Filling and voiding symptoms in the American Urological Association symptom index: the value of their distinction in a Veterans Affairs randomized trial of medical therapy in men with a clinical diagnosis of benign prostatic hyperplasia.
OBJECTIVE
We used data from a large Veterans Affairs trial of medical therapy for men with benign prostatic hyperplasia to evaluate the value of calculating separate filling and voiding subscores of the American Urological Association (AUA) symptom index.


METHODS
We performed factor analysis to assess the psychometric validity of separating the 7 items of the AUA symptom index into filling and voiding subsets. To assess the clinical usefulness of calculating these subscores we correlated them against baseline measurements of symptom interference as well as urodynamic and anatomical measures of disease severity, and used them for predicting the response to medical therapy.


RESULTS
Factor analysis confirmed the psychometric validity of separating the AUA symptom index into a 3-item filling and a 4-item voiding subscale. However, calculating filling and voiding subscores did not result in differential correlations with measures of disease interference or severity. It also did not enable us to predict a better symptomatic or uroflowmetry response to medical therapy.


CONCLUSIONS
Calculating separate filling and voiding subscores of the AUA symptom index is psychometrically valid but not clinically useful.
Barry
M J
MJ
Medical Practices Evaluation Center, Massachusetts General Hospital and Center for Survey Research, University of Massachusetts-Boston, Boston, Massachusetts, USA.
Williford
W O
WO
Fowler
F J
FJ
Jones
K M
KM
Lepor
H
H
D000368:Aged; D000369:Aged, 80 and over; D005163:Factor Analysis, Statistical; D006305:Health Status Indicators; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011470:Prostatic Hyperplasia / Q000175:diagnosis*; D011594:Psychometrics; D014555:Urination Disorders / Q000209:etiology*