Evaluation of the psychometric properties of the life satisfaction checklist as a screening tool for erectile dysfunction.
BACKGROUND
There is a need for a more feasible and acceptable screening tool for erectile dysfunction (ED) in our health context. The Fugl-Meyer's Life Satisfaction Checklist (LISAT-8) has been shown to be a simple and good instrument for assessing the satisfaction of ED patients in different aspects of their lives and has also shown acceptable psychometric properties to be used in the Spanish population with ED. Furthermore, this checklist has been used as a screening tool in patients with and without ED, showing valid and reliable properties for detection of ED.


OBJECTIVE
To evaluate the validity and feasibility of LISAT-8 checklist as a screening tool to detect ED.


METHODS
A cross-sectional, multicenter, and observational study was conducted including 6,986 Spanish men aged over 18 years. Patients completed the International Index of Erectile Function (IIEF), Sexual Health Inventory for Men (SHIM) and LISAT-8 checklists. Questions about the simplicity of SHIM and LISAT-8 and time to complete them were used for feasibility evaluation. We used logistic regression analysis to select the best predictors for ED among the different items of LISAT-8 and the receiver operating characteristic (ROC) curve analysis to select the best cutoff value discriminating ED vs. non-ED subjects. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), along with kappa agreement coefficient, were also estimated.


RESULTS
A total of 6,986 patients were included. Among the patients, 71.2% preferred LISAT-8 to SHIM. Time to completion of checklist was 0.5 minute less with LISAT-8 than with SHIM (P < 00001). Items 2 (sexual life), 5 (contacts with friends and acquaintances), and 3 (partner relationship) of LISAT-8 were selected as predictors for ED. ROC curve analysis showed a cutoff point >/=15 with a sensitivity of 81.7% (95% confidence intervals: 80.5-82.9), a specificity of 79.2% (77.5-80.8), and PPV of 88.7% (87.6-89.8%) and NPV of 72.0% (70.0-73.0%). Kappa agreement coefficients were 0.57 (LISAT-8 vs. SHIM) and 0.60 (LISAT-8 vs. IIEF).


CONCLUSIONS
LISAT-8 and its composite variable (formed by items 2 + 3 + 5) showed acceptable psychometric properties, and it could be a valid screening tool for ED in daily clinical practice.
Department of Urology, Hospital Gregorio Marañón, Madrid, Spain. ignacio@moncada.name
Ignacio
I
Moncada
Cristina Fernández
CF
Micheltorena
Eva M
EM
Martínez-Sánchez
Javier Rejas
JR
Gutiérrez
D000328:Adult; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis; D012747:Sexual Partners / Q000523:psychology; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires