title: The FIGO assessment scoring system (FASS): a new holistic classification tool to assess women with pelvic floor dysfunction: validity and reliability.
abstract: OBJECTIVE
  The aim of our study was to assess the interobserver and intraobserver reliability as well as the content and construct validity of the FIGO prolapse assessment scoring system (FASS).
  
  
  METHODS
  Women with and without (controls) symptoms of pelvic organ prolapse (POP) attending gynaecology outpatient clinics in four different countries were recruited prospectively. Each woman was assessed using the FASS which included: (1) physical examination findings designated with the letter P; (2) presence of symptoms of prolapse, urinary and bowel symptoms designated with the letter S; and (3) assessment of degree of bother designated with the letter B. A scoring system was also developed. For interobserver reliability women were examined by two separate examiners using the FASS. For intraobserver reliability the FASS was repeated by the same examiner within 2 weeks. The interclass correlation coefficient (ICC) was also calculated to assess limits of agreements. Validity was assessed by comparing the FASS scores between symptomatic and asymptomatic women using the Mann-Whitney U test (p value <0.001).
  
  
  RESULTS
  A total of 177 women (98 symptomatic and 79 controls) were recruited. Intraobserver reliability had ICCs between 0.716 and 1. Interobserver reliability had ICCs between 0.795 and 0.909. Domain and total scores were significantly different between symptomatic and asymptomatic women (p < 0.001, Mann-Whitney U test). There was a good correlation between FASS P scores and POP-Q scores (rho 0.763, p < 0.001).
  
  
  CONCLUSIONS
  The FIGO prolapse assessment scoring system has good intraobserver and interobserver agreement and has demonstrated both content and construct validity.
authors.affiliation: Department of Urogynaecology, S. Mary's Hospital, Academic Department of Obstetrics and Gynaecology, Mint Wing, South Wharf, W2 1NY, London, UK, a.digesu@imperial.ac.uk.
authors.forename: G Alessandro
authors.initials: GA
authors.lastname: Digesu
authors.forename: Steven
authors.initials: S
authors.lastname: Swift
authors.forename: Federica
authors.initials: F
authors.lastname: Puccini
authors.forename: Jittima
authors.initials: J
authors.lastname: Manonai
authors.forename: Vik
authors.initials: V
authors.lastname: Khullar
authors.forename: Ruwan
authors.initials: R
authors.lastname: Fernando
authors.forename: Oscar Contreras
authors.initials: OC
authors.lastname: Ortiz
authors.forename: Stefano
authors.initials: S
authors.lastname: Salvatore
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000145:classification*; D056887:Pelvic Organ Prolapse; D010808:Physical Examination; D015203:Reproducibility of Results; D055815:Young Adult