title: Is There Any Difference Between Questionnaires on Pediatric Lower Urinary Tract Dysfunction?
abstract: OBJECTIVE
  To investigate the diagnostic properties of 3 different scoring systems (Dysfunctional Voiding Symptom Score [DVSS], Dysfunctional Voiding and Incontinence Symptoms Score [DVISS], Incontinence Symptom Index-Pediatric [ISI-P, for children older than 11 years]) that are used to evaluate lower urinary tract symptoms in pediatric population.
  
  
  METHODS
  Eighty-four participants were evaluated by detailed history, physical examination, 3 different scoring systems (DVSS, DVISS, ISI-P), ultrasonography, and uroflowmetry. Depending on the tests, cases were stratified as healthy or lower urinary tract symptoms (LUTS) by 2 urologists who were blinded to the questionnaires. Patients were reevaluated by the same tests and questionnaires 3 months after treatment. Diagnostic properties of questionnaires were calculated. Additionally, parents were asked to scale the improvement of symptoms subjectively from 0% to 100% to correlate to each of the three scoring systems.
  
  
  RESULTS
  The mean ages of the normal and the LUTS groups were 9.1 ± 2.6 years and 10.1 ± 2.8 years, respectively (P = .301). Gender (male:female) distribution was 21:21 in the LUTS group and 25:17 in the control group (P = .381). In terms of diagnosis, DVISS has the highest accuracy (sensitivity: 81%, specificity: 97.6%, accuracy: 89%) followed by ISI-P (sensitivity: 55.6%, specificity: 100%, accuracy: 82%) and DVSS (sensitivity: 54.8%, specificity: 97.6%, accuracy: 76%). The similar order was valid for the 23 patients older than 11 years (accuracy for DVISS: 87%, for ISI-P: 82%, and for DVSS: 78%). In terms of response to treatment, all 3 tests showed good correlation with parents' ratings (DVSS: P < .001, DVISS: P = .005, ISI-P: P = .042).
  
  
  CONCLUSIONS
  Although DVISS had the highest accuracy in distinguishing the patients from healthy controls, all 3 questionnaires seem to be equivalent for the evaluation of response to treatment.
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Altan
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Çitamak
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey. Electronic address: alicansu@doctor.com.
authors.forename: Ali Cansu
authors.initials: AC
authors.lastname: Bozaci
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Mammadov
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
authors.forename: Hasan Serkan
authors.initials: HS
authors.lastname: Doğan
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, Sıhhıye, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Tekgül
mesh_terms: D002648:Child; D000068598:Data Accuracy; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis*; D008297:Male; D010372:Pediatrics / Q000379:methods / Q000592:standards; D012107:Research Design; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods*; D014421:Turkey