title: Methods of developing UWIN, the modified American Urological Association symptom score.
abstract: OBJECTIVE
  The American Urological Association symptom score instrument is widely used to assess lower urinary tract symptom severity in men. We describe the methods used to develop a shorter form of the American Urological Association symptom score that may provide symptom score assessment with minimal compromise in accuracy.
  
  
  METHODS
  Complete American Urological Association symptom score data were collected on 8,731 men who attended Prostate Cancer Awareness Week in 2003 or 2004. Correlation analysis and area under the ROCs were used to determine the best reduced index and cutoff points in scores for the severity categories of mild, moderate and severe.
  
  
  RESULTS
  The number of responses in the original 7 American Urological Association symptom score items was lowered from 6 to 4 and for the bothersome index it was lowered from 7 to 3. Four of the original 7 items were retained. Cronbach's α was 0.851 for the symptom score items in our data. The combination of items with the best joint correlation to the American Urological Association symptom score and bothersome score was UWIN (urgency, weak stream, incomplete emptying and nocturia). The correlation of UWIN with the American Urological Association symptom score was 0.938. The correlation of UWIN bother to the American Urological Association bothersome score was 0.638. The ROC for the mild, moderate and severe UWIN categories compared to the categorized American Urological Association symptom score was 0.96, 0.97 and 0.99, respectively.
  
  
  CONCLUSIONS
  The UWIN instrument may potentially be a valuable tool to assess American Urological Association symptom score severity and bother. Clinical validation of this instrument is indicated in a prospective comparative study.
authors.affiliation: Department of Surgery, University of Colorado-Denver, School of Medicine, Aurora, Colorado 80045, USA. Al.barqawi@ucdenver.edu
authors.forename: Al B
authors.initials: AB
authors.lastname: Barqawi
authors.forename: Kathryn F
authors.initials: KF
authors.lastname: Sullivan
authors.forename: E David
authors.initials: ED
authors.lastname: Crawford
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.forename: Alexa
authors.initials: A
authors.lastname: Hughes
authors.forename: Michael
authors.initials: M
authors.lastname: O'Leary
authors.forename: Nelson
authors.initials: N
authors.lastname: Stone
authors.forename: Colin I
authors.initials: CI
authors.lastname: O'Donnell
mesh_terms: D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000150:complications; D012720:Severity of Illness Index; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000175:diagnosis* / Q000209:etiology; D014572:Urology