Psychometric Evaluation of the Hypogonadism Impact of Symptoms Questionnaire.
BACKGROUND
The Hypogonadism Impact of Symptoms Questionnaire (HIS-Q) is a patient-reported outcome measurement designed to comprehensively evaluate the symptoms of hypogonadism and to detect changes in these symptoms in response to treatment.


OBJECTIVE
To conduct item analysis and reduction, evaluate the psychometric properties of the HIS-Q, and provide guidance on interpreting the instrument score.


METHODS
A 12-week observational, longitudinal study of hypogonadal men was conducted. Participants completed the HIS-Q every 2 weeks. Blood samples were collected to evaluate testosterone levels. Participants also completed the Aging Male's Symptoms Scale, the International Index of Erectile Function, the Short Form-12 Health Survey, and the Patient-Reported Outcomes Measurement Information System Sexual Activity, Satisfaction with Sex Life, Sleep Disturbance, and Applied Cognition Scales (at baseline and weeks 6 and 12). Clinicians completed the Clinical Global Impression of Severity and Change measurements and a clinical form.


METHODS
Individual item performance was evaluated using descriptive statistics and Rasch analyses. Reliability (internal consistency and test-retest), validity (concurrent and know groups), and responsiveness were assessed.


RESULTS
In total, 177 men participated in the study (mean age = 54.1 years, range = 23-83). The original 53-item draft HIS-Q was reduced to 28 items; the final instrument included five domains (sexual, energy, sleep, cognition, and mood) with two sexual subdomains (libido and sexual function). For all domains, test-retest reliability was acceptable (intraclass correlation coefficients > 0.70), construct validity was good (|r > 0.30| for all comparisons). Known-groups validity was demonstrated for all HIS-Q domain scores, subdomain scores, and the total score as measured by the Clinical Global Impression of Severity, and total testosterone level at baseline (P < .05 for all comparisons). All domains and subdomains were responsive to change based on patient-rated anchor questions (P < .05 for all comparisons).


CONCLUSIONS
The final 28-item HIS-Q is reliable, valid, and responsive. The HIS-Q is suitable for inclusion in future clinical trials to help characterize the effects of testosterone replacement therapy.
Evidera, Bethesda, MD, USA. Electronic address: heather.gelhorn@evidera.com.
Heather L
HL
Gelhorn
Evidera, Bethesda, MD, USA.
Ebony
E
Dashiell-Aje
AbbVie, North Chicago, IL, USA.
Michael G
MG
Miller
Maryland Center for Sexual Health, Lutherville, MD, USA.
Leonard R
LR
DeRogatis
Johns Hopkins University, Baltimore, MD, USA.
Adrian
A
Dobs
Cooper Medical School, Rowan University, Camden, NJ, USA.
Allen D
AD
Seftel
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Stanley E
SE
Althof
The Brod Group, Mill Valley, CA, USA.
Meryl
M
Brod
Evidera, Bethesda, MD, USA.
Dennis A
DA
Revicki
D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D007006:Hypogonadism / Q000523:psychology*; D007989:Libido / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life; D015203:Reproducibility of Results; D012725:Sexual Behavior; D011795:Surveys and Questionnaires / Q000592:standards*; D013739:Testosterone / Q000378:metabolism / Q000627:therapeutic use; D055815:Young Adult
D013739:Testosterone
Hypogonadism; Hypogonadism Impact of Symptoms Questionnaire; Patient-Reported Outcome; Psychometric Properties; Reliability; Responsiveness; Validity