Development and Validation of the Quality of Erection Questionnaire

Abstract

Introduction There are no psychometrically validated assessment tools designed to solely and specifically evaluate satisfaction with the quality of erections. Aim To develop and psychometrically analyze the Quality of Erection Questionnaire (QEQ), a new patient-reported measure developed to evaluate men’s satisfaction with the quality of their erections. Methods The questionnaire was developed through in-depth qualitative interviews of men with erectile dysfunction (ED) in the United States and Australia. An exploratory methodology study was conducted on 65 men with ED. Subsequently, the psychometric properties were confirmed in a larger dataset of 558 men with ED from two combined clinical trials. Main Outcome Measures Identification of potential redundancy or outliers in items (Pearson inter-item correlations); exploratory factor analysis (unrotated and varimax rotated); internal consistency (Cronbach’s alpha); convergent validity (Pearson correlation coefficients between the QEQ total score and domain scores of the International Index of Erectile Function); known-groups validity (ability of the QEQ scores to differentiate between ED severity groups); test–retest reliability (Pearson correlation coefficient). Results The QEQ demonstrated excellent convergent and known-groups validity. Additional analysis demonstrated high internal consistency (Cronbach’s alpha, 0.92). Item analysis demonstrated a unidimensional structure and suggested that satisfaction with hardness may be the key driver for satisfaction with overall quality of erections (r = 0.8). The smaller exploratory study demonstrated good test–retest reliability (r = 0.82). Conclusion The QEQ is a six-item, patient-reported measure with a unidimensional structure, which produces a total score that may be transformed to a 0–100 scale. Psychometric analysis confirmed reliability and validity of the QEQ, which solely and specifically evaluates satisfaction of men with the quality of their erections. The QEQ is a potentially useful measure for monitoring and evaluating treatment in those who are bothered by, or concerned about, their erectile function.

Clinically meaningful improvement on the quality of erection questionnaire in men with erectile dysfunction

“…3 Unlike other ED-specific PROs, the QEQ is the only psychometrically validated PRO designed to solely and specifically evaluate satisfaction with the quality of erections. 2,3 Satisfaction with the quality of erections is a key measure for assessing ED because 'lack of satisfaction is a prerequisite to concern or bother, the drivers of treatment-seeking behavior'. 2 Unless a man is dissatisfied with the quality of his erections, he will be unlikely to treat his ED.…”

“…2,3 Satisfaction with the quality of erections is a key measure for assessing ED because 'lack of satisfaction is a prerequisite to concern or bother, the drivers of treatment-seeking behavior'. 2 Unless a man is dissatisfied with the quality of his erections, he will be unlikely to treat his ED. In the treatment of ED, erection hardness (which can be easily monitored with the Erection Hardness Score) and erection maintenance were the primary attributes sought by patients.…”

“…1,2 Although the past decade has seen the development of many PROs to evaluate ED, 3 the QEQ is unique in that it is the only psychometrically validated assessment tool designed to solely and specifically evaluate satisfaction with the quality of erections. 2,3 The development and validation of the QEQ were described previously. 2 In prospective trials of flexible-dose sildenafil citrate (25,50 or 100 mg) for the treatment of men with ED, the mean ± s.d.…”

“…2,3 The development and validation of the QEQ were described previously. 2 In prospective trials of flexible-dose sildenafil citrate (25,50 or 100 mg) for the treatment of men with ED, the mean ± s.d. transformed QEQ total score increased by more than 40 points, from baseline values of 22 1 and 34 4 points, in men treated with sildenafil.…”

An assessment of patient-reported outcomes for men with erectile dysfunction: Pfizer's perspective

“…16 The International Index of Erectile Function (IIEF)-and especially its Erectile Function (EF) domain-is widely accepted as the standard PRO to assess erectile function of men in clinical trials of ED. [16][17][18][19] Other well-known PROs in clinical trials include the Sexual Health Inventory for Men (SHIM), [20][21] Quality of Erection Questionnaire (QEQ), [22][23] the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), 24 the Self-Esteem And Relationship questionnaire (SEAR) [25][26][27] and the Erection Hardness Score (EHS). [28][29][30] A recent member to the list of PROs is the Sexual Experience Questionnaire (SEX-Q).…”