The Neurogenic Bladder Symptom Score (NBSS): A secondary assessment of its validity, reliability among people with a spinal cord injury

Blayne Welk, Sara Lenherr, Sean Elliott, John Stoffel, Angela P. Presson, Chong Zhang, Jeremy B. Myers

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Study design: Prospective cross-sectional study. Objectives: Validate the Neurogenic Bladder Symptom Score (NBSS) for people with spinal cord injury (SCI). Setting: United States (recruitment from community/tertiary neurourology clinics). Methods: We used data from a prospective observational study of people with a SCI who enrolled during December 2015-September 2016. Participants completed the NBSS and other measurement tools (SF-12 and SCI-QOL Bladder Management Complications tool). Data were used to determine the internal consistency (Cronbach's alpha), validity (hypothesis testing), and test-re-Test reliability (using an intraclass correlation coefficient). Results: 609 people with a SCI had complete data. The median NBSS total score was 22 (IQR 15-30), and median quality of life was "mixed". The Cronbach's alpha of the total and the incontinence, storage/voiding, and consequences domains was 0.85, 0.93, 0.76, and 0.49 respectively. All item to domain correlations were ≥0.3, aside from 3/7 of the items from the consequences domain. Appropriate correlations between the NBSS domains and external variables and other questionnaires were observed, such as a moderate correlation between the SCI-QOL Bladder Management complications tool and the NBSS total score. For the reliability assessment, 174 people had 3 month followup data and did not have a significant change to their urologic health. The intraclass correlation coefficients were >0.75 for all subdomains and the overall score. Conclusions: The NBSS demonstrated good validity and reliability in a large cohort of people with a SCI, and is a suitable tool to assess neurogenic bladder symptoms. Sponsorship: Patient-Centered Outcomes Research Institute (PCORI) Award CER14092138.

Original languageEnglish (US)
Pages (from-to)259-264
Number of pages6
JournalSpinal Cord
Issue number3
StatePublished - Mar 1 2018

Bibliographical note

Funding Information:
Acknowledgements This work was (partially) supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER14092138). Disclaimer: All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI.

Publisher Copyright:
© 2017 International Spinal Cord Society.


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