Patient-Reported Outcome Measures (PROMs) capture treatment effects from the patient perspective and are increasingly recognized as essential in outcome-based urology. In idiopathic overactive bladder (OAB), several validated PROMs exist, but their use in clinical practice is limited because it is unclear how changes in PROMs relate to clinically meaningful improvement. This study aimed to determine the Minimal Clinically Important Difference (MCID) for three key OAB PROMs: the Overactive Bladder Questionnaire Short Form (OAB-q SF), Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7), in patients undergoing one-week Percutaneous Nerve Evaluation (PNE) prior to sacral neuromodulation (SNM).

This prospective cohort study included patients with idiopathic OAB completing the OAB-q SF, UDI-6, and IIQ-7 at baseline and during PNE. The Patient Global Impression of Improvement (PGI-I) served as the anchor for MCID determination. Receiver Operating Characteristic (ROC) analysis compared absolute and relative changes in PROM scores, with the metric showing the highest area under the curve (AUC) used to define the MCID corresponding to the highest Youden index.

A total of 46 patients were included. All patients with a positive PNE reported improvement (PGI-I score ≥1), whereas patients with a negative PNE reported no improvement (PGI-I = 0). The OAB-q SF symptom subscale demonstrated the highest discriminative performance (AUC = 0.730), outperforming UDI-6 (AUC = 0.619), OAB-q SF quality-of-life subscale (AUC = 0.652), and IIQ-7 (AUC ≤ 0.499). Relative change showed better discrimination than absolute change for OAB-q SF symptom and UDI-6 scores. The corresponding MCID values were: 
•	OAB-q SF symptom: 36.4% relative improvement
•	UDI-6: 56.3% relative improvement
•	OAB-q SF QoL: 7.7-point absolute change
•	IIQ-7: 16.7-point absolute change.

These findings indicate that the OAB-q SF symptom subscale most reliably identifies clinically meaningful improvement during PNE. Relative changes in PROM scores provide superior discrimination over absolute changes, suggesting that percentage-based thresholds are preferable for interpreting patient-reported outcomes in idiopathic OAB.

A ≥36% relative improvement on the OAB-q SF symptom subscale represents a clinically important response during PNE in patients with idiopathic OAB. This supports the use of the OAB-q SF symptom subscale as the preferred PROM for assessing treatment response and guiding patient selection for sacral neuromodulation. Collection of bladder diary metrics will further refine PROM-based criteria, enhancing patient-centered decision-making in idiopathic OAB management.

Continence 19S (2026) 102687
DOI: 10.1016/j.cont.2026.102687