Pilot study highlights disparities, lack of diversity in OAB data

Racial and ethnic disparities among patients with overactive bladder (OAB) were highlighted in a recent study investigating the prevalence and perception of OAB treatment and diagnosis.¹

“Previous studies could be inadvertently excluding large populations of patients…due to language barriers, access to academic centers, collecting research data, or differences in beliefs in health care in general,” co-author Beth Edelblute, MD, MPH, explained in an interview with Urology Times. “So, especially for a diagnosis like OAB that's made subjectively, the disparity and reporting is even more pronounced than maybe for other diseases,” added Edelblute, a urology resident at the Icahn School of Medicine at Mount Sinai.

In this pilot study, which was shared during the 2022 Society of Women in Urology Annual Clinical Mentoring Conference, a diverse population of 115 patients with OAB completed a survey so that investigators could gather data on their demographics, Overactive Bladder Questionnaire (OAB-q) scores, Patient Perception of Bladder Condition (PPBC) scores, and perception of OAB treatment (RedCap survey).

OAB-q and PPBC scores are derived from self-reported questionnaires, in which OAB-q asked participants about the symptoms and bother related to OAB, as well as their health-related quality of life (cores range from 0 to 100, with higher scores indicating more bother), and PPBC asked participants to rate their urinary issues on a scale of 1 to 6 (higher scores equate to more severe problems).

Participants were also asked to rank their preference of treatment options, including no treatment, physical therapy, dietary modifications, medications, acupuncture, and other surgical options.

To evaluate the differences in scores among various racial and ethnic groups, a one-way ANOVA test was conducted using average OAB-q and PPBC data.

Results showed that while there was a significant difference in OAB-q scores between men and women (median: females 1.76, males 0.58; P <.01), there was no difference in scores between racial or ethnic groups,

“This suggests that the current body of literature truly is underrepresenting disease prevalence among racial and ethnic minorities,” Edelblute and coauthors wrote in their poster.

Additionally, investigators found that OAB-q scores were significantly correlated to differences in PPBC scores (Rho, 0.72).

“The OAB-q score...had similar results that correlated well with a single-item patient perception of bladder condition, or the PPBC score,” said Edelblute. “That's an important finding because the single-item score could be more widely applied to a diverse group of patients in whom language barriers [and] education levels might limit the use of a more detailed survey.”

This study will be the basis of a larger study in the future, the authors said, where they will recruit a larger, diverse population and conduct targeted focus groups to expand the data.

“We see so many patients with OAB that can be confused for other urologic diseases,” co-author Vannita Simma-Chiang, MD, associate director of the Urology Residency Program at the Icahn School of Medicine at Mount Sinai, said in an interview with Urology Times, “and it's just important for us as a specialty to continue building upon many aspects of OAB diagnosis, including treatments, understanding what the patients' perspectives are, [and] understanding what their wishes are for treatment.”

To minimize these disparities in the future, Simma-Chiang said a more diverse and inclusive space for urologic patients can be achieved “by recruiting a diverse workforce [and] by initiating, participating, supporting, and sponsoring research that focuses on the health needs of diverse populations...When we're all committed to the health of all of our communities, we all benefit.”

Reference

1. Edelblute B, Mohamed N, Stanislaw S, Simma-Chiang V. Racial and ethnic disparities in perceptions of overactive bladder diagnosis and treatment. Paper presented at: 2022 Society of Women in Urology Annual Clinical Mentoring Conference; February 7-9, 2022; New Orleans, Louisiana. Poster 5987.