Grading Severity and Bother Using the International Prostate Symptom Score and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Score in Men Seeking Lower Urinary Tract Symptoms Therapy

No AccessJournal of UrologyAdult Urology1 Nov 2020Grading Severity and Bother Using the International Prostate Symptom Score and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Score in Men Seeking Lower Urinary Tract Symptoms TherapyThis article is commented on by the following:Editorial Comment Hiroki Ito, Grace J. Young, Amanda L. Lewis, Peter S. Blair, Nikki Cotterill, J. Athene Lane, Kentaro Sakamaki, Marcus J. Drake, and Paul Abrams Hiroki ItoHiroki Ito Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom , Grace J. YoungGrace J. Young Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom , Amanda L. LewisAmanda L. Lewis Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom , Peter S. BlairPeter S. Blair Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom , Nikki CotterillNikki Cotterill Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom , J. Athene LaneJ. Athene Lane Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom , Kentaro SakamakiKentaro Sakamaki Center for Data Science, Yokohama City University, Yokohama, Japan , Marcus J. DrakeMarcus J. Drake *Correspondence: Bristol Medical School, Learning & Research Bldg, Southmead Hospital, Bristol, BS10 5NB, United Kingdom E-mail Address: [email protected] Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom , and Paul AbramsPaul Abrams Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom View All Author Informationhttps://doi.org/10.1097/JU.0000000000001149AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. References 1. : Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder. Eur Urol 2009; 56: 14. 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Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of UrologySep 4, 2020, 12:00:00 AMEditorial Comment Volume 204Issue 5November 2020Page: 1003-1011Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordssurveys and questionnairesurodynamicslower urinary tract symptomsAcknowledgmentsThe authors thank all the men who participated in the UPSTREAM trial. We also thank the participating NHS hospitals,10 in particular the principal investigators, research nurses, clinical trial assistants, administrators and all other support staff, for their dedication and hard work. The study would not have been possible without the involvement of patients and the centers, and we are extremely grateful. We also thank the members of the independent Trial Steering Committee and Data Monitoring Committee, as well as our Trial Management Group (consisting of co-applicants, representatives from the Study Office and patient representatives) for their continued counsel and support.This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme (project number 12/140/01). The views and opinions expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. This study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a UKCRC Registered Clinical Trials Unit (CTU) which, as part of the Bristol Trials Centre (BTC), is in receipt of NIHR CTU support funding. The UPSTREAM trial was sponsored by North Bristol NHS Trust (NBT). Study data were collected and managed using REDCap (Research Electronic Data Capture25) hosted at the University of Bristol.MetricsAuthor Information Hiroki Ito Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom More articles by this author Grace J. Young Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom More articles by this author Amanda L. Lewis Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom More articles by this author Peter S. Blair Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom More articles by this author Nikki Cotterill Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom More articles by this author J. Athene Lane Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom Bristol Randomised Trials Collaboration (BRTC) as part of the Bristol Trials Centres (BTC), University of Bristol, Bristol, United Kingdom More articles by this author Kentaro Sakamaki Center for Data Science, Yokohama City University, Yokohama, Japan More articles by this author Marcus J. Drake Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom *Correspondence: Bristol Medical School, Learning & Research Bldg, Southmead Hospital, Bristol, BS10 5NB, United Kingdom E-mail Address: [email protected] More articles by this author Paul Abrams Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement Loading ...