DEVELOPMENT AND VALIDATION OF THEFEMALE VISUAL SYMPTOM SCORE FOR LOWER URINARY TRACT SYMPTOMS ANDINCONTINENCE
C. A. LOVATT 1, L.STOTHERS2, A. MACNAB 2;
1MDundergraduate Program, Univ. of British Columbia, Vancouver, Canada,2Univ. of British Columbia, Vancouver, Canada.
Introduction: Symptoms score areintegral tools to allow assessment of severity of symptoms,progression of symptoms and efficacy of therapy, though theyinherently depend on literacy and language interpretation. There is avalidated male Visual Prostate Symptom Score (VPSS) for use inurology. (1) We applied this concept to a female specific visualscore that would circumvent literacy comprehension and providevalidated symptom information on frequency, nocturia, urgency, stressurinary incontinence (SUI), dysuria and quality of life(QoL).
Objective: Develop and complete initial validationof a Visual Urinary Symptom Score for Women (VUSS). Measure contentvalidity by: (1) evaluate construct validity through patientunderstanding of each pictogram (2) comparing VUSS pictogramsresponses to the Urinary Distress Inventory (UDI-6) and the AmericanUrological Associated Symptom Inventory (AUA-SI) (3) obtain patientinput to enhance information capture.
Methods: Participantscompleted the VUSS, the UDI-6 and the AUA-SI independently.Participants provided their interpretation of each pictogram and alsoprovided feedback on each image with the intention of optimizingcomprehension. Statistical analysis: Student’s t, Fisher’s exact,and Spearman’s correlation tests.
Results: Three hundredscores in N=100 subjects were collected (mean age 46, range 21-91);25 had grade 8-12 high school education; 75 with postsecondaryeducation (mean 4.2 years, range of 0 years - 8 years). All surveyswere completed independently. VUSS Q1 and Q2, indicating daytimefrequency and nocturia, had the best inherent recognition of conceptwith 97% correct interpretation. Quality of life images had thepoorest inherent recognition of concept with 72% correctinterpretation. VUSS Q5, indicating dysuria, was thought by theparticipants to be the clearest. VUSS and UDI-6 totals had 0.878correlation, while VUSS AUA-SI had 0.72 correlation.
Conclusions:Our novel pictogram based urinary symptoms score - the VUSS - hadcontent that correlated well with UDI-6 total scores. Comprehensionwould benefit from increasing contrast details in pictograms. Furtherdevelopment can add to the ability to measure women’s LUTS on aglobal scale to reduce language and literacy barriers to historytaking. Next steps will incorporate changes from this validation andtesting in a low resource environment with the aim of making the VUSSapplicable globally.