title: Linguistic and psychometric validation of the Erection Hardness Score to Spanish.
abstract: BACKGROUND
  The Erection Hardness Score (EHS) is a one-item questionnaire that assesses rigidity on a 4-point scale.
  
  
  OBJECTIVE
  To perform a validation of a Spanish version of the EHS by comparison with the International Index of Erectile Function (IIEF) questionnaire.
  
  
  METHODS
  Validation of the EHS included: (i) professional translation of the scale; (ii) scientific evaluation of the translation from four independent urologists; (iii) assessment on five individuals to test correct comprehension and idiomatic adequacy (iv) validation of the EHS by a cross-sectional, multicenter comparison with the IIEF.
  
  
  METHODS
  Patients were required to respond to a Spanish version of the EHS and IIEF. Statistic correlation was carried out between the EHS score and IIEF-erectile function domain (EF) score.
  
  
  RESULTS
  A total of 125 patients were recruited. Overall prevalence of erectile dysfunction (ED) by the EHS questionnaire was of 80.2% patients (n=97). Mean EHS was 2.74±0.97. Mean IIEF-EF score was 17.4±9.5. The EHS showed good reliability. The rate of missing responses to the EHS questionnaire was 0%. A one-factor analysis of variance was performed between the EHS and EF subdomain of IIEF (P=0.000). Pearson's correlation coefficient between EHS and EF subdomain of IIEF was 0.834, P<0.01.
  
  
  CONCLUSIONS
  The EHS is a reliable tool to test ED and its Spanish version was satisfactorily understood by patients and correlated with IIEF-EF.
authors.affiliation: Hospital Clínic, Department of Urology, Barcelona, Spain. edu_garcia_cruz@yahoo.com
authors.forename: Eduard
authors.initials: E
authors.lastname: García-Cruz
authors.forename: Javier
authors.initials: J
authors.lastname: Romero Otero
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Martínez Salamanca
authors.forename: Asier
authors.initials: A
authors.lastname: Leibar Tamayo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rodríguez Antolín
authors.forename: Ander
authors.initials: A
authors.lastname: Astobieta Odriozola
authors.forename: Antonio
authors.initials: A
authors.lastname: Alcaraz
mesh_terms: D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000523:psychology; D006801:Humans; D008037:Linguistics; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000523:psychology; D011594:Psychometrics; D015203:Reproducibility of Results; D013030:Spain; D011795:Surveys and Questionnaires / Q000592:standards*; D014175:Translating