Patient demographic and psychosocial characteristics associated with 30-day recall of self-reported lower urinary tract symptoms

Kathryn E. Flynn*, Sarah A. Mansfield, Abigail R. Smith, Brenda W. Gillespie, Catherine S. Bradley, David Cella, Margaret E. Helmuth, H. Henry Lai, Ziya Kirkali, Pooja Talaty, James W. Griffith, Kevin P. Weinfurt

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Aims: Measurement of self-reported lower urinary tract symptoms (LUTS) typically uses a recall period, for example, “In the past 30 days….” Compared to averaged daily reports, 30-day recall is generally unbiased, but recall bias varies by item. We examined the associations between personal characteristics (eg, age, symptom bother) and 30-day recall of LUTS using items from the Symptoms of Lower Urinary Tract Dysfunction Research Network Comprehensive Assessment of Self-reported Urinary Symptoms questionnaire. Methods: Participants (127 women and 127 men) were recruited from 6 US tertiary care sites. They completed daily assessments for 30 days and a 30-day recall assessment at the end of the study month. For each of the 18 tested items, representing 10 LUTS, the average of the participant's daily responses was modeled as a function of their 30-day recall, the personal characteristic, and the interaction between the 30-day recall and the characteristic in separate general linear regression models, adjusted for sex. Results: Nine items representing 7 LUTS exhibited under- or overreporting (recall bias) for at least 25% of participants. Bias was associated with personal characteristics for six LUTS. Underreporting of incontinence was associated with older age, lower anxiety, and negative affect; overreporting of other LUTS was associated with, symptom bother, symptom variability, anxiety, and depression. Conclusions: We identified under- or overreporting that was associated with personal characteristics for six common LUTS. Some cues (eg, less bother and lower anxiety) were related to recall bias in an unexpected direction. Thus, providers should exercise caution when making judgments about the accuracy of a patient's symptom recall based on patient demographic and psychosocial characteristics.

Original languageEnglish (US)
Pages (from-to)1939-1948
Number of pages10
JournalNeurourology and Urodynamics
Volume39
Issue number7
DOIs
StatePublished - Sep 1 2020

Keywords

  • humans
  • lower urinary tract symptoms
  • measurement
  • mental recall
  • patient-reported outcomes
  • self-report
  • urination

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

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    Flynn, K. E., Mansfield, S. A., Smith, A. R., Gillespie, B. W., Bradley, C. S., Cella, D., Helmuth, M. E., Lai, H. H., Kirkali, Z., Talaty, P., Griffith, J. W., & Weinfurt, K. P. (2020). Patient demographic and psychosocial characteristics associated with 30-day recall of self-reported lower urinary tract symptoms. Neurourology and Urodynamics, 39(7), 1939-1948. https://doi.org/10.1002/nau.24461