Mallya Ashwin, Keshavamurthy Ramaiah, Karthikeyan Vilvapathy S, Kumar Sumit, Nagabhushana Mahadevappa, Kamath Ananth J
Department of Urology, Institute of Nephrourology, Bangalore, India.
Low Urin Tract Symptoms. 2018 May;10(2):131-134. doi: 10.1111/luts.12149. Epub 2017 Mar 3.
The American Urology Association symptom index (AUASI) is the most accepted tool to assess lower urinary tract symptoms (LUTS). UWIN (urgency, weak stream, incomplete void, nocturia) score is a simplified questionnaire with fewer and more distinctive options omitting three questions from AUASI. We sought to identify if UWIN is equally efficient in capturing LUTS and could replace the gold-standard AUASI.
Consecutive consenting male patients with benign prostatic hyperplasia (BPH)-LUTS were randomized to receive either UWIN/AUASI questionnaire first followed by the other. Education levels, time taken to complete, need for assistance, ease of comprehension and satisfaction to symptom assessment were assessed for each questionnaire. Correlation analysis was done for corresponding items, total and QoL scores on both questionnaires.
Total of 294 completely filled questionnaire pairs were analyzed. Between corresponding UWIN and AUASI items, there was 93-97% correlation. When obstructive and irritative scores were added, correlation was 85% and for QOL scores 89%. Overall, AUASI required more assistance (58 vs 34%, P < 0.001), took longer to complete (11.2 vs 4.8 min, P < 0.001) and required higher educational level for comprehension (P = 0.02). Significantly higher percentage of patients preferred the UWIN and more comprehensible.
UWIN is as effective in capturing LUTS as the gold-standard AUASI in spite of three questions of AUASI being omitted in UWIN. Severity of obstructive and irritative nature of LUTS and quality of life are interpreted similar to AUASI. UWIN is easier to comprehend and rapid, needing lesser assistance even with lower educational status.
美国泌尿外科学会症状指数（AUASI）是评估下尿路症状（LUTS）最常用的工具。UWIN（尿急、尿流无力、排尿不尽、夜尿）评分是一份简化问卷，选项更少且更具特异性，它省略了AUASI中的三个问题。我们旨在确定UWIN在捕捉LUTS方面是否同样有效，以及能否取代金标准的AUASI。
连续入选的患有良性前列腺增生（BPH）-LUTS且同意参与的男性患者被随机分为先接受UWIN/AUASI问卷，然后再接受另一份问卷。对每份问卷评估教育水平、完成所需时间、是否需要协助、理解难易程度以及对症状评估的满意度。对两份问卷的相应项目、总分和生活质量（QoL）得分进行相关性分析。
共分析了294对完全填写完整的问卷。在UWIN和AUASI的相应项目之间，相关性为93%-97%。当加入梗阻性和刺激性得分时，相关性为85%，QoL得分的相关性为89%。总体而言，AUASI需要更多协助（58%对34%，P<0.001），完成时间更长（11.2分钟对4.8分钟，P<0.001），且理解所需教育水平更高（P=0.02）。明显更高比例的患者更喜欢UWIN且认为其更易于理解。
尽管UWIN省略了AUASI的三个问题，但在捕捉LUTS方面与金标准的AUASI同样有效。LUTS的梗阻性和刺激性严重程度以及生活质量的解读与AUASI相似。UWIN更易于理解且快速，即使教育程度较低也需要更少的协助。
