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The FIGO assessment scoring system (FASS): a new holistic classification tool to assess women with pelvic floor dysfunction: validity and reliability

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Abstract

Introduction and hypothesis

The aim of our study was to assess the interobserver and intraobserver reliability as well as the content and construct validity of the FIGO prolapse assessment scoring system (FASS).

Methods

Women with and without (controls) symptoms of pelvic organ prolapse (POP) attending gynaecology outpatient clinics in four different countries were recruited prospectively. Each woman was assessed using the FASS which included: (1) physical examination findings designated with the letter P; (2) presence of symptoms of prolapse, urinary and bowel symptoms designated with the letter S; and (3) assessment of degree of bother designated with the letter B. A scoring system was also developed. For interobserver reliability women were examined by two separate examiners using the FASS. For intraobserver reliability the FASS was repeated by the same examiner within 2 weeks. The interclass correlation coefficient (ICC) was also calculated to assess limits of agreements. Validity was assessed by comparing the FASS scores between symptomatic and asymptomatic women using the Mann-Whitney U test (p value <0.001).

Results

A total of 177 women (98 symptomatic and 79 controls) were recruited. Intraobserver reliability had ICCs between 0.716 and 1. Interobserver reliability had ICCs between 0.795 and 0.909. Domain and total scores were significantly different between symptomatic and asymptomatic women (p < 0.001, Mann-Whitney U test). There was a good correlation between FASS P scores and POP-Q scores (rho 0.763, p < 0.001).

Conclusions

The FIGO prolapse assessment scoring system has good intraobserver and interobserver agreement and has demonstrated both content and construct validity.

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Conflicts of interest

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Authors and Affiliations

  1. Department of Urogynaecology, S. Mary’s Hospital, Academic Department of Obstetrics and Gynaecology, Mint Wing, South Wharf, W2 1NY, London, UK

    G. Alessandro Digesu, Federica Puccini, Vik Khullar & Ruwan Fernando

  2. Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA

    Steven Swift

  3. Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Jittima Manonai

  4. Ob/Gyn Department, School Hospital Jose De San Martin, Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina

    Oscar Contreras Ortiz

  5. Department of Urogynaecology, Ospedale San Raffaele, Milan, Italy

    Stefano Salvatore

Authors
  1. G. Alessandro Digesu
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  2. Steven Swift
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  3. Federica Puccini
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  4. Jittima Manonai
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  5. Vik Khullar
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  6. Ruwan Fernando
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  7. Oscar Contreras Ortiz
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  8. Stefano Salvatore
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Corresponding author

Correspondence to G. Alessandro Digesu.

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Digesu, G.A., Swift, S., Puccini, F. et al. The FIGO assessment scoring system (FASS): a new holistic classification tool to assess women with pelvic floor dysfunction: validity and reliability. Int Urogynecol J 26, 859–864 (2015). https://doi.org/10.1007/s00192-014-2604-6

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  • DOI: https://doi.org/10.1007/s00192-014-2604-6

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