title: Validation of a Visual Prostate Symptom Score in Men With Lower Urinary Tract Symptoms in a Health Safety Net Hospital.
abstract: OBJECTIVE
  To evaluate the correlation between the International Prostate Symptom Score (IPSS) and the Visual Prostate Symptom Score (VPSS), a visual assessment of urinary stream, frequency, nocturia, and quality of life using pictograms, in a health safety net population.
  
  
  METHODS
  Men presenting to San Francisco General Hospital with lower urinary tract symptoms completed the IPSS and the VPSS without and then with assistance. Statistical analysis was performed using the chi-square test, the Wilcoxon signed rank test, and the Spearman rank correlation.
  
  
  RESULTS
  One hundred twenty-one patients were enrolled between December 2013 and May 2014 with a mean age of 54 years. There were statistically significant correlations between total VPSS and total IPSS (ρ = 0.71; P <.001) and for frequency (ρ = 0.47; P <.001), nocturia (ρ = 0.69; P <.001), force of stream (ρ = 0.65; P <.001), and quality of life (ρ = 0.69; P <.001). In addition, there were statistically significant correlations between total VPSS and both VPSS quality of life (ρ = 0.69; P <.001) and Qmax (ρ = -0.473; P = .006). The mean absolute disagreement for participants who took the IPSS independently vs with assistance was greater than for those who took the VPSS independently vs assistance for all symptoms: frequency (0.64 vs 0.3, respectively; P <.001), weak stream (0.82 vs 0.14, respectively; P <.001), nocturia (0.38 vs 0.23, respectively; P = .023), and quality of life (0.63 vs 0.32, respectively; P = .005).
  
  
  CONCLUSIONS
  Many men altered their IPSS responses when they received assistance. There was significantly less alteration in responses using the VPSS, suggesting that the VPSS is useful in determining lower urinary tract symptoms, particularly in patients with limited education and literacy.
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Selekman
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA.
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Harris
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA.
authors.forename: Pauline
authors.initials: P
authors.lastname: Filippou
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Chi
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA.
authors.forename: Amjad
authors.initials: A
authors.lastname: Alwaal
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Blaschko
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco, CA. Electronic address: bbreyer@urology.ucsf.edu.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D064876:Safety-net Providers; D011795:Surveys and Questionnaires; D014554:Urination; D055815:Young Adult