title: Performance of Massachusetts Male Aging Study (MMAS) and androgen deficiency in the aging male (ADAM) questionnaires in the prediction of free testosterone in patients aged 40 years or older treated in outpatient regimen.
abstract: OBJECTIVE
  At present, calculated free testosterone assessment is considered as the gold standard in diagnosing male hypogonadism. However, this assessment is not available for all the individuals diagnosed with decreased testicular function. The investigators of this study were, thus, prompted to evaluate whether the androgen deficiency in the aging male (ADAM) and the Massachusetts Male Ageing Study (MMAS) questionnaires could be used to replace biochemical parameters in the diagnosis for hypogonadism in men aged 40 years and above.
  
  
  METHODS
  We evaluated 460 men, aged 40 years and above, all volunteers of a screening program for prostate cancer based at the Hospital de Clínicas of Porto Alegre. In this study, we assessed the efficiency of the ADAM and MMAS questionnaires in diagnosing Brazilian men with low levels of total, calculated free and bioavailable testosterone.
  
  
  RESULTS
  The sensitivity of the ADAM questionnaire in diagnosing the calculated free testosterone was 73.6%, whereas specificity was 31.9%. ADAM could be used to properly classify our cohort into normal or hypogonadal individuals in 52.75% of the cases. The sensitivity of the MMAS questionnaire was 59.9%, whereas the specificity was 42.9%, resulting in a successful classification of 51.4% of the patients.
  
  
  CONCLUSIONS
  The ADAM and MMAS questionnaires showed adequate sensitivity in diagnosing male patients with low levels of free testosterone. However, because of the lack of specificity, these tools cannot replace calculated free testosterone assessments in men aged 40 years and above.
authors.affiliation: Urology Department, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul , Porto Algre , Brazil.
authors.forename: Renan Desimon
authors.initials: RD
authors.lastname: Cabral
authors.forename: Luciane
authors.initials: L
authors.lastname: Busin
authors.forename: Tiago Elias
authors.initials: TE
authors.lastname: Rosito
authors.forename: Walter José
authors.initials: WJ
authors.lastname: Koff
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology; D000728:Androgens / Q000172:deficiency*; D001938:Brazil / Q000453:epidemiology; D005058:Eunuchism / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood*
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: ADAM; MMAS; free testosterone; male aging; screening questionnaire