Validity of self-reported male sexual function scales in a young Chinese population: a comparative study with clinician-assisted evaluation

Abstract

Psychometric scales, commonly used to gauge sexual function, can sometimes be influenced by response biases. In our research from June 2020 to April 2021, we examined the accuracy of self-reported sexual function scales. We invited patients from the Department of Infertility and Sexual Medicine at the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China), who have male sexual dysfunction, to participate by filling out a self-reported version of a specific questionnaire. In addition, they went through a clinician-assisted version of this questionnaire, encompassing tools such as the Premature Ejaculation Diagnostic Tool (PEDT), the 6-item International Index of Erectile Function (IIEF-6), the Erection Hardness Scale (EHS), and the Masturbation Erection Index (MEI). Using the clinician-assisted version as a reference, we categorized patients and applied various statistical methods, such as the Chi-square test, intraclass correlation coefficient (ICC), logistic regression, and the Bland–Altman plot, to gauge reliability. In our study with 322 participants, we found that while there were no notable discrepancies in error rates based on our categorization, certain scales showed significant differences in terms of overestimation and underestimation, with the exception of the PEDT. The positive diagnosis rate consistency between the self-reported and clinician-assisted versions was observed. High ICC values between the two versions across the scales were indicative of remarkable reliability. Our findings show that the self-reported versions of tools such as EHS, IIEF-6, MEI, and PEDT are credible and hold clinical reliability. However, employing a dual-diagnosis approach might be more prudent to circumvent potential misdiagnoses.