Jacqueline Speed

Jacqueline is a Female Pelvic Floor Medicine and Reconstructive Surgery Fellow at Stanford University in the Department of Urology. She is particularly interested in voiding dysfunction for men and women with urinary leakage as well as inability to urinate. In her Fellowship Thesis, she is studying decision-making for next-line therapy in patients who have failed medical management for overactive bladder.

Overactive bladder affects 16.5% of adults and is often suboptimally treated with behavioral and medical management alone, with only 20-30% of patients continuing their medications long-term. While additional "third-line" therapies exist and are more effective, only 5-15% of patients with overactive bladder pursue these treatments. It is not known why so few patients go on to receive third-line therapies, though insufficient patient counseling may play a role. While there is limited qualitative data on factors that may affect treatment decisions, there have been no prior studies quantifying the relative value patients place on treatment factors.

Adaptive choice-based conjoint analysis will be used to better understand how patients value different aspects of third-line therapies with the goal to improve patient-physical shared decision-making and ultimately increase utilization of third-line therapies.