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Utilizing Technology in Assessment of Lower Urinary Tract Symptoms: A Randomized Trial of Electronic Versus Paper Voiding Diaries

Sussman, Rachael D. MD; Richter, Lee A. MD; Tefera, Eshetu MS; Park, Amy J. MD; Sokol, Andrew I. MD; Gutman, Robert E. MD; Iglesia, Cheryl B. MD

Female Pelvic Medicine & Reconstructive Surgery: July/August 2016 - Volume 22 - Issue 4 - p 224–228
doi: 10.1097/SPV.0000000000000266
Original Articles

Objectives The aim of this study was to compare a Web app developed by the American Urogynecologic Society, called “BladderTrakHer,” to the traditional paper voiding diary (PVD) for reliability and satisfaction.

Methods Women presenting to our urogynecology practice with lower urinary tract symptom and access to an iPhone/iPad were randomized to a 3-day electronic voiding diary (EVD), using the BladderTrakHer Web app or PVD. Participants then completed a second voiding diary using the alternate format. Estimated fluid intake and output, number of voids, and episodes of incontinence were compared between formats. Patient and practitioner surveys assessed ease of use, ease of data interpretation, time to data entry, and overall satisfaction.

Results Thirty-one of 122 patients completed both diary formats and the survey. The EVD and PVD showed good test-retest reliability. Patients recorded a higher number of entries for both voids and leaks while using the PVD (28.0 vs 25.5 [P = 0.03] and 4.5 vs 2.8 [P = 0.02], respectively). There was no significant difference in time to data entry among diary formats; 51.6% of patients preferred the EVD, and 78% of patients would prefer an electronic format if the app were improved. Four of 6 practitioners found the PVD easier to interpret, but all stated a preference for an EVD if the data were presented in a more organized fashion.

Conclusions The use of an EVD is acceptable and reliable in our population of adult female patients with lower urinary tract symptom. Electronic voiding diary and PVD have good test-retest reliability, although the number of voids and leaks entered is slightly lower for the EVD.

This randomized cross over study demonstrated that an electronic voiding diary is an acceptable and reliable alternative to a paper voiding diary in our population of adult female patients with lower urinary tract symptoms.

From the *MedStar Georgetown University Hospital and †MedStar Washington Hospital Center, Washington, DC; ‡Department of Biostatistics and Bioinformatics, MedStar Health Research Institute, Hyattsville, MD; and §Departments of Obstetrics/Gynecology and Urology, Georgetown University School of Medicine, National Center for Advanced Pelvic Surgery, MedStar Washington Hospital Center, Washington, DC.

Reprints: Rachael D. Sussman, MD, MedStar Georgetown University Hospital, 3800 Reservoir Rd, NW-1 PHC, Washington, DC 20007. E-mail: sussman.rachael@gmail.com.

Conflicts of interest and source of funding: none declared.

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