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Dr. Stephens-Shields on recent MAPP study findings


“We were a bit surprised that the males with IC/BPS didn't look more like the females with regard to the magnitude of decrease in urinary symptom severity required to feel better,” says Alisa J. Stephens-Shields, PhD.

In this video, Alisa J. Stephens-Shields, PhD, discusses notable findings from the Journal of Urology study, “Clinically Important Differences for Pain and Urinary Symptoms in Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study.” Stephens-Shields is an associate professor of biostatistics, epidemiology, and informatics at the University of Pennsylvania Perelman School of Medicine in Philadelphia.


It was really interesting. As I mentioned, part of the MAPP is subtyping and classifying individuals who experience this condition. And so when we were trying to determine the amount of change on these scales that's meaningful to patients, we looked at whether that differed by different characteristics such as whether they had Hunner's lesions ornot, or whether they were males with CP/CPPS [chronic prostatitis/chronic pelvic pain syndrome] only or IC/BPS [interstitial cystitis/bladder pain syndrome], or whether they were female. We looked at whether they had localized or widespread pain, and also whether they had a type of pain that we classified as likely neuropathic or likely non neuropathic using a pain detect scale. It was interesting to us in determining that patients who have particular phenotypes require greater decreases in pain to feel better. So with regard to pelvic pain severity, patients who have Hunner's lesions or who have a likely neuropathic phenotype require a much greater decrease in their pelvic pain severity to report that they feel better. With regard to the urinary symptoms, we observed that females—and, by definition, all of the females in the study had IC/BPS—require larger decreases in urinary symptoms to feel better as compared with males with IC/BPS, or males with CP/ CPPS only. I think those findings were really important just regarding how to perceive observation of changes of different magnitudes on those scales with regard to patients, and what is necessary in treating patients, what types of changes we would like to see in order for the patient to feel that they've improved. As far as results that were surprising, we were a bit surprised that the males with IC/BPS didn't look more like the females with regard to the magnitude of decrease in urinary symptom severity required to feel better. I think that while not surprising as far as there being a greater magnitude of change in pelvic pain severity required to feel better for patients with Hunner's lesions, I think the magnitude of the difference was quite striking. They required decreases that are about twice as large as compared with patients who do not have Hunner's lesions or patients with a likely neuropathic phenotype required decreases twice as large as patients with a non-neuropathic phenotype to feel better and so I think just how drastic the difference was surprising.

This transcription was edited for clarity.

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