Abstract
This study aimed to reevaluate the Acute Cystitis Symptom Score (ACSS). The ACSS is a simple and standardized self-reporting questionnaire for the diagnosis of acute uncomplicated cystitis (AC) assessing typical and differential symptoms, quality of life, and possible changes after therapy in female patients with AC. This paper includes literature research, development and evaluation of the ACSS, an 18-item self-reporting questionnaire including (a) six questions about “typical” symptoms of AC, (b) four questions regarding differential diagnoses, (c) three questions on quality of life, and (d) five questions on additional conditions that may affect therapy. The ACSS was evaluated in 228 women (mean age 31.49 ± 11.71 years) in the Russian and Uzbek languages. Measurements of reliability, validity, predictive ability, and responsiveness were performed. Cronbach’s alpha for ACSS was 0.89, split-half reliability was 0.76 and 0.79 for first and second halves, and the correlation between them was 0.87. Mann-Whitney U test revealed a significant difference in scores of the “typical” symptoms between patients and controls (10.50 vs. 2.07, p < 0.001). The optimal threshold score was 6 points, with a 94% sensitivity and 90% specificity to predict AC. The “typical” symptom score decreased significantly when comparing before and after therapy (10.4 and 2.5, p < 0.001). The reevaluated Russian and Uzbek ACSS are accurate enough and can be recommended for clinical studies and practice for initial diagnosis and monitoring the process of the treatment of AC in women. Evaluation in German, UK English, and Hungarian languages was also performed and in other languages evaluation of the ACSS is in progress.
Highlights
Urinary tract infections (UTIs) are common, with an estimated annual global incidence of at least 250 million, with the vast majority (84%) of visits related to female patients presenting with acute uncomplicated cystitis (AC) [1,2,3]
The following main symptoms of women diagnosed with AC were identified: frequent voiding of small volumes, urgency, painful urination, feeling of incomplete bladder emptying after voiding, suprapubic discomfort and hematuria
Our study aimed to develop a highly sensitive and specific as well as simple patient self-reporting questionnaire assessing the symptoms of AC and their impact on quality of life, differentiating AC from other urogynecological disorders with similar symptomatology, and assessing treatment efficacy
Summary
Urinary tract infections (UTIs) are common, with an estimated annual global incidence of at least 250 million, with the vast majority (84%) of visits related to female patients presenting with acute uncomplicated cystitis (AC) [1,2,3]. AC is a benign condition, recurrent episodes are associated with a reduction in quality of life, a negative impact on everyday activity and working ability, disturbances in sexual life and psychosexual disorders [4,5,6]. Various urinary symptoms have been used to assess the diagnosis and severity of AC in women. Questionnaires, and symptom scores used in these studies were mainly adapted from other tools. A few publications devoted to the studies regarding the development of the questionnaires, evaluating the severity of symptoms of the AC and their interference with activities [15,16]. Up to today, no single, unified, valid, and specific questionnaire existed for diagnosis, differential diagnosis, assessment of symptoms’ severity, and quality of life that is available to monitor treatment efficacy [4,15,16,17]
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