Bazaev V V, Shibaev A N, Pavlova Yu V
M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow.
Urologiia. 2016 Nov(5):27-31.
The IPSS-QOL questionnaire is frequently used to assess symptoms and quality of life of men with urethral strictures. However, the psychometric properties of the questionnaire in assessing these patients have not been evaluated.
To test the psychometric properties of the IPSS-QoL questionnaire in assessing patients with anterior urethral strictures.
Thirty five men with anterior urethral strictures self-completed the IPSS-QoL questionnaire. The reliability of the questionnaire was estimated by computing Cronbachs coefficient and the "point-scale" correlation coefficients. Validity was assessed by the "external criteria" - the correlations between the questionnaire scores and objective indicators - maximum urinary flow rate (Qmax) and residual urine volume (Ures), between QoL scores and index values and EQ-5D scores using a VAS rating scale.
The content validity of the IPSS-QoL was assessed by experts and patients: the storage symptoms were found insignificant for patients with anterior urethral stricture, while the symptoms of primary importance (post-micturition dribbling) were not covered. Cronbachs coefficient of reliability was 0.65 (0.55-0.69 with one of the questions removed), i.e. it was below the generally accepted threshold of 0.7. The "point-scale" correlation coefficients ranged from 0.146 to 0.585; for 2 of the 7 questions they were lower, than the conventional threshold of 0.2, showing the internal inconsistencies of the questionnaire. The construct validity assessment showed no correlation between the questionnaire scores and objective indicators Qmax (R=0.178, p=0.306), Ures (R=-0.074, p=0.673). Correlations between QoL scores and index values and EQ-5D scores on the VAS were weak and statistically insignificant: R=-0.26, p=0.18 and R=-0.21, p=0.27, respectively.
IPSS-QoL questionnaire in assessing men with anterior urethral stricture does not have sufficient reliability and validity. Its design does not allow for adequate assessment of all the symptoms, reliability indices are unsatisfactory, the questionnaire scores do not correlate with objective indicators. This questionnaire cannot be recommended for evaluating health status and quality of life of this category of patients.
国际前列腺症状评分生活质量问卷（IPSS-QOL问卷）常用于评估尿道狭窄男性的症状和生活质量。然而，该问卷在评估这类患者时的心理测量特性尚未得到评估。
测试IPSS-QoL问卷在评估前尿道狭窄患者时的心理测量特性。
35名前尿道狭窄男性自行完成IPSS-QoL问卷。通过计算克朗巴哈系数和 “量表评分” 相关系数来估计问卷的信度。通过 “外部标准” 评估效度，即问卷得分与客观指标（最大尿流率（Qmax）和残余尿量（Ures））之间的相关性，以及生活质量得分与指数值和使用视觉模拟评分量表（VAS）的EQ-5D得分之间的相关性。
IPSS-QoL的内容效度由专家和患者进行评估：发现储尿症状对前尿道狭窄患者无显著意义，而最重要的症状（排尿后滴沥）未涵盖在内。克朗巴哈信度系数为0.65（去掉其中一个问题后为0.55-0.69），即低于普遍接受的阈值0.7。“量表评分” 相关系数范围为0.146至0.585；7个问题中有2个低于传统阈值0.2，表明问卷存在内部不一致性。结构效度评估显示问卷得分与客观指标Qmax（R = 0.178，p = 0.306）、Ures（R = -0.074，p = 0.673）之间无相关性。生活质量得分与指数值和VAS上的EQ-5D得分之间的相关性较弱且无统计学意义，分别为R = -0.26，p = 0.18和R = -0.21，p = 0.27。
IPSS-QoL问卷在评估前尿道狭窄男性时缺乏足够的信度和效度。其设计无法充分评估所有症状，信度指标不令人满意，问卷得分与客观指标不相关。不推荐使用该问卷来评估这类患者的健康状况和生活质量。
