The Comprehensive Assessment of Self-Reported Urinary Symptoms: A New Tool for Research on Subtypes of Patients with Lower Urinary Tract Symptoms

Abstract

Purpose: To improve the potential for finding clinically important subtypes of patients with lower urinary tract symptoms we developed the CASUS (Comprehensive Assessment of Self-reported Urinary Symptoms). We used it to present data on the experiences of lower urinary tract symptoms in treatment seeking women and men from a prospective observational cohort.

Materials and methods: We created an initial list of lower urinary tract symptoms that were confirmed in 22 qualitative interviews with providers, and 88 qualitative interviews with care seeking and noncare seeking women and men with lower urinary tract symptoms. Items from extant measures were adopted and revised, and new items were developed. All items were evaluated for understanding in 64 cognitive interviews. Items were administered to a prospective cohort of female and male patients with lower urinary tract symptoms who were seeking care. Analyses were done to describe item response distributions and correlations among item responses separately for women and men.

Results: A total of 444 males and 372 females provided responses to the CASUS. Several sets of items showed different relationships for women compared to men. In particular the associations between sensation related items and incontinence related items were generally positive among females but often negative among males.

Conclusions: After using an intensive development process the CASUS addresses a wide range of lower urinary tract symptoms. It should help identify clinically important subtypes of patients. Further, item collection can provide the foundation for shorter measures for use in the clinic and as trial end points.

Keywords: lower urinary tract symptoms; patient acceptance of health care; patient reported outcome measures; surveys and questionnaires; urinary bladder.

Figures

Figure 1.

Pairwise polychoric correlations of CASUS items (Females only, sex-specific questions removed).

Figure 2.

Pairwise polychoric correlations of CASUS items (Males only, sex-specific questions removed).

Figure 3.

Pairwise polychoric correlations of CASUS items (Differences between males and females, sex-specific questions removed) Note: Green color indicates males have a higher correlation than females; orange indicates females have a higher correlation than males.