Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
J Urol. 2020 Nov;204(5):1003-1011. doi: 10.1097/JU.0000000000001149. Epub 2020 May 29.
We established severity banding ranges, bother assessment and key item content in principal patient reported outcomes measures in men seeking therapy for lower urinary tract symptoms.
Data for International Prostate Symptom Score (I-PSS) and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) were derived from a study evaluating 820 men at 26 United Kingdom hospitals. ROC curves were used to establish severity bandings.
Classification tree showed that thresholds between mild-moderate and moderate-severe severity bands were 15 and 27 for I-PSS, 16 and 26 for ICIQ-MLUTS/severity, and 22 and 81 for ICIQ-MLUTS/bother, respectively. Highest area under the ROC curve and lowest Akaike's information criteria of univariate logistic regression indicated that ICIQ-MLUTS/bother was more related to global quality of life than were I-PSS and ICIQ-MLUTS/severity. The symptoms affecting I-PSS-quality of life (QoL) were only fully identified by ICIQ-MLUTS, because 2 key symptoms (urinary incontinence and post-micturition dribble) are not measured by I-PSS. ICIQ-MLUTS demonstrated that bother of some lower urinary tract symptoms is disproportionate to severity, and that persisting high bother levels following surgery are more likely due to storage (18% to 25%) and post-voiding (18% to 28%) lower urinary tract symptoms than voiding lower urinary tract symptoms (5% to 13%). Symptom improvement after surgery was uncertain if baseline I-PSS-QoL score was less than 3.
The severity threshold scores were measured for the 2 key lower urinary tract symptoms patient reported outcomes measures, and the results indicate suitable categories of symptom severity for use in men referred for urological care. The ICIQ-MLUTS measures all the lower urinary tract symptoms affecting quality of life and includes individual symptom bother scores.
我们为寻求下尿路症状治疗的男性确定了主要患者报告结局测量指标中的严重程度分级范围、困扰评估和关键项目内容。
国际前列腺症状评分（I-PSS）和国际尿失禁咨询问卷男性下尿路症状（ICIQ-MLUTS）的数据来自于一项在英国 26 家医院评估 820 名男性的研究。ROC 曲线用于建立严重程度分级。
分类树显示，I-PSS 中轻度-中度和中度-重度严重程度分级之间的阈值分别为 15 和 27，ICIQ-MLUTS/严重程度为 16 和 26，ICIQ-MLUTS/困扰为 22 和 81。ROC 曲线下面积最高且单变量逻辑回归的 Akaike 信息准则最低，表明 ICIQ-MLUTS/困扰与整体生活质量的相关性高于 I-PSS 和 ICIQ-MLUTS/严重程度。影响 I-PSS 生活质量（QoL）的症状仅由 ICIQ-MLUTS 完全识别，因为 2 个关键症状（尿失禁和排尿后滴沥）未被 I-PSS 测量。ICIQ-MLUTS 表明，一些下尿路症状的困扰与其严重程度不成比例，并且术后持续存在高困扰水平更可能是由于储存（18%至 25%）和排尿后（18%至 28%）下尿路症状，而不是排尿下尿路症状（5%至 13%）。如果基线 I-PSS-QoL 评分小于 3，则术后症状改善情况不确定。
为 2 个关键下尿路症状患者报告结局测量指标确定了严重程度阈值评分，结果表明适用于泌尿科就诊男性的症状严重程度分类。ICIQ-MLUTS 测量了所有影响生活质量的下尿路症状，并包括个体症状困扰评分。
