title: Misinterpretation of the international prostate symptom score questionnaire by Indian patients.
abstract: BACKGROUND
  The international prostate symptom score (IPSS) is commonly used in the evaluation of the severity of symptoms of patients with prostatic enlargement. It is a self-administered questionnaire. It has not been validated in any Indian language and an English version is used which can be difficult to interpret by our patients who do not have English as their primary language. In this study, we evaluate the patient's ability to understand the IPSS by comparing the scores when the IPSS questionnaire was self-administered versus when it was administered using the assistance of a clinician.
  
  
  METHODS
  Patients who presented with lower urinary tract symptoms suggestive of benign prostatic hyperplasia, who had passed at least twelfth grade of school and had a reasonable command over English were included in the study. They were allowed to self-administer the IPSS questionnaire following which a clinician, blinded to these scores, assisted the patient in filling the questionnaire. For each question, the score in both the questionnaires was noted and kappa agreement statistical test was used to assess the agreement between the two scores.
  
  
  RESULTS
  A total of 87 patients were included in the study. It was found that none of the questions had a perfect agreement of scores in the self-administered and the assisted administration.
  
  
  CONCLUSIONS
  Our results show that our patients misinterpret the IPSS questionnaire. This problem can lead to significant errors in interpretation of the symptom severity.
authors.affiliation: Department of Urology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Jindal
authors.affiliation: Department of Urology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Rajan Kumar
authors.initials: RK
authors.lastname: Sinha
authors.affiliation: Department of Urology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Subhabrata
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Department of Urology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Soumendra Nath
authors.initials: SN
authors.lastname: Mandal
authors.affiliation: Department of Urology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Karmakar
keywords: Benign prostatic hyperplasia; lower urinary tract symptoms; prostate questionnaires
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