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. 2010 Nov;203(5):512.e1-6.
doi: 10.1016/j.ajog.2010.06.071. Epub 2010 Aug 21.

Quantification of vaginal support: are continuous summary scores better than POPQ stage?

Linda Brubaker  1 , Matthew D Barber, Ingrid Nygaard, Charlie W Nager, Edward Varner, Joseph Schaffer, Anthony Visco, Susan Meikle, Cathie Spino; Pelvic Floor Disorders Network
Affiliations

Quantification of vaginal support: are continuous summary scores better than POPQ stage?

Linda Brubaker et al. Am J Obstet Gynecol. 2010 Nov.

Abstract

Objective: This analysis compared 3 continuous variables as summary support loss (SL) scores with pelvic organ prolapse (POP) quantification (POPQ) ordinal stages.

Study design: We used pooled baseline data from 1141 subjects in 3 randomized trials (CARE, n = 322; OPUS, n = 380; ATLAS, n = 439) to test 3 SL measures. The relative responsiveness was assessed using the standardized response mean of 2-year outcome data from the CARE trial.

Results: Each SL measure was strongly correlated with POPQ ordinal staging; the single most distal POPQ point had the strongest correlation. Improvements in anatomic support were weakly correlated with improvements in POP Distress Inventory (r = 0.17-0.24; P < .01 for each) but not with changes in POP Impact Questionnaire for all measures of SL or POPQ stage.

Conclusion: While continuous, single number summary measures compared favorably to ordinal POPQ staging system, the single most distal POPQ point may be preferable to POPQ ordinal stages to summarize or compare group data.

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Figures

Figure One
Figure One. Equations for Three Summary Scores for Support Loss
SL3 = (TVL + C) + (Ba + 3) + (Bp + 3); and SLmax = location of single most distal point. Zero is the theoretical lower limit of SL5 and SL3 and -3 is the limit for SLmax, and represent perfect support. Higher values of SL measures represent greater support loss.
See this image and copyright information in PMC

References

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