 · NCATS · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI RACHEL HESS, Jennifer Juhl Majersik · 2023 to 2026
$21.9M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
University of Utah Center for Clinical and Translational Science-UL1UL1TR000105 · NCATS · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2012 to 2013
$5.1M
Utah Women's Reproductive Health Research Career Development ProgramK12HD085816 · NICHD · UNIVERSITY OF UTAH · PI SILVER, ROBERT M. · 2015 to 2024
$3.2M
NCATS NIH HHS UL1TR000105NCATS NIH HHS UL1 TR001067NCATS NIH HHS UL1 TR002538NCATS NIH HHS UM1 TR004409NCRR NIH HHS UL1 RR025764NICHD NIH HHS K12 HD085816
6 · The paper itself

Abstract

purposeWe compared fluctuations in treatment response after onabotulinumtoxinA and sacral neuromodulation for urgency incontinence using Markov models. MATERIALS AND

methodsWe fit data from a randomized trial to Markov models to compare transitions of success/failure over 6 months between 200 U onabotulinumtoxinA and sacral neuromodulation. Objective failure was <50% reduction in urgency incontinence episodes from baseline; subjective failure "strongly disagree" to "neutral" to the Patient Global Symptom Control questionnaire.

resultsOf the 357 participants (median baseline daily urgency incontinence episodes 4.7 [IQR 3.7-6.0]) 61% vs 51% and 3.2% vs 6.1% reported persistent states of objective success and failure over 6 months after onabotulinumtoxinA vs sacral neuromodulation. Participants receiving onabotulinumtoxinA vs sacral neuromodulation had lower 30-day transition probabilities from objective and subjective success to failure (10% vs 14%, ratio 0.75 [95% CI 0.55-0.95]; 14% vs 21%, ratio 0.70 [95% CI 0.51-0.89]). The 30-day transition probability from objective and subjective failure to success did not differ between onabotulinumtoxinA and sacral neuromodulation (40% vs 36%, ratio 1.11 [95% CI 0.73-1.50]; 18% vs 17%, ratio 1.14 [95% CI 0.65-1.64]).

conclusionsOver 6 months after treatment, 2 in 5 women's symptoms fluctuate. Within these initial 6 months, women receiving onabotulinumtoxinA transitioned from success to failure over 30 days less often than sacral neuromodulation. For both treatments, there was an almost 20%-40% probability over 30 days that women returned to subjective and objective success after failure. Markov models add important information to longitudinal models on how symptoms fluctuate after urgency incontinence treatment.

Indexed as

Botulinum Toxins, Type ATranscutaneous Electric Nerve StimulationUrinary Bladder, OveractiveFemaleHumansProbabilityRandomized Controlled Trials as TopicSacrumTreatment OutcomeUrinary Incontinence, UrgeBotulinum Toxins, Type AMarkov processoveractive bladderpatient-reported outcome

Identifiers

PMID37871326
PMCPMC10842509
OpenAlexW4387869023

What OpenQuestion holds

Textmetadata
LicenceTDM
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.