Pelvic Floor Distress Inventory (PFDI - 20)

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Objective

The PFDI-20 is both a symptom inventory and a measure of the degree of bother and distress (quality-of-life) caused by pelvic floor symptoms.  It is a short-form version of the Pelvic Floor Distress Inventory.

Intended Population

Women with disorders of the pelvic floor including urinary incontinence, pelvic organ prolapse, and fecal incontinence.

Method of Use

The PFDI-20 includes 20 questions and 3 scales.  Each of the 3 scales is scored from 0 (least distress) to 100 (greatest distress).  The sum of the scores of these 3 scales serves as the overall summary score of the PFDI-20 and ranges from 0 - 300.  The 3 scales include questions taken from the following widely used outcome measures:  Urinary Distress Inventory - 6 questions, Pelvic Organ Prolapse Distress Inventory - 6 questions, and Colorectal-Anal Distress Inventory - 8 questions.

Evidence

Reliability

The PFDI-20 has good test-retest reliability intraclass coefficient .86, P< .001.  Each of the 3 scales (Urinary Distress Inventory, Pelvic Organ Prolapse Distress Inventory, and Colorectal-Anal Distress Inventory) demonstrates significant correlation with their long-form scales (r = .86, r = .92, and  r = .93, respectively, P < .0001.

Validity

The PFDI-20 demonstrates construct validity as it demonstrates a significant association with appropriate measures of symptom severity and pelvic floor diagnoses.

Responsiveness

Each of the 3 scales of the PFDI-20 demonstrated moderate to excellent responsiveness with effect size and standardized response mean values ranging from .70 to 1.28.  The sensitivity of the PFDI-20 as a whole was excellent with an effect size of 1.48  P < .0001 and standardized response mean of 1.09 P < .0001.  The ability of the PFDI-20 to discriminate between subjects who indicated that they were "worse" after surgery from those who indicated they were "better" was excellent with c-statistic of .95.

Miscellaneous

The strength of the PFDI-20 is that it is a short form that gives a comprehensive assessment of the effect of pelvic floor disorders on the quality of life of women, rather than assessing just one aspect of pelvic floor function such as urinary incontinence.  A more generic quality-of-life form as the SF-36 has demonstrated poor responsiveness in patients undergoing treatment for urinary incontinence.  In these patient populations, it may be important to use both a generic quality-of-life instrument and a condition-specific instrument that has demonstrated responsiveness.  The PFDI-20 is easy to use in both clinical and research settings.

The MCID needs to be studied in larger populations.

Links

Pelvic Floor Distress Inventory (PFDI-20)

References

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