Silva Caroline S, Freitas Katia S, R Ribeiro Anna Paloma, Gomes Cristiano M, Bessa Junior Jose
Department of Public Health, State University of Feira de Santana, Feira de Santana, Bahia, Brazil.
Division of Urology, Medical School, University of São Paulo, Sao Paulo, Sao Paulo, Brazil.
PeerJ. 2020 May 25;8:e9039. doi: 10.7717/peerj.9039. eCollection 2020.
Lower urinary tract symptoms (LUTS) are common complaints in the adult male population and have a negative affect in the quality of life and represent an economic burden for the healthcare system worldwide. The International Prostatism Symptom Score (IPSS) is a validated tool for assessing these symptoms, but patients with low literacy may have difficulties comprehending and completing it accurately. The Urgency, Weak Stream, Incomplete Emptying, and Nocturia (UWIN) questionnaire was developed as a shorter tool in the assessment of LUTS to improve accuracy and minimize error. This study aimed at performing cross-cultural adaptation to Brazilian Portuguese and validation of UWIN questionnaire for patients with LUTS. The cross-cultural adaptation followed the steps of conceptual, item, semantic, operational, and pre-test equivalence to obtain the UWIN-Br version. The IPSS (gold standard) and UWIN-Br were coadministered, and information regarding the uroflowmetry examination was also recorded. We evaluated 306 men, median age 59 [52-66] years. There was a positive correlation = 0.804 ( < 0.001) between the total IPSS score and the total UWIN-Br score, as well as the quality of life question ( = 0.761) ( < 0.001). The Bland-Altman plot showed good agreement between. Also, we observed that the maximum flow values decreased with the severity of the LUTS. UWIN-Br demonstrated excellent diagnostic accuracy in detecting the most severe cases. The area under the ROC curve was 89% [81-97%] 95% CI. 280 (91.5%) subjects completed the questionnaires without help, while 26 (8.5%) did so through an interview. The response time was 1.2 [1.0-1.5] min for UWIN-Br and 2.8 [2.2-3.4] min for IPSS ( < 0.001). UWIN-Br presents satisfactory and similar psychometric properties to the IPSS in the evaluation of LUTS and quality of life and is suitable for use in both clinical practice and research in our country.
下尿路症状（LUTS）是成年男性群体中的常见主诉，对生活质量有负面影响，并且给全球医疗保健系统带来经济负担。国际前列腺症状评分（IPSS）是评估这些症状的有效工具，但文化程度低的患者可能难以理解并准确完成该评分。尿急、尿流变弱、排尿不尽和夜尿症（UWIN）问卷是作为一种更简短的工具开发出来的，用于评估LUTS，以提高准确性并尽量减少误差。本研究旨在对巴西葡萄牙语进行跨文化改编，并对LUTS患者的UWIN问卷进行验证。跨文化改编遵循概念、条目、语义、操作和预测试等效性的步骤，以获得UWIN-Br版本。同时发放IPSS（金标准）和UWIN-Br问卷，并记录尿流率检查的相关信息。我们评估了306名男性，中位年龄59岁[52 - 66岁]。IPSS总分与UWIN-Br总分之间存在正相关（r = 0.804，P < 0.001），生活质量问题得分之间也存在正相关（r = 0.761，P < 0.001）。Bland-Altman图显示两者之间具有良好的一致性。此外，我们观察到最大尿流率值随LUTS严重程度的增加而降低。UWIN-Br在检测最严重病例方面表现出出色的诊断准确性。ROC曲线下面积为89%[81 - 97%]，95%置信区间。280名（91.5%）受试者在无需帮助的情况下完成了问卷，而26名（8.5%）受试者通过访谈完成。UWIN-Br的回答时间为1.2分钟[1.0 - 1.5分钟]，IPSS的回答时间为2.8分钟[2.2 - 3.4分钟]（P < 0.001）。在评估LUTS和生活质量方面，UWIN-Br呈现出与IPSS令人满意且相似的心理测量学特性，适用于我国的临床实践和研究。
