Luján Galán M, Páez Borda A, Martín Osés E, Llanes González L, Berenguer Sánchez A
Servicio de Urología, Hospital Universitario de Getafe, Madrid, España.
Arch Esp Urol. 1997 Oct;50(8):847-53.
The IPSS is a well-known method for symptom evaluation in patients with prostate disease. The present study analyzes the validity of this self-administered questionnaire in a group of patients from an industrial area in Spain.
513 questionnaires (test 1) were sent out to patients with benign prostatic hyperplasia (BPH) who had undergone TUR or adenomectomy. After an interval of 30-60 days, the same questionnaire (test 2) was sent out to all those patients who had correctly answered test 1. The feasibility and reliability of this test in our hands, as well as its ability to discriminate, were determined. Moreover, the relationship between symptoms (S) and quality of life (L) was analyzed.
Patient ages ranged from 50 to 86 years (mean 67.6). A) Feasibility (percentage of patients who answered the questionnaire correctly) was 71%. B) Reliability: internal consistency (Cronbach's alpha) was 0.74 and the retest reliability (correlation between the scores of tests 1 and 2) was 0.76 (Pearson's r) and 0.5 (Kendall's T). C) Correlation between symptoms (S) and quality of life (L) was 0.53 (Pearson) and 0.33 (Kendall). D) Discriminating validity (ability of the test alone to diagnose patients with BPH correctly). The patients in the study were compared with a group of 420 "healthy" males from a prostate cancer screening program; the area below the ROC curve was 0.98 (scantily evaluable: healthy patients vs surgical BPH cases).
In our setting, the self-administered IPSS questionnaire had a moderate feasibility (29% of the patients were unable to understand the questionnaire). Our results, in terms of internal consistency and retest reliability, are similar to those of other validation studies conducted in our country (and appreciably worse than those of the original validation studies in the English language). Nevertheless, some items of the questionnaire have an unacceptable retest reliability, particularly those relating to frequency or urgency. Finally, the total symptom (S) score showed a scanty correlation with quality of life (L). We can conclude that although the IPSS questionnaire is a useful method in the assessment of patients with prostate disease, its reliability remains far from optimal.
国际前列腺症状评分（IPSS）是评估前列腺疾病患者症状的一种常用方法。本研究分析了这份自填式问卷在西班牙某工业区一组患者中的有效性。
向接受经尿道前列腺切除术（TUR）或腺瘤切除术的良性前列腺增生（BPH）患者发放了513份问卷（测试1）。间隔30 - 60天后，向所有正确回答测试1的患者发放相同问卷（测试2）。确定了该测试在我们手中的可行性、可靠性及其鉴别能力。此外，还分析了症状（S）与生活质量（L）之间的关系。
患者年龄在50至86岁之间（平均67.6岁）。A）可行性（正确回答问卷的患者百分比）为71%。B）可靠性：内部一致性（克朗巴哈系数）为0.74，重测可靠性（测试1和测试2得分之间的相关性）为0.76（皮尔逊相关系数r）和0.5（肯德尔等级相关系数T）。C）症状（S）与生活质量（L）之间的相关性为0.53（皮尔逊）和0.33（肯德尔）。D）鉴别效度（该测试单独正确诊断BPH患者的能力）。将研究中的患者与来自前列腺癌筛查项目的420名“健康”男性组成的群体进行比较；ROC曲线下面积为0.98（难以评估：健康患者与手术治疗的BPH病例）。
在我们的研究环境中（29%的患者无法理解问卷），自填式IPSS问卷的可行性一般。就内部一致性和重测可靠性而言，我们的结果与我国进行的其他验证研究相似（明显比英文原版验证研究的结果差）。然而，问卷的一些项目重测可靠性不可接受，特别是那些与排尿频率或尿急相关的项目。最后，总症状（S）评分与生活质量（L）的相关性较弱。我们可以得出结论，尽管IPSS问卷在评估前列腺疾病患者方面是一种有用的方法，但其可靠性仍远非最佳。
