Comprehension and construct validity of the Visual Prostate Symptom Score by men with obstructive lower urinary tract symptoms in rural Africa

Stothers, Lynn; Macnab, Andrew; Bajunirwe, Francis; Mutabazi, Sharif; Lobatt, Catherine

doi:10.5489/cuaj.4589

Cited by 12 publications

(11 citation statements)

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“…We evaluated 306 men aged 59 [52-67] years, 26 (8.7%) of whom had severe symptoms, while 99 (33%) had moderate symptoms, and 175 (58.3%) had mild symptoms according to the IPSS (Table -1 The Bland-Altman analysis showed good agreement between the two questionnaires (Figure-2) (bias=0.056; p <0.001). Maximum urinary flow rates were found to be significantly lower in moderate and severe cases when compared to those with mild symptoms, i.e., 12mL/s [8][9][10][11][12][13][14][15][16][17][18] and 17 mL/s [13][14][15][16][17][18][19][20][21][22][23][24][25], respectively (p <0.001), with a median difference of 5mL/s. Furthermore, maximum urinary flow rates decreased in correlation with the pictograms depicting the force of the urinary stream, with the following median Qmax values: A=17.5 [13][14][15][16], B=15 [11][12][13][14][15][16][17][18][19][20][21][22][23], C=12 [8][9]…”

Section: Resultsmentioning

confidence: 99%

“…According to a 2016 study, items that evaluate nocturia and quality of life were deemed unclear by many participants, and the dark pictogram background was also significantly criticized. Suggested improvements included the use of larger images for the pictogra-ms depicting urinary frequency and nocturia and the inclusion of images depicting urinary urgency (19). Although not previously highlighted, we found additional limitations, including the lack of an option for nocturia zero times, typical values for daytime urinary frequency, such as four micturition/day, are scored as increased frequency.…”

Section: Introductionmentioning

confidence: 88%

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Luts-V: A new simplified score for assessing lower urinary tract symptoms in men

et al. 2021

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Objectives: Develop and validate a new and simplified score for evaluating the lower urinary tract symptoms in men. Materials and methods: We modified the existing visual prostate symptom score, including changes in the images, sequence, and new alternatives, resulting in a new visual score (LUTS visual score-LUTS-V). For the validation of the new tool, we used the International Prostatic Symptom Score as the gold-standard and the new LUTS-V to 306 men. The total IPSS score and the total LUTS-V score of each subject were evaluated to determine the agreement between the two instruments. ROC curve was used to evaluate the diagnostic accuracy and best cut-off of LUTS-V. Sensitivity, specificity, and diagnostic odds ratios were used to describe the diagnostic properties. Results: The mean age of the participants was 59 [52-87] years. There was a significant correlation between LUTS-V and IPSS. (r=0.72 (p <0.0001). The Bland-Altman analyzes demonstrate good agreement between the two questionnaires (bias=5.6%). LUTS-V demonstrated excellent diagnostic accuracy in detecting the most serious cases with an area under the ROC curve of 83% [78-87%] 95% CI. p <0.001). LUTS-V >4 was the best threshold, with a sensitivity of 74% and specificity of 78%. Conclusions: LUTS-V is a simple, self-administered tool with a significant discriminatory power to identify subjects with moderate to severe LUTS and may represent a useful instrument for the diagnosis and follow-up of men with urinary symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

Luts-V: A new simplified score for assessing lower urinary tract symptoms in men

et al. 2021

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“…There are several studies on the connection of primary health care providers' level of education on LUTS and their ability to recognize LUTS in patients, as well as on the connection of patients' education on LUTS rehabilitation and their recovery rate. [19][20][21] Certain studies have assessed the connection between a person's educational level and the ability to evaluate the severity of LUTS using questionnaires in rural Africa, 22 or seeking medical help regarding incontinence in women. 23 Others have noted patients' educational level but have not linked it to the ability to assess the presence or severity of LUTS.…”

Section: Introductionmentioning

confidence: 99%

Family Physician’s Educational Interview with Patients Helps in Early Recognition of Lower Urinary Tract Symptoms

Brizić¹,

Mozetič²

2021

IJGM

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Purpose Lower urinary tract symptoms (LUTS) can have an etiology outside the lower urinary tract (LUT) and are therefore an important diagnostic indicator for assessing the overall health of a person. However, LUTS is still mainly neglected by primary health care providers as well as by patients. In this study, we assessed the importance of an educational interview (EI) conducted by a GP on the patients’ ability to recognize LUTS. We also investigated other factors that affect the recognition of LUTS: subjects’ personal educational level, number of LUT symptoms and their bothersome level on a scale 0–10. Patients and Methods This cross-sectional study was conducted in Croatia (2018–2020) by interviewing 499 subjects. We compared recognized LUT symptoms before and after the EI and determined whether their number, their bothersome level, or the subjects’ personal educational level were associated with LUTS recognition. Results EI significantly improved the ability to recognize LUTS (p=0.001). The number of LUT symptoms and bothersome level in subjects before EI was much greater than the number in subjects after EI (p<0.0001, mean>4 and p<0.0001, median>8, respectively). Subjects with higher educational level recognized LUTS with fewer symptoms after the EI (p<0.01), but no difference was observed among subjects who recognized LUTS before the EI. Conclusion For subjects to recognize LUTS, their condition had to be severe – more than 4 symptoms and bothersome level >8/10. Personal educational level had little impact on LUTS recognition. However, an EI proved to be an excellent tool for raising awareness about LUTS and its early recognition.

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“…Simplified questionnaires have been developed and validated and may be more appropriate for the evaluation of subjects with lower education level (Van Der Walt et al, 2011;Eid et al, 2014;Stothers et al, 2017;Mallya et al, 2017;Moses et al, 2017). Among these instruments is the UWIN (Urgency, Weak Stream, Incomplete Emptying and Nocturia), which was developed to facilitate the completion of the IPSS questionnaire, thus making the administration of the questionnaire more efficient.…”

Section: Introductionmentioning

confidence: 99%

Transcultural adaptation and validation of the questionnaire “Urgency, Weak stream, Incomplete emptying and Nocturia (UWIN)” for the Brazilian Portuguese

Silva

Freitas

Ribeiro

et al. 2020

PeerJ

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Lower urinary tract symptoms (LUTS) are common complaints in the adult male population and have a negative affect in the quality of life and represent an economic burden for the healthcare system worldwide. The International Prostatism Symptom Score (IPSS) is a validated tool for assessing these symptoms, but patients with low literacy may have difficulties comprehending and completing it accurately. The Urgency, Weak Stream, Incomplete Emptying, and Nocturia (UWIN) questionnaire was developed as a shorter tool in the assessment of LUTS to improve accuracy and minimize error. This study aimed at performing cross-cultural adaptation to Brazilian Portuguese and validation of UWIN questionnaire for patients with LUTS. The cross-cultural adaptation followed the steps of conceptual, item, semantic, operational, and pre-test equivalence to obtain the UWIN-Br version. The IPSS (gold standard) and UWIN-Br were coadministered, and information regarding the uroflowmetry examination was also recorded. We evaluated 306 men, median age 59 [52-66] years. There was a positive correlation r = 0.804 (p < 0.001) between the total IPSS score and the total UWIN-Br score, as well as the quality of life question (r = 0.761) (p < 0.001). The Bland-Altman plot showed good agreement between. Also, we observed that the maximum flow values decreased with the severity of the LUTS. UWIN-Br demonstrated excellent diagnostic accuracy in detecting the most severe cases. The area under the ROC curve was 89% [81–97%] 95% CI. 280 (91.5%) subjects completed the questionnaires without help, while 26 (8.5%) did so through an interview. The response time was 1.2 [1.0–1.5] min for UWIN-Br and 2.8 [2.2–3.4] min for IPSS (p < 0.001). UWIN-Br presents satisfactory and similar psychometric properties to the IPSS in the evaluation of LUTS and quality of life and is suitable for use in both clinical practice and research in our country.

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Comprehension and construct validity of the Visual Prostate Symptom Score by men with obstructive lower urinary tract symptoms in rural Africa

Cited by 12 publications

References 14 publications

Luts-V: A new simplified score for assessing lower urinary tract symptoms in men

Luts-V: A new simplified score for assessing lower urinary tract symptoms in men

Family Physician’s Educational Interview with Patients Helps in Early Recognition of Lower Urinary Tract Symptoms

Transcultural adaptation and validation of the questionnaire “Urgency, Weak stream, Incomplete emptying and Nocturia (UWIN)” for the Brazilian Portuguese

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