Stress Urinary Incontinence Measures

The American Urological Association (AUA) led an effort in concert with the American Congress of Obstetricians and Gynecologists (ACOG) to develop stress urinary incontinence (SUI) measures based on the AUA's Guideline for Surgical Management of Female Stress Urinary Incontinence: 2009 Update and other available evidence. An interdisciplinary technical expert panel, including representatives from primary care, geriatrics, urogynecology, nursing and private insurers, as well as the American Board of Urology, the American Medical Association, the American College of Surgeons and the U.S. Food and Drug Administration, was convened to develop a set of quality measures focused on achieving better outcomes for female patients with SUI. The panel was co-chaired by Roger R. Dmochowski, MD, and Peggy A. Norton, MD.

This project began under the auspices of the independent measure development process of the American Medical Association Physician Consortium for Performance Improvement (AMA PCPI). Members of the technical panel, together with AUA staff and representatives from PCPI, created a proposed measure set, which aims to ensure that effective treatment for SUI is appropriately applied and that the success of such treatment is ensured. These measures are designed for practitioner-level quality improvement and are appropriate for the ambulatory/office-based setting

Near the end of the measure development process, the National Quality Forum (NQF) announced that it would test a new process for approving quality measures by launching a pilot project focused on gastrointestinal and genitourinary measures. The new process has two components — Stage 1, where the measure concept is reviewed, and Stage 2, in which the measures are tested for reliability, validity, usability and feasibility. The AUA seized this opportunity and submitted a set of five stress urinary incontinence (SUI) measures.

At this time, the status of the AUA's measures is pending with the NQF. Regardless of the NQF's decision, the AUA will also submit the measures to the PCPI's evaluation and endorsement process. The ultimate goal is to have the measures endorsed and included in national quality measurement programs such as the Center for Medicare and Medicaid's Merit-Based Incentive Payment System. More urology measures would hopefully increase and simplify the participation of urologists.