Application of the Chinese version of the International Prostate Symptom Score for the management of lower urinary tract symptoms in a primary health care setting.

ABSTRACT

OBJECTIVES: To determine whether the Chinese version of the International Prostate Symptom Score can differentiate surgically treatable conditions from functional disorders among patients with lower urinary tract symptoms. DESIGN: Retrospective cross-sectional study. SETTING: Community hospital, Hong Kong. PATIENTS A cohort of 121 adult males with lower urinary tract symptoms referred to a specialty clinic from July 2006 to February 2007. MAIN OUTCOME MEASURES: Scores were obtained following self-administration of the Chinese version of the International Prostate Symptom questionnaire. A combination of uroflowmetry and urethrocystoscopy were applied as the gold-standard diagnostic tests for surgically treatable conditions. The effectiveness of the instrument was explored in terms of sensitivity, specificity, and positive and negative predictive values. RESULTS: A total of 121 records were reviewed, among which 58 patients with lower urinary tract symptoms had completed both the questionnaire and gone through the relevant diagnostic tests. The receiver operating characteristics curve was constructed; the area under curve was 0.68. Using the receiver operating characteristics analysis, the optimal cut-off value for the Chinese version of the International Prostate Symptom Score was 24. The respective sensitivity and specificity values were 62% and 84%. The positive predictive value was 68% and negative predictive value was 79%. CONCLUSION: The Chinese version of International Prostate Symptom Score is not a sensitive instrument for diagnosing surgically treatable conditions and it is not a suitable medical test to exclude patients from referrals to secondary health care services. An acceptable specificity with a score of 24 was advantageous for triaging patients to receive early specialist attention.