Brain Alteration Patterns in Children with Duchenne Muscular Dystrophy: A Machine Learning Approach to Magnetic Resonance Imaging.

Urinary incontinence (UI) is highly prevalent among women, yet it is often under-treated due to embarrassment and stigma. UI affects approximately 50% of women in their lifetime and the condition can be present in women as young as 20 years of age. As women become older, the likelihood of experiencing UI increases and can be a predictor of poor physical, social, sexual, and mental health that can worsen based on the severity of the condition. Although this condition can be managed through various non-invasive (nonpharmacologic and pharmacologic) and surgical treatments, many women do not discuss UI with their primary care provider (PCP). Many believe that UI is a normal part of aging, or are embarrassed by the condition, causing them to sit in silence. Alternatively, PCPs may not always discuss UI with their patients because of the discomfort associated with diagnosing and treating UI, and a need to prioritize other conditions that must be addressed during a time-limited appointment. Screening for UI is the first step in identifying bothersome UI. The Women’s Preventative Services Initiative recommends conducting annual screenings for UI and this recommendation is now a Medicare quality measure. Once a patient screens positive and UI is addressed, then non-surgical management of UI can begin, and quality of life can improve. However, it is unknown what methods of UI screening are most efficacious in triggering a conversation between provider and patient. Therefore, for this project, which was part of a larger primary care pilot intervention study to improve UI care, we hypothesized that if a patient reported experiencing new or bothersome UI, and their provider was notified prior to the appointment, then a discussion surrounding the patient’s UI symptoms would take place at the appointment 50% of the time. The project aims included (1) testing the feasibility of an online screening method to identify patients with new or worsening bothersome UI; and (2) measure the proportion of screen-positive women who discussed UI with their provider.