Effect of administration mode (patient vs physician) and patient's educational level on the Turkish version of the International Prostate Symptom Score

Abstract

Objectives : To compare the effectiveness of the International Prostate Symptom Score (IPSS) when administered by the physician to when self-administered by the patient. The effect of the patient's educational level on the IPSS was also evaluated. Methods : One hundred and seven previously untreated patients with symptomatic benign prostatic hyperplasia (BPH) completed the Turkish version of the International Prostate Symptom Score (Turkish I-PSS) and quality of life (QOL) questionnaires during a single office visit, first on their own and then with an interviewing physician. The patients were categorized into three groups according to their educational levels. Paired t -tests were performed to compare the total IPSS (tIPSS) and QOL results between the two testing modes. IPSS and QOL scores resulting from both modes were compared using a kappa test. Differences between the physician-assisted and self-administered scores among the different educational groups were further compared using a one-way ANOVA test and Post Hoc Multiple Comparisons. To compare the objective effectiveness of tIPSS and QOL between the two testing modes, we selected the positive actual state, which was maximum urine flow (Q max ) of 15 mL/s or less and constructed receiver operating characteristics (ROC) curves for all patients. This estimation was constructed for each educational level.Results : There were no statistical differences in IPSS and QOL values obtained by the patients or physicians ( P > 0.05). The ROC areas for tIPSS were 0.94 and 0.93, and the ROC areas for QOL scores were 0.97 and 0.91 for information obtained by physicians and patients, respectively. When IPSS answers and QOL scores were evaluated separately, consistency was found across both modes of administration. However, there were lower levels of consistency in answers to IPSS questions 2, 5 and 6 ( P = 0.59; 0.42; 0.52, respectively). There was no significant difference among the aforementioned data in the educational groups. Conclusion : Although the total IPSS and QOL scores were not affected by the different modes of administration, we recommend that the physicians should evaluate answers to questions 2, 5 and 6 carefully. The present study demonstrates that the educational level did not affect the IPSS and QOL when administered either by the physician or the patient.

Correlation of Visual Prostate Symptom Score with International Prostate Symptom Score and Uroflowmetry Parameters in Nepalese Male Patients withLower Urinary Tract Symptoms

“…Using a medical personnel to assist the patient in completing IPSS introduces potential bias and imposes an additional burden on the medical staff. 16,17 The VPSS includes schematic diagrams and can be understood easily even by illiterate elderly man. It reduces the risk of misinterpretation in translating the patient's symptoms into meaningful scoring system.…”

A pilot study evaluating a new questionnaire for prostatic symptom scoring, the SPSS, and its sensitivity as constructed to objective measures of outflow obstruction

“…Even in a country like Japan, there are many dialects which sometimes lead to a misunderstanding or lack of comprehension and hence discrepancy and variation in symptom scores. In order to minimize these negative factors related to self‐scoring of symptoms, it is helpful that doctors or nurses help patients to understand the content of each item that is being queried, as pointed out by Bozlu et al 30 . From an international point of view, the results of studies in particular countries may not be generally applicable to other countries, necessitating the development of country specific scoring systems.…”

Evaluation of Lower Urinary Tract Functions in Diabetic Patients

“…Using the voided volume and PVR volume, the BVE was calculated as follows: BVE=100% voided volume/ (voided volume + PVR) (8). The conditions of the patients in terms of LUTS were evaluated using the Turkish version of the IPSS (9,10,11,12). The IPSS was used for quantification of the symptoms in diabetic patients, although it was developed to quantify LUTS in patients with BPH.…”