Development of the OAB-q

Given the high prevalence and substantial negative impact of OAB, reliable and well validated measures are needed to assess treatment outcomes on patients' quality of life. Because OAB is defined by symptoms, patient-reported outcome measures (PROs) are essential for complete assessment of these symptoms and their impact. Thus, the Overactive Bladder Questionnaire (OAB-q) was developed in the following steps (Coyne et al. 2002):

1. Based on focus groups with male and female OAB patients as well as literature review, 66 initial items were generated for the OAB-q.
   
   
2. Content validity of these items was assessed through interviews with clinical experts and cognitive debriefing with OAB patients.
   
   
3. Through item and factor analysis, the initial pool of 66 items was reduced to the final 33-item questionnaire.

The OAB-q has been validated in diverse clinical and community samples of over 2500 total participants, thereby capturing the range of mild to severe OAB symptoms and HRQL impact.

    Among both continent and incontinent OAB patients, the OAB-q has consistently demonstrated good internal consistency reliability, test-retest reliability, concurrent validity, discriminant validity, and responsiveness to treatment-related change.

Reliability

The OAB-q has demonstrated high internal consistency reliability in both clinical and community samples, with Cronbach's α in various samples ranging from 0.86 to 0.93 for the symptom bother scale and 0.75 to 0.96 for the HRQL subscales (e.g., Coyne et al. 2002).

The OAB-q has demonstrated good test-retest reliability (reproducibility) with intraclass correlation coefficients in the moderate to high range between assessments two weeks apart (all subscales = 0.83) (Matza et al. 2005).

Validity

The OAB-q has demonstrated criterion validity through statistically significant correlations with previously established patient-reported outcome measures (e.g., the SF-36) and clinical data. OAB-q subscales have been shown to discriminate among continent OAB patients, incontinent OAB patients, and controls without OAB. The OAB-q has also shown discriminant validity in that it distinguishes among patients with varying levels of urge intensity, micturition frequency, and frequency of nocturia episodes (Coyne et al. 2002; Coyne et al. 2003).

Responsiveness

Responsiveness to treatment-related change has been assessed using data from a large 12-week clinical trial. The OAB-q was highly responsive with subscale effect sizes ranging from 0.44 (social interaction) to 1.2 (symptom bother). A reduction of > 3 urgency episodes, > 3 micturitions, or > 1 incontinence episode per day resulted in significant score changes in all OAB-q subscales (p <0.05). Improvements in OAB-q scales were associated with changes in patient and physician perceptions of treatment benefit (Coyne et al. 2005). Responsiveness to change has also been demonstrated separately among continent and incontinent OAB patients (Coyne et al. 2007).

Click here for selected citations of studies that have examined or used the OAB-q.

Frequently Asked Questions about the Three OAB-q Instruments

• What is the difference between the three questionnaires?
• How do I score the questionnaires?
• How do I obtain permission to use the questionnaires?
• Are the OAB-q questionnaires available in languages other than English?
• What differentiates the OAB-q from other condition-specific questionnaires such as the KHQ, IIQ, or I-QOL?

What is the difference between the three questionnaires?

There are three questionnaires in the OAB-q family. The choice of the most appropriate instrument will depend upon the intended use of the questionnaire and the specific research objectives.

• OAB-q: The original version of the OAB-q was developed to assess symptom bother and health-related quality of life (HRQL) among patients with either continent or incontinent overactive bladder. The original OAB-q has an 8-item symptom bother scale and four HRQL subscales (coping, concern, sleep, social interaction), which are derived from 25 items. The original OAB-q should be used when the research objectives relate to assessing symptom bother as a study endpoint or when assessing specific aspects of OAB's impact on HRQL are desired, such as effects on sleep, social interaction, and so on.
  
  
• OAB-q SF: A short form of the original OAB-q was derived to provide a "quick" assessment of symptom bother and global HRQL. This "short form," called the OAB-q SF, consists of a 6-item symptom bother scale and a 13-item HRQL scale. The OAB-q SF should be used when the assessment of symptom bother is desired, but may not be a primary or secondary endpoint or when a global assessment of HRQL, rather than specific domains of HRQL, is desired.
  
  
• OAB Awareness Tool: The 8-item Symptom Bother scale of the original OAB-q was validated for use as an awareness tool to identify patients who may have bothersome OAB symptoms. The format and instructions of the OAB Awareness Tool were designed for screener use.

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How do I score the questionnaires?

When you order an instrument on this website, you will automatically be sent a scoring manual. Please follow the scoring instructions in the manual.

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Are the questionnaires available in languages other than English?

Validated versions of the questionnaires are available in a wide range of languages. Click here to order the questionnaires by language.

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What differentiates the OAB-q from other condition-specific questionnaires such as the KHQ, IIQ, or I-QOL?

A range of well-validated condition-specific questionnaires are available for use among patients with symptoms of OAB. Questionnaires vary in terms of the domains assessed and the number of items assessing a specific domain. Depending upon the goals of the research or clinical question, one questionnaire may be preferable over another particularly if it assesses a desired domain that other questionnaires may or may not address adequately.

    Another distinguishing feature of each questionnaire involves the specific patient population for which it was designed and validated. Instruments should have demonstrated evidence of reliability and validity in the patient population under investigation (Leidy et al. 1999). A questionnaire shown to be valid in one population is not necessarily valid for use in a population with different demographic or clinical characteristics. Therefore, when choosing an instrument, it is critical to match the questionnaire with the intended study sample. Please see the table below summarizing Condition-Specific Health-Related Quality of Life Instruments for further information on relevant questionnaires.

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