Reevaluation of the Acute Cystitis Symptom Score, a Self-Reporting Questionnaire. Part II. Patient-Reported Outcome Assessment

Abstract

This study aimed to reevaluate the Acute Cystitis Symptom Score (ACSS). The ACSS is a self-reporting questionnaire for the clinical diagnosis of acute uncomplicated cystitis (AC) and the assessment of symptomatic changes after therapy in female patients with AC. The part II of the present study was to reevaluate the utility of the different domains of the ACSS after therapy. The applicability of these domains in assessing changes in symptoms, as a function of time, in this population was investigated. The ACSS was evaluated in 48 female patients (mean age 31.1 ± 10.6) in the Uzbek and Russian languages, who returned after therapy and filled in part B of the ACSS, which corresponds to part A with the additional “Dynamics” domain. Descriptive statistics were used, where suitable. The reduction of typical symptoms and quality of life assessment between first and follow-up visit correlated significantly with answers in the “Dynamics” domain. Success/Cure and Non-success/Failure could be clearly differentiated by the scores obtained in “Typical” and “Quality of Life” domains. The ACSS has proven to be a useful instrument to clinically diagnose AC in women. It is also a suitable instrument for patient-reported outcome measures, with applicability both in daily practice and clinical studies. Slight modifications in the “Dynamics” domain will even increase the applicability.

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

“…It contains 10 subjective and 1 objective signs and symptoms divided into typical, such as frequent urination (frequency), urgent urination (urgency), painful urination (dysuria), feeling incomplete bladder emptying, pain in the lower abdomen (suprapubic pain) and visible hematuria, and so-called differential (flank pain, abnormal vaginal discharge, discharge from the urethra, feeling fever/high body temperature and measured hyperthermia) domains [19][20][21][22]. Different language versions of the ACSS can be found in the ACSS website http://www.acss.world.…”

Effect of a Herbal Therapy on Clinical Symptoms of Acute Lower Uncomplicated Urinary Tract Infections in Women: Secondary Analysis from a Randomized Controlled Trial

“…In addition, the proportion of "clinically cured" patients on Day 7 was significantly higher in the verum group compared to the placebo group. The definition of clinical cure as used in this post-hoc analysis is however rather strict and was adjusted from an earlier analysis, in which Alidjanov et al [23] used a sum-score of 4 or less including all six ACSS symptoms with no individual symptom score above 1 (mild).…”

“…This means that the following patients were excluded from microPP: patients whose bacterial count was less than 10 4 CFU/mL at the time of inclusion patients whose urine cultures were contaminated and, therefore, not evaluable patients who took concomitant medication that could influence the results of the urine cultures. For this secondary analysis, we defined a new patient-relevant clinical endpoint (i.e., clinical improvement of symptoms) based on the Acute Cystitis Symptom Score (ACSS) (Table S3), a validated, standardized self-reporting questionnaire used to evaluate the symptoms of acute uncomplicated cystitis in women [22][23][24][25][26]. In addition, we analyzed whether the herbal combination reduced the rate of antibiotic use.…”

“…Thus, from the reported symptoms, three so-called ACSS-symptoms could be adapted and determined according to Alidjanov et al [23] (symptom 1 = 'pollakisuria', symptom 3 = 'dysuria', and symptom 5 = 'suprapubic pain').…”

“…To this end, new symptomatic endpoints based on the Acute Cystitis Symptom Score (ACSS) were defined. The ACSS is a validated, standardized self-reporting questionnaire used to evaluate the symptoms of acute uncomplicated cystitis in women, which can be used for clinical diagnostics and patient-reported outcome assessment [22][23][24][25]. In addition, the proportion of patients who required additional antibiotic therapy to treat their acute lower uUTIs was analyzed more closely.…”