Con Kelleher - Academia.edu (original) (raw)

Papers by Con Kelleher

Research paper thumbnail of The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study

Bju International, Jun 1, 2008

Research paper thumbnail of PUK10 a Comparative Study of the Economic Burden of Overactive Bladder and Urinary Urge Incontinence Across 6 Western Countries

Value Health, 2006

the French Sickness Fund. METHODS: Medical consumption was based on clinical trial data. Cost dat... more the French Sickness Fund. METHODS: Medical consumption was based on clinical trial data. Cost data (medical fees, hospitalization, surgery) were extracted from the National Health Insurance website (www.ameli.fr) and from PMSI database. Cost-efficacy ratios were calculated to compare therapies when significant differences were demonstrated on study outcomes. RESULTS: Costs per clinical progression prevented were respectively €7404 for finasteride, €7314 for doxazosin, and €8206 for the combination of both as compared with placebo. Costefficacy ratio (additional drug costs per invasive therapy avoided) was €16,153 for finasteride versus placebo, and €3153 versus doxazosin. It was €16,400 for combination therapy versus doxazosin, and €28,779 versus placebo. CONCLUSION: Costefficacy ratios of finasteride and doxazosin for the prevention of clinical progression were in the same range. The cost-efficacy ratio of the combination was slightly higher, but with a further significant clinical benefit. Only finasteride alone or in combination with doxazosine reduced the risk of invasive therapy. Its cost-efficacy ratio for preventing invasive therapy remains in an acceptable range in the French setting. OBJECTIVES: To estimate the direct annual costs (from May 2004 to May 2005) associated with Lower Urinary Tract Symptoms (LUTS) in Italian women from the NHS perspective. To assess, at the same time, costs borne by subgroup of women with Urinary Incontinence (UI). METHODS: This evaluation was carried out as a part of the FLOW project: a 2-year observational study aimed at evaluating the prevalence, incidence and remission rates of LUTS in a large sample of women followed at 39 Italian Urology Clinics. NHS costs, such as specialist visits, hospitalizations, therapy and laboratory tests were collected retrospectively. The Dowell-Bryant Incontinence Cost Index (DBICI) was used to investigate personal UI costs, such as: disposable pads, re-usable incontinence products, laundry and health professional expenditure, surgery/diagnostic investigation and medication. RESULTS: A sample of 279 women were re-evaluated after two years follow-up. The estimated total annual cost to the Italian NHS for curing female with LUTS ranged between €70,488,843 and €1,325,850,296. The average annual NHS costs per patient in our sample were €232.90, of which the major components were: rehabilitative therapy (€83.24), surgical therapy (€64.54) and instrumental tests (€47.39). As for women with UI, surgery interventions accounted for 35% of the total NHS costs Vs 27% for whole study sample with LUTS. Regarding women with UI, the average annual personal cost estimated by DBICI was 215.21€ of which disposable pads and medications accounted respectively for 50% and 33%. CONCLUSION: After 2-yr follow-up the higher costs for the NHS seem to be associated to rehabilitative therapy and surgical procedures. Some differences were detected among the NHS resources used by the subgroup of women with UI. Costs borne by women with UI were quite high and the most important estimated component were the use of disposable products.

Research paper thumbnail of Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American Journal of Managed Care, Dec 1, 2002

Research paper thumbnail of Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American Journal of Managed Care, 2003

O veractive bladder (OAB) is a common and distressing chronic bladder condition characterized by ... more O veractive bladder (OAB) is a common and distressing chronic bladder condition characterized by symptoms of urinary frequency, urgency, and, in many cases, urge incontinence. While not life threatening, OAB has significant health-related quality of life (HRQoL) implications. Discomfort, embarrassment, and loss of self-confidence in OAB sufferers may prompt withdrawal from social life. The condition may also affect multiple areas of functioning, including social, psychological, occupational, domestic, physical, and sexual domains.

Research paper thumbnail of Epizootiology of avian influenza: Effect of season on incidence in sentinel ducks and domestic turkeys in Minnesota

Applied and Environmental Microbiology

Sentinel ducks and domestic turkey flocks were monitored for influenza infection during a 4-year ... more Sentinel ducks and domestic turkey flocks were monitored for influenza infection during a 4-year period. The onset of infection among ducks was similar each year, occurring in late July or early August. Influenza in turkeys was also shown to be seasonal, but the usual onset was 6 to 8 weeks after the detection of influenza in sentinel ducks. Possible explanations for the delayed infection in turkeys are (i) increased waterfowl activity associated with fledging and congregating in late summer and early fall; (ii) vectors transmitting virus from the waterfowl habitat to poultry farms; (iii) cooler environmental temperature, allowing prolonged virus viability; (iv) cooler surface water temperature, allowing prolonged virus viability; (v) groundwater contamination from contaminated surface water; and (vi) virus adaptation in domestic turkeys before infection is detected. We conclude that ducks are not only a natural reservoir of influenza but also have a seasonal infection that appears to be related to seasonal influenza outbreaks in domestic turkeys in Minnesota. However, only some influenza A virus isolates circulating among waterfowl at any given time appear capable of causing detectable infection in turkeys. It is speculated that the seasonal infection in migratory waterfowl may also be related to seasonal influenza infections in other species including humans.

Research paper thumbnail of Overactive bladder significantly affects quality of life. Am J Manag Care 6(11 Suppl):S580-S590

The American journal of managed care

Research paper thumbnail of The treatment of endometriosis

Research paper thumbnail of Effect of Treatment for Overactive Bladder on Work Productivity: Results from the MATRIX Study

Research paper thumbnail of Multinational study of reliability and validity of the King's Health Questionnaire in patients with overactive bladder

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2003

Overactive bladder (OAB) has substantial impact on health-related quality of life (HRQoL). The pu... more Overactive bladder (OAB) has substantial impact on health-related quality of life (HRQoL). The purpose of this research was to evaluate the psychometric properties of the King's Health Questionnaire (KHQ). The KHQ (n = 1284) was administered at baseline and 12 weeks post-treatment in a multinational, double-blind, randomized clinical trial of tolterodine for treatment of OAB. Country-specific psychometric analyses of HRQoL instruments were performed. Countries demonstrating marginal psychometric properties on the KHQ were pooled with same-language countries, re-evaluated, and aggregate analysis performed on the pooled data. Internal consistency of the KHQ was high, item characteristics were good, most assumptions of summed scales were met, and it is externally valid and consistent. Few problems with the KHQ were noted although the performance of the personal relationships domain was complicated by the 'not applicable' response category. Psychometric testing supports the ...

Research paper thumbnail of Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American journal of managed care, 2002

To evaluate the long-term effects of tolterodine on the health-related quality of life (HRQoL) of... more To evaluate the long-term effects of tolterodine on the health-related quality of life (HRQoL) of patients diagnosed with overactive bladder with incontinence. Patients who completed a 12-week randomized, double-blind, safety and efficacy trial comparing tolterodine with placebo were invited to enroll in a 12-month open-label continuation trial to assess the long-term safety and efficacy of tolterodine. This study reports the HRQoL results from the King's Health Questionnaire (KHQ) and the Short Form-36 (SF-36) that were administered at baseline, at the end of the 12-week trial, and 3 and 12 months following open-label treatment with tolterodine. One thousand seventy-seven patients were included in the intent-to-treat (ITT(B)) population. KHQ translations were available for 838 patients (mean age, 61.1 years; 80.9% women) in the ITT(B) population. HRQoL, as measured by the KHQ, significantly improved from baseline to months 3 and 12 on the following domains: incontinence impact,...

Research paper thumbnail of Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American journal of managed care, 2002

To compare the health-related quality of life (HRQoL) of overactive bladder (OAB) patients foilow... more To compare the health-related quality of life (HRQoL) of overactive bladder (OAB) patients foilowing treatment with tolterodine extended-release (ER) 4 mg once daily versus placebo. Multinational, placebo-controlled, randomized, double-blind 12-week study. Patients with urinary frequency ( > or = 8 micturitions/24 hours over a 7-day period), urge incontinence ( > or = 5 episodes/week), and symptoms of OAB for at least 6 months were eligible for inclusion. Patients (81% female) received oral therapy with tolterodine ER (n = 507) or placebo (n = 508) for 12 weeks. HRQoL was assessed using the King's Health Questionnaire (KHQ) and Medical Outcomes Study Short Form 36-item questionnaire (SF-36). Patients also rated their bladder condition. Assessments were performed at baseline and at the end of treatment. At end of treatment, KHQ domains selected a priori as primary HRQoL end points (incontinence impact and role limitations) significantly improved (P < or = .001) with tolt...

Research paper thumbnail of Overactive bladder significantly affects quality of life

The American journal of managed care, 2000

Overactive bladder (OAB), with symptoms of frequency, urgency, and urge incontinence, substantial... more Overactive bladder (OAB), with symptoms of frequency, urgency, and urge incontinence, substantially affects the lives of millions of people. The symptoms associated with OAB can significantly affect the social, psychological, occupational, domestic, physical, and sexual aspects of those who suffer from it. Unfortunately, many sufferers are reluctant to discuss their condition with their healthcare provider or family members. As a result, OAB remains underreported, despite increased awareness and improved diagnosis and treatment. Health-related quality of life can be measured objectively, and several instruments have been developed, validated, and used in research. Currently, there are 2 major types of quality-of-life questionnaires: generic and disease specific. Although these questionnaires have been helpful and are widely used, the goal is to establish a single questionnaire that is acceptable throughout the world for use by urologists, gynecologists, urogynecologists, geriatricia...

Research paper thumbnail of Increased Sexual Dysfunction in Women With Luts Including Oab in a Uk General Practice Setting: Analyses From the Thin Database

Research paper thumbnail of Estimation of a preference-based index from a condition-specific measure: the King's Health Questionnaire

Medical decision making : an international journal of the Society for Medical Decision Making

Generic preference-based measures of health may not adequately cover the impact of some condition... more Generic preference-based measures of health may not adequately cover the impact of some conditions. There is therefore increasing interest in developing condition-specific preference-based measures. The purpose of this study was to estimate a preference-based measure from a condition-specific measure of health for urinary incontinence, the 21-item King's Health Questionnaire, for use in economic evaluation. The King's Health Questionnaire (KHQ) was revised into a 5-dimensional health state classification amenable to valuation using items selected using psychometric evidence. Forty-nine states were valued using standard gamble by a representative sample of patients with urinary incontinence attending UK hospital outpatient clinics. Each respondent was asked to value 9 health states. Models have been estimated for predicting health state valuations for all 1024 states defined by the KHQ classification. The modeling had to cope with the clustering of data by respondent and its ...

Research paper thumbnail of PUK11 Effects of Long-Term Tolterodine Treatment on Physical and Symptom Aspects of Health-Related Quality of Life in Overactive Bladder Patients

Research paper thumbnail of PKU4: Linguistic Validation of the King's Health Questionnaire (KHQ) in Eight Languages

Research paper thumbnail of MP33-04 Effects of the Β3-ADRENOCEPTOR Agonist, Mirabegron, on Quality of Life in Older Patients With Overactive Bladder: A Post-Hoc Analysis of Pooled Data From 3 Randomised Phase 3 Trials

The Journal of Urology, 2014

INTRODUCTION AND OBJECTIVES: To evaluate the longterm outcomes from the tension-free vaginal tape... more INTRODUCTION AND OBJECTIVES: To evaluate the longterm outcomes from the tension-free vaginal tape (TVT) procedure, we investigated the data from minimal 13-year follow-up and predictive risk factors affecting efficacy for treatment of female stress urinary incontinence (SUI).

Research paper thumbnail of Definition and adjustment of Cesarean section rates and assessments of hospital performance

International Journal for Quality in Health Care, 1999

Background. Demand is growing for comparative data such as Cesarean section rates, but little eff... more Background. Demand is growing for comparative data such as Cesarean section rates, but little effort has been made to develop either standardized definitions or risk adjustment approaches.

Research paper thumbnail of Correlations among improvements in urgency urinary incontinence, health-related quality of life, and perception of bladder-related problems in incontinent subjects with overactive bladder treated with tolterodine or placebo

Health and Quality of Life Outcomes, 2009

Background: Previous studies demonstrate that tolterodine extended release (ER) significantly imp... more Background: Previous studies demonstrate that tolterodine extended release (ER) significantly improves urgency urinary incontinence (UUI) episodes. Instruments that measure patient-reported outcomes (PROs) provide additional information that is valuable for assessing whether clinical improvements are meaningful to the patient. This study determined the correlation of changes in bladder diary variables and other PROs in subjects with overactive bladder (OAB).

Research paper thumbnail of Long-term safety, tolerability, and efficacy of fesoterodine treatment in men and women with overactive bladder symptoms

Current Medical Research and Opinion, 2011

To evaluate long-term safety, tolerability, and efficacy of fesoterodine for men and women with o... more To evaluate long-term safety, tolerability, and efficacy of fesoterodine for men and women with overactive bladder (OAB) symptoms. This was a post hoc analysis of data pooled from two open-label extensions (NCT00220402, NCT00220376) of double-blind studies. All subjects began open-label treatment with fesoterodine 8 mg once daily, with voluntary dose reduction to 4 mg and re-escalation to 8 mg each permitted once annually. Maximum allowable duration of open-label treatment ranged from 24 to 36 months. Safety and discontinuations were assessed throughout treatment; subject-reported treatment tolerability and 3-day bladder diaries were evaluated at open-label baseline and months 1, 4, 8, 12, and 24. A total of 185 men and 705 women enrolled; 83 men (45%) and 356 women (50%) continued open-label treatment for ≥ 24 months. Most men (84%) and women (75%) remained on fesoterodine 8 mg throughout open-label treatment. No new or unexpected safety signals were observed. Dry mouth was the most common treatment-emergent adverse event (men, 24%; women, 32%), rates of discontinuation due to dry mouth were low (men, 1%; women, 2%). Most men and women (≥ 91%) reported at least &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;good&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; tolerance. For men and women, statistically significant improvements in urgency urinary incontinence episodes, micturitions, urgency episodes, and mean voided volume per micturition achieved between double-blind baseline and open-label baseline were sustained or further improved through month 24; significant improvements in most OAB symptoms were observed between double-blind baseline and month 24 when subjects were stratified by double-blind treatment (placebo, tolterodine extended release 4 mg, fesoterodine 4 mg, fesoterodine 8 mg). Limitations include the lack of a placebo control and that subjects completing double-blind treatment may have been more likely to tolerate or respond to long-term fesoterodine treatment. Long-term fesoterodine treatment was well tolerated and associated with sustained improvements in OAB symptoms in men and women.

Research paper thumbnail of The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study

Bju International, Jun 1, 2008

Research paper thumbnail of PUK10 a Comparative Study of the Economic Burden of Overactive Bladder and Urinary Urge Incontinence Across 6 Western Countries

Value Health, 2006

the French Sickness Fund. METHODS: Medical consumption was based on clinical trial data. Cost dat... more the French Sickness Fund. METHODS: Medical consumption was based on clinical trial data. Cost data (medical fees, hospitalization, surgery) were extracted from the National Health Insurance website (www.ameli.fr) and from PMSI database. Cost-efficacy ratios were calculated to compare therapies when significant differences were demonstrated on study outcomes. RESULTS: Costs per clinical progression prevented were respectively €7404 for finasteride, €7314 for doxazosin, and €8206 for the combination of both as compared with placebo. Costefficacy ratio (additional drug costs per invasive therapy avoided) was €16,153 for finasteride versus placebo, and €3153 versus doxazosin. It was €16,400 for combination therapy versus doxazosin, and €28,779 versus placebo. CONCLUSION: Costefficacy ratios of finasteride and doxazosin for the prevention of clinical progression were in the same range. The cost-efficacy ratio of the combination was slightly higher, but with a further significant clinical benefit. Only finasteride alone or in combination with doxazosine reduced the risk of invasive therapy. Its cost-efficacy ratio for preventing invasive therapy remains in an acceptable range in the French setting. OBJECTIVES: To estimate the direct annual costs (from May 2004 to May 2005) associated with Lower Urinary Tract Symptoms (LUTS) in Italian women from the NHS perspective. To assess, at the same time, costs borne by subgroup of women with Urinary Incontinence (UI). METHODS: This evaluation was carried out as a part of the FLOW project: a 2-year observational study aimed at evaluating the prevalence, incidence and remission rates of LUTS in a large sample of women followed at 39 Italian Urology Clinics. NHS costs, such as specialist visits, hospitalizations, therapy and laboratory tests were collected retrospectively. The Dowell-Bryant Incontinence Cost Index (DBICI) was used to investigate personal UI costs, such as: disposable pads, re-usable incontinence products, laundry and health professional expenditure, surgery/diagnostic investigation and medication. RESULTS: A sample of 279 women were re-evaluated after two years follow-up. The estimated total annual cost to the Italian NHS for curing female with LUTS ranged between €70,488,843 and €1,325,850,296. The average annual NHS costs per patient in our sample were €232.90, of which the major components were: rehabilitative therapy (€83.24), surgical therapy (€64.54) and instrumental tests (€47.39). As for women with UI, surgery interventions accounted for 35% of the total NHS costs Vs 27% for whole study sample with LUTS. Regarding women with UI, the average annual personal cost estimated by DBICI was 215.21€ of which disposable pads and medications accounted respectively for 50% and 33%. CONCLUSION: After 2-yr follow-up the higher costs for the NHS seem to be associated to rehabilitative therapy and surgical procedures. Some differences were detected among the NHS resources used by the subgroup of women with UI. Costs borne by women with UI were quite high and the most important estimated component were the use of disposable products.

Research paper thumbnail of Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American Journal of Managed Care, Dec 1, 2002

Research paper thumbnail of Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American Journal of Managed Care, 2003

O veractive bladder (OAB) is a common and distressing chronic bladder condition characterized by ... more O veractive bladder (OAB) is a common and distressing chronic bladder condition characterized by symptoms of urinary frequency, urgency, and, in many cases, urge incontinence. While not life threatening, OAB has significant health-related quality of life (HRQoL) implications. Discomfort, embarrassment, and loss of self-confidence in OAB sufferers may prompt withdrawal from social life. The condition may also affect multiple areas of functioning, including social, psychological, occupational, domestic, physical, and sexual domains.

Research paper thumbnail of Epizootiology of avian influenza: Effect of season on incidence in sentinel ducks and domestic turkeys in Minnesota

Applied and Environmental Microbiology

Sentinel ducks and domestic turkey flocks were monitored for influenza infection during a 4-year ... more Sentinel ducks and domestic turkey flocks were monitored for influenza infection during a 4-year period. The onset of infection among ducks was similar each year, occurring in late July or early August. Influenza in turkeys was also shown to be seasonal, but the usual onset was 6 to 8 weeks after the detection of influenza in sentinel ducks. Possible explanations for the delayed infection in turkeys are (i) increased waterfowl activity associated with fledging and congregating in late summer and early fall; (ii) vectors transmitting virus from the waterfowl habitat to poultry farms; (iii) cooler environmental temperature, allowing prolonged virus viability; (iv) cooler surface water temperature, allowing prolonged virus viability; (v) groundwater contamination from contaminated surface water; and (vi) virus adaptation in domestic turkeys before infection is detected. We conclude that ducks are not only a natural reservoir of influenza but also have a seasonal infection that appears to be related to seasonal influenza outbreaks in domestic turkeys in Minnesota. However, only some influenza A virus isolates circulating among waterfowl at any given time appear capable of causing detectable infection in turkeys. It is speculated that the seasonal infection in migratory waterfowl may also be related to seasonal influenza infections in other species including humans.

Research paper thumbnail of Overactive bladder significantly affects quality of life. Am J Manag Care 6(11 Suppl):S580-S590

The American journal of managed care

Research paper thumbnail of The treatment of endometriosis

Research paper thumbnail of Effect of Treatment for Overactive Bladder on Work Productivity: Results from the MATRIX Study

Research paper thumbnail of Multinational study of reliability and validity of the King's Health Questionnaire in patients with overactive bladder

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2003

Overactive bladder (OAB) has substantial impact on health-related quality of life (HRQoL). The pu... more Overactive bladder (OAB) has substantial impact on health-related quality of life (HRQoL). The purpose of this research was to evaluate the psychometric properties of the King's Health Questionnaire (KHQ). The KHQ (n = 1284) was administered at baseline and 12 weeks post-treatment in a multinational, double-blind, randomized clinical trial of tolterodine for treatment of OAB. Country-specific psychometric analyses of HRQoL instruments were performed. Countries demonstrating marginal psychometric properties on the KHQ were pooled with same-language countries, re-evaluated, and aggregate analysis performed on the pooled data. Internal consistency of the KHQ was high, item characteristics were good, most assumptions of summed scales were met, and it is externally valid and consistent. Few problems with the KHQ were noted although the performance of the personal relationships domain was complicated by the 'not applicable' response category. Psychometric testing supports the ...

Research paper thumbnail of Long-term health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American journal of managed care, 2002

To evaluate the long-term effects of tolterodine on the health-related quality of life (HRQoL) of... more To evaluate the long-term effects of tolterodine on the health-related quality of life (HRQoL) of patients diagnosed with overactive bladder with incontinence. Patients who completed a 12-week randomized, double-blind, safety and efficacy trial comparing tolterodine with placebo were invited to enroll in a 12-month open-label continuation trial to assess the long-term safety and efficacy of tolterodine. This study reports the HRQoL results from the King's Health Questionnaire (KHQ) and the Short Form-36 (SF-36) that were administered at baseline, at the end of the 12-week trial, and 3 and 12 months following open-label treatment with tolterodine. One thousand seventy-seven patients were included in the intent-to-treat (ITT(B)) population. KHQ translations were available for 838 patients (mean age, 61.1 years; 80.9% women) in the ITT(B) population. HRQoL, as measured by the KHQ, significantly improved from baseline to months 3 and 12 on the following domains: incontinence impact,...

Research paper thumbnail of Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder

The American journal of managed care, 2002

To compare the health-related quality of life (HRQoL) of overactive bladder (OAB) patients foilow... more To compare the health-related quality of life (HRQoL) of overactive bladder (OAB) patients foilowing treatment with tolterodine extended-release (ER) 4 mg once daily versus placebo. Multinational, placebo-controlled, randomized, double-blind 12-week study. Patients with urinary frequency ( > or = 8 micturitions/24 hours over a 7-day period), urge incontinence ( > or = 5 episodes/week), and symptoms of OAB for at least 6 months were eligible for inclusion. Patients (81% female) received oral therapy with tolterodine ER (n = 507) or placebo (n = 508) for 12 weeks. HRQoL was assessed using the King's Health Questionnaire (KHQ) and Medical Outcomes Study Short Form 36-item questionnaire (SF-36). Patients also rated their bladder condition. Assessments were performed at baseline and at the end of treatment. At end of treatment, KHQ domains selected a priori as primary HRQoL end points (incontinence impact and role limitations) significantly improved (P < or = .001) with tolt...

Research paper thumbnail of Overactive bladder significantly affects quality of life

The American journal of managed care, 2000

Overactive bladder (OAB), with symptoms of frequency, urgency, and urge incontinence, substantial... more Overactive bladder (OAB), with symptoms of frequency, urgency, and urge incontinence, substantially affects the lives of millions of people. The symptoms associated with OAB can significantly affect the social, psychological, occupational, domestic, physical, and sexual aspects of those who suffer from it. Unfortunately, many sufferers are reluctant to discuss their condition with their healthcare provider or family members. As a result, OAB remains underreported, despite increased awareness and improved diagnosis and treatment. Health-related quality of life can be measured objectively, and several instruments have been developed, validated, and used in research. Currently, there are 2 major types of quality-of-life questionnaires: generic and disease specific. Although these questionnaires have been helpful and are widely used, the goal is to establish a single questionnaire that is acceptable throughout the world for use by urologists, gynecologists, urogynecologists, geriatricia...

Research paper thumbnail of Increased Sexual Dysfunction in Women With Luts Including Oab in a Uk General Practice Setting: Analyses From the Thin Database

Research paper thumbnail of Estimation of a preference-based index from a condition-specific measure: the King's Health Questionnaire

Medical decision making : an international journal of the Society for Medical Decision Making

Generic preference-based measures of health may not adequately cover the impact of some condition... more Generic preference-based measures of health may not adequately cover the impact of some conditions. There is therefore increasing interest in developing condition-specific preference-based measures. The purpose of this study was to estimate a preference-based measure from a condition-specific measure of health for urinary incontinence, the 21-item King's Health Questionnaire, for use in economic evaluation. The King's Health Questionnaire (KHQ) was revised into a 5-dimensional health state classification amenable to valuation using items selected using psychometric evidence. Forty-nine states were valued using standard gamble by a representative sample of patients with urinary incontinence attending UK hospital outpatient clinics. Each respondent was asked to value 9 health states. Models have been estimated for predicting health state valuations for all 1024 states defined by the KHQ classification. The modeling had to cope with the clustering of data by respondent and its ...

Research paper thumbnail of PUK11 Effects of Long-Term Tolterodine Treatment on Physical and Symptom Aspects of Health-Related Quality of Life in Overactive Bladder Patients

Research paper thumbnail of PKU4: Linguistic Validation of the King's Health Questionnaire (KHQ) in Eight Languages

Research paper thumbnail of MP33-04 Effects of the Β3-ADRENOCEPTOR Agonist, Mirabegron, on Quality of Life in Older Patients With Overactive Bladder: A Post-Hoc Analysis of Pooled Data From 3 Randomised Phase 3 Trials

The Journal of Urology, 2014

INTRODUCTION AND OBJECTIVES: To evaluate the longterm outcomes from the tension-free vaginal tape... more INTRODUCTION AND OBJECTIVES: To evaluate the longterm outcomes from the tension-free vaginal tape (TVT) procedure, we investigated the data from minimal 13-year follow-up and predictive risk factors affecting efficacy for treatment of female stress urinary incontinence (SUI).

Research paper thumbnail of Definition and adjustment of Cesarean section rates and assessments of hospital performance

International Journal for Quality in Health Care, 1999

Background. Demand is growing for comparative data such as Cesarean section rates, but little eff... more Background. Demand is growing for comparative data such as Cesarean section rates, but little effort has been made to develop either standardized definitions or risk adjustment approaches.

Research paper thumbnail of Correlations among improvements in urgency urinary incontinence, health-related quality of life, and perception of bladder-related problems in incontinent subjects with overactive bladder treated with tolterodine or placebo

Health and Quality of Life Outcomes, 2009

Background: Previous studies demonstrate that tolterodine extended release (ER) significantly imp... more Background: Previous studies demonstrate that tolterodine extended release (ER) significantly improves urgency urinary incontinence (UUI) episodes. Instruments that measure patient-reported outcomes (PROs) provide additional information that is valuable for assessing whether clinical improvements are meaningful to the patient. This study determined the correlation of changes in bladder diary variables and other PROs in subjects with overactive bladder (OAB).

Research paper thumbnail of Long-term safety, tolerability, and efficacy of fesoterodine treatment in men and women with overactive bladder symptoms

Current Medical Research and Opinion, 2011

To evaluate long-term safety, tolerability, and efficacy of fesoterodine for men and women with o... more To evaluate long-term safety, tolerability, and efficacy of fesoterodine for men and women with overactive bladder (OAB) symptoms. This was a post hoc analysis of data pooled from two open-label extensions (NCT00220402, NCT00220376) of double-blind studies. All subjects began open-label treatment with fesoterodine 8 mg once daily, with voluntary dose reduction to 4 mg and re-escalation to 8 mg each permitted once annually. Maximum allowable duration of open-label treatment ranged from 24 to 36 months. Safety and discontinuations were assessed throughout treatment; subject-reported treatment tolerability and 3-day bladder diaries were evaluated at open-label baseline and months 1, 4, 8, 12, and 24. A total of 185 men and 705 women enrolled; 83 men (45%) and 356 women (50%) continued open-label treatment for ≥ 24 months. Most men (84%) and women (75%) remained on fesoterodine 8 mg throughout open-label treatment. No new or unexpected safety signals were observed. Dry mouth was the most common treatment-emergent adverse event (men, 24%; women, 32%), rates of discontinuation due to dry mouth were low (men, 1%; women, 2%). Most men and women (≥ 91%) reported at least &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;good&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; tolerance. For men and women, statistically significant improvements in urgency urinary incontinence episodes, micturitions, urgency episodes, and mean voided volume per micturition achieved between double-blind baseline and open-label baseline were sustained or further improved through month 24; significant improvements in most OAB symptoms were observed between double-blind baseline and month 24 when subjects were stratified by double-blind treatment (placebo, tolterodine extended release 4 mg, fesoterodine 4 mg, fesoterodine 8 mg). Limitations include the lack of a placebo control and that subjects completing double-blind treatment may have been more likely to tolerate or respond to long-term fesoterodine treatment. Long-term fesoterodine treatment was well tolerated and associated with sustained improvements in OAB symptoms in men and women.