The validity of a single-question self-report of erectile dysfunction

Abstract

OBJECTIVE:To determine how well a single question of self-reported erectile dysfunction compares to a gold standard clinical urologic examination. DESIGN AND SETTING:Clinical validation study nested within the Massachusetts Male Aging Study (MMAS), which is an observational cohort study of aging and health in a population-based random sample of men.MEASUREMENT: During an in-person interview, men were asked to respond to a single-question self-report of erectile dysfunction. A subsample of MMAS participants was then subjected to a clinical urologic examination to obtain a clinical diagnosis of erectile dysfunction. PARTICIPANTS:One hundred thirty-nine men 55 to 85 years of age from the MMAS. RESULTS:Complete data were available from 137 men. Erectile dysfunction (ED) measured by self-report and independent urologic examination were strongly correlated (Spearman r =.80). Receiver operating curve analysis showed that the self-reported ED item accurately predicts the clinician-diagnosed ED (area under the curve [AUC] =0.888). Stratum-specific likelihood ratios (95% confidence intervals) for selfreports predicting the gold standard were: no ED =0.11 (0.06 to 0.22), minimal ED =1.48 (0.67 to 3.26), moderate ED =8.57 (1.21 to 60.65), and complete ED =12.69 (1.81 to 88.79). These data indicate that men diagnosed with ED by urologic examination can be distinguished from men not diagnosed with ED by urologic examination if the respondent self-reported no, moderate, or complete ED. CONCLUSION:Our single-question self-report accurately identifies men with clinically diagnosed ED, and may be useful as a referral screening tool in both research studies and general practice settings. (Table 1). We have previously shown that self-administration of this single question correlates well with the IIEF and the BMSFI, and that the proportion with missing data for the single question (9%) was similar to that for the BMSFI (8%) and lower than that for the IIEF (18% METHODSThe MMAS is an observational cohort study of health and aging in a population-based random sample of men. The design has been well-described elsewhere. 3,22,23 As part of the in-person interview, respondents were queried about erectile function with a single question. Table 1 presents the ED single question as it was presented to respondents in the MMAS. The substudy was described to all participants at the conclusion of the in-person interview, and each was offered the opportunity to participate. They were told that participation was strictly voluntary and independent of their participation in

Erectile Dysfunction and Undiagnosed Diabetes, Hypertension, and Hypercholesterolemia

“…This single, self-reported question has previously been validated for clinical erectile dysfunction. 7 Using an approach similar to that used in previous studies, 8 we considered men who responded "never able" or "sometimes able" to have erectile dysfunction and considered those who responded "usually able" or "always or almost always able" to have normal erectile function.…”

Risk factors of erectile dysfunction and penile vascular changes after surgical repair of penile fracture

“…All patients were re-evaluated using the Sexual Health Inventory for Men questionnaire for married cases, 20 and the single question self-report of ED was used for single cases. 21 Local examination was carried out for all patients to detect penile deviation and fibrotic scaring. Patients with ED were evaluated by CDU.…”

The impact of the use of PDE5 inhibitors for erectile dysfunction on the lives of Australian men

“…Clinical assessment tools have been noted to potentially be oversensitive and classify people from the general population as dysfunctional when they may not have perceived themselves as such, 21 and hence these assessment measures were deemed inappropriate for use in this study. It has been demonstrated that single-item measures of self-reported experiences of ED are able to predict clinically diagnosed ED with reasonable accuracy; 22 however, it is noted that validated measures of ED would be more appropriate and would have allowed comparison of participants' subjective ratings against a validated objective rating scale. Greater confidence could be placed in the causative nature of the relationships in the current study through the use of a longitudinal study design and through use of matched samples.…”