Paper towel test as independently self‐administered to quantify cough‐related urine loss: Compliance and comparisons with survey‐only data in SWAN.

Aims: The epidemiologic Study of Women's Health Across the Nation (SWAN) includes urinary incontinence (UI) questionnaire items. We introduced an independently self‐administered paper towel test (PTT‐ISA; invention disclosure #2021‐347) to objectively demonstrate UI. Aims were to determine: (1) PTT‐ISA compliance and (2) relationship to questionnaire results. Methods: 276 community women were invited to complete both SWAN questionnaire and PTT‐ISA. For PTT‐ISA, a woman holds a trifold brown paper towel against her perineum while coughing hard three times. She checks the towel for wetness and compares it with pictorial showing wetted area gradations (dry towel through >6 ml/saturated). She then selects the best photo match for her towel. A newly conceptualized variable constructed as PTT‐ISA plus questionnaire results was formed. Results: Of 276 women, noncompliance with PTT‐ISA was 2.2% (6 women). Four others (1.5%) were missing questionnaires. For the remaining 266 women, conceptual cohesiveness between questionnaire‐only and PTT‐ISA + questionnaire was demonstrated in 165 (62.0%). Lack of cohesiveness occurred in 101 (38.9%), including 41 women who said "no" to the questionnaire item indicative of stress UI and had leakage on PTT‐ISA; leakage degree varied across the full pictorial spectrum from drops to saturated. Conclusion: PTT‐ISA demonstrates high compliance, with rate comparable to survey compliance. It is a novel measure for objective sign of urine loss when independently self‐administered by community women outside of a clinic environment. Further research comparing PTT‐ISA with clinician‐observed cough test is warranted. As independently self‐administered, PTT‐ISA is simple, noninvasive, inexpensive, and an acceptable test that adds value to otherwise survey‐dependent research. [ABSTRACT FROM AUTHOR]