Editorial Comment

Abstract

Standardized questionnaires can be used to record the manifestations of an illness from the patient's perspective. These data can be used to measure symptom severity, predict prognosis, and quantify the response to treatment. Although symptoms are fundamentally subjective, well-designed questionnaires can measure them objectively. In fact, in the assessment of the impact of benign prostatic hyperplasia, measures of symptom severity can be more reproducible over time than measures often thought to be more objective, such as peak uroflow rates and prostate-specific antigen levels. 1 Barry M.J. Girman C.J. O'Leary M.P. et al. Using repeated measures of symptom score, uroflowmetry and prostate specific antigen in the clinical management of prostate disease: Benign Prostatic Hyperplasia Treatment Outcomes Study Group. J Urol. 1995; 153: 99-103 Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar The 7-item lower urinary tract symptoms questionnaire included in the International Prostate Symptom Score (IPSS), also known as the American Urological Association Symptom Index, has stood the test of time as a measure of lower urinary tract symptoms among older men, both for assessing symptom severity at the baseline and measuring the effect of treatment, and has been translated into many languages. However, the widespread international problem of limited literacy can interfere with the use of self-administered questionnaires, including the IPSS. What can be done to capture similar information among patients with this problem? First, interviewer administration of the symptom scale in the IPSS has been shown to yield similar results. 2 Barry M.J. Fowler F.J. Chang Y. et al. The American Urological Association Symptom Index: does mode of administration affect its psychometric properties?. J Urol. 1995; 154: 1056-1059 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Although interviewer administration is seen as labor intensive, it is much less so and can be done by personnel with less training than for other clinical data, such as uroflowmetry. In this article, the authors 3 Ceylan Y, Gunlusoy B, Degirmenci T, et al. Is new visual prostate symptom score useful as International Prostate Symptom Score in the evaluation of men with lower urinary tract symptoms? A prospective comparison of 2 symptom scores in Turkish society. Urology. 2015;85:653-658. Google Scholar tested a previously developed Visual Prostate Symptom Score as an alternative to a self-administered IPSS among Turkish men about half of whom had primary school educations. The pictograms in the score cover 4 items: day frequency, nocturia, strength of stream, and overall happiness with the symptom state. As in previous studies, more men were able to complete the visual score than the IPSS without assistance. They found that total scores on the pictogram scale explained about half the variation in the total IPSS (although possibly summing the eighth quality of life question with the 7 symptom questions, which would not be recommended). This relatively weak correlation might be due to reliability problems with both scales in this population (measuring retest reliability would help sort this out), or that the scales are measuring somewhat different constructs. Both questionnaires are better that not trying to objectively measure symptoms, but they do not appear to be measuring the same thing. Is New Visual Prostate Symptom Score Useful as International Prostate Symptom Score in the Evaluation of Men With Lower Urinary Tract Symptoms? A Prospective Comparison of 2 Symptom Scores in Turkish SocietyUrologyVol. 85Issue 3PreviewTo evaluate the correlation between the visual prostate symptom score (VPSS) and the International Prostate Symptom Score (IPSS) and uroflowmetry parameters in Turkish men with lower urinary tract symptoms. Full-Text PDF ReplyUrologyVol. 85Issue 3PreviewWe are pleased to be given the opportunity to state our opinions about the editorial comment.1 The relevance of symptom scores in choosing the correct treatment modality and to monitor the patient afterward is controversial. The International Prostate Symptom Score (IPSS) is a validated and standard questionnaire for the objective assessment of lower urinary tract symptoms throughout the world, currently. However, IPSS scores of different patients are not directly comparable because of interindividual differences about perception and understanding of the symptoms and the questions. Full-Text PDF