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Validity study of the severity index, a simple measure of urinary incontinence in women

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1096
  1. Janet Hanley (, research managera,
  2. Ann Capewell, consultant physician in medicine of the elderlyb,
  3. Suzanne Hagen, research adviser/statisticianc
  1. a Lothian Primary Care NHS Trust, Edenhall Hospital, Musselburgh EH21 7TZ
  2. b Royal Victoria Hospital, Edinburgh EH4 2DN
  3. c Nursing Research Initiative for Scotland, Faculty of Health, Glasgow Caledonian University, Glasgow G4 0BA
  1. Correspondence to: J Hanley
  • Accepted 23 January 2001

Lack of a universally accepted, easily applied, outcome measure is one reason why urinary incontinence in women is poorly evaluated and treated.1 The severity index, developed by Sandvik et al, is short and simple enough for use in almost any context.2 We evaluated the reliability, validity, and sensitivity to change of the severity index in a wide range of women in Scotland.

Methods and results

The severity index comprises the following two questions. How often do you experience urine leakage (0=never, 1=less than once a month, 2=one or several times a month, 3=one or several times a week, 4=every day and/or night)? How much urine do you lose each time (1=drops or little, 2=more)? The total score is the score for the first question multiplied by the score for the second question (0=dry, 1-2=slight, 3-4=moderate, 6-8=severe). We added the category “dry” for women whose urinary incontinence was cured. A version of the index splitting the “severe” …

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