Kim JH, Lee MH, Doo SW, Yang WJ, Song YS, Yoo BW, Kwon SS. Re-categorisation of male lower urinary tract symptoms based on the international prostate symptom score questionnaire.
Int J Clin Pract 2013;
67:789-94. [PMID:
23668808 DOI:
10.1111/ijcp.12091]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/06/2012] [Indexed: 11/30/2022] Open
Abstract
AIMS
The purpose of this study was to develop a new sub-classification system for male lower urinary tract symptoms (LUTS)-mild, moderate and severe-using the conventional International Prostate Symptoms Score (I-PSS).
METHODS
From October 2007 to March 2012, a total of 2234 male patients (≥ 50 years old) presenting with LUTS were enrolled in this study. Patients were sorted according to their I-PSS (ranging from 1 to 35 points) and divided into three groups based on their quality of life (QoL) score. A chi-square automatic interaction detection (CHAID) algorithm, based on adjusted significance testing, was used. The Kappa coefficient was calculated for the agreement of original and new categorisation.
RESULTS
Mean total I-PSS and QoL scores were 11.0 and 2.9 respectively. According to the original classification, 838 patients (38.6%) had mild, 1053 (48.5%) had moderate and 282 (13.0%) had severe symptoms. After the CHAID algorithm was applied, the scores were re-categorised as 'mild' (1-6 points), 'moderate' (7-21 points) and 'severe' (22-35 points). The overall model was able to correctly predict whether an I-PSS was associated with mild, moderate or severe symptoms, with 70.1% accuracy. According to this new classification, 704 patients (32.4%) were shown to have mild, 1255 (57.8%) to have moderate and 214 (9.8%) to have severe LUTS. The agreement of conventional and new categorisation is very strong (Kappa coefficient = 0.84).
CONCLUSIONS
Conventional categorisation of LUTS by I-PSS needs to be updated and the category of moderate LUTS should be broadened.
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