THE NATIONAL INSTITUTES OF HEALTH CHRONIC PROSTATITIS SYMPTOM INDEX: DEVELOPMENT AND VALIDATION OF A NEW OUTCOME MEASURE

No AccessJournal of UrologyClinical Urology: Original Articles1 Aug 1999THE NATIONAL INSTITUTES OF HEALTH CHRONIC PROSTATITIS SYMPTOM INDEX: DEVELOPMENT AND VALIDATION OF A NEW OUTCOME MEASURE MARK S. LITWIN, MARY McNAUGHTON-COLLINS, FLOYD J. FOWLER, J. CURTIS NICKEL, ELIZABETH A. CALHOUN, MICHEL A. PONTARI, RICHARD B. ALEXANDER, JOHN T. FARRAR, and MICHAEL P. O'LEARY MARK S. LITWINMARK S. LITWIN More articles by this author , MARY McNAUGHTON-COLLINSMARY McNAUGHTON-COLLINS More articles by this author , FLOYD J. FOWLERFLOYD J. FOWLER More articles by this author , J. CURTIS NICKELJ. CURTIS NICKEL More articles by this author , ELIZABETH A. CALHOUNELIZABETH A. CALHOUN More articles by this author , MICHEL A. PONTARIMICHEL A. PONTARI More articles by this author , RICHARD B. ALEXANDERRICHARD B. ALEXANDER More articles by this author , JOHN T. FARRARJOHN T. FARRAR More articles by this author , and MICHAEL P. O'LEARYMICHAEL P. O'LEARY More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68562-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Chronic abacterial prostatitis is a syndrome characterized by pelvic pain and voiding symptoms, which is poorly defined, poorly understood, poorly treated and bothersome. Research and clinical efforts to help men with this syndrome have been hampered by the absence of a widely accepted, reliable and valid instrument to measure symptoms and quality of life impact. We developed a psychometrically valid index of symptoms and quality of life impact for men with chronic prostatitis. Materials and Methods: We conducted a structured literature review of previous work to provide a foundation for the new instrument. We then conducted a series of focus groups comprising chronic prostatitis patients at 4 centers in North America, in which we identified the most important symptoms and effects of the condition. The results were used to create an initial draft of 55 questions that were used for formal cognitive testing on chronic prostatitis patients at the same centers. After expert panel review formal validation testing of a revised 21-item draft was performed in a diverse group of chronic prostatitis patients and 2 control groups of benign prostatic hyperplasia patients and healthy men. Based on this validation study, the index was finalized. Results: Analysis yielded an index of 9 items that address 3 different aspects of the chronic prostatitis experience. The primary component was pain, which we captured in 4 items focused on location, severity and frequency. Urinary function, another important component of symptoms, was captured in 2 items (1 irritative and 1 obstructive). Quality of life impact was captured with 3 items about the effect of symptoms on daily activities. The 9 items had high test-retest reliability (r = 0.83 to 0.93) and internal consistency (alpha = 0.86 to 0.91). All but the urinary items discriminated well between men with and without chronic prostatitis. Conclusions: The National Institutes of Health chronic prostatitis symptom index provides a valid outcome measure for men with chronic prostatitis. The index is psychometrically robust, easily self-administered and highly discriminative. It was formally developed and psychometrically validated, and may be useful in clinical practice as well as research protocols. References 1 : Prevalence of bothersome genitourinary symptoms and diagnosis in younger men on routine primary care visits. Urology1998; 52: 422. Google Scholar 2 : How common is prostatitis? A national survey of physician visits. J. Urol.1998; 159: 1224. Link, Google Scholar 3 : Results of a questionnaire among Dutch urologists and general practitioners concerning diagnostics and treatment of patients with prostatitis syndromes. Eur. Urol.1992; 22: 14. Google Scholar 4 : Diagnosis and treatment of prostatitis in Canada. Urology1998; 52: 797. Crossref, Medline, Google Scholar 5 Executive summary: NIH workshop on chronic prostatitis. Bethesda, Maryland, 1995 Google Scholar 6 : Use of terazosin in prostatodynia and validation of a symptom score questionnaire. Urology1994; 43: 460. Google Scholar 7 : Chronic pelvic pains represent the most prominent urogenital symptoms of “chronic prostatitis”. Urology1996; 48: 715. Google Scholar 8 : Transurethral microwave thermotherapy for nonbacterial prostatitis: a randomized double-blind sham controlled study using new prostatitis specific assessment questionnaires. J. Urol.1996; 155: 1950. Link, Google Scholar 9 : The “Giessen Prostatitis Symptom Score” (GSS): standardization of the questionnaire and prevalence of symptoms. J Urol.1997; 157: 239. abstract 936. Google Scholar 10 : Psychological test studies of symptoms in patients with chronic prostatitis and prostadynia. Urol. A.1986; 25: 97. Google Scholar 11 : Prostatodynia or painful male urethral syndrome?. Urology1990; 36: 146. Google Scholar 12 : Diagnosis and treatment of 409 patients with prostatitis syndromes. Urology1993; 41: 301. Crossref, Medline, Google Scholar 13 : Chronic prostatitis: results of an Internet survey. Urology1996; 48: 568. Google Scholar 14 : Sickness impact of chronic nonbacterial prostatitis and its correlates. J. Urol.1996; 155: 965. Link, Google Scholar 15 : Psychic disturbances in patients with chronic prostatitis. Ann. Clin. Res.1981; 13: 45. Google Scholar 16 : Illness behavior and personality changes in patients with chronic prostatitis during a two-year follow-up period. Eur. Urol.1989; 16: 181. Google Scholar 17 : Personality variables involved in chronic prostatitis. Urology1993; 42: 654. Google Scholar 18 : Psychological problems in chronic prostatitis patients with pain. Clin. J. Pain.1994; 10: 218. Google Scholar 19 : The American Urological Association symptom index for benign prostatic hyperplasia. J. Urol.1992; 148: 1549. Link, Google Scholar 20 : Coefficient alpha and the internal structure of tests. Psychometrika1951; 16: 297. Crossref, Google Scholar 21 : Measuring disease-specific quality of life in clinical trials. Canad. Med. Assn. J.1986; 134: 889. Google Scholar 22 : Measuring health status: what are the necessary measurement properties?. J. Clin. Epidemiol.1992; 45: 1341. Google Scholar 23 : Hard measures of subjective outcomes: validating symptom indexes in urology. J. Urol.1992; 148: 1546. Link, Google Scholar 24 : An introduction to test theory. Oncology1990; 4: 43. Medline, Google Scholar 25 : Measuring quality of life today: methodological aspects. Oncology1990; 4: 29. Google Scholar 26 : A critical appraisal of the quality of quality-of-life measurements. J.A.M.A.1994; 272: 619. Google Scholar 27 : Diagnosis and treatment of chronic prostatitis. Abbott Laboratories1998; . Google Scholar From the Departments of Urology and Health Services, University of California, Los Angeles, Los Angeles, California, General Medicine Unit, Massachusetts General Hospital, Center for Survey Research, University of Massachusetts, Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, Department of Urology, Queen's University, Kingston, Canada, Institute of Health Services Research and Health Policy Studies, and Department of Urology, Northwestern University Medical School, Chicago, Illinois, Department of Urology, Temple University School of Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, and Department of Surgery, University of Maryland School of Medicine, Baltimore, MarylandAccepted for publication March 5, 1999.Supported by Grants R01DK53738, R01DK53736, R01DK53746, R01DK53730, R01DK53734, R01DK53732 and R01DK53752 from the National Institute of Diabetes and Digestive and Kidney Diseases.(Farrar) Financial interest and/or other relationship with Parke Davis, Anesta, Abbott and Smith Kline Beechum.The Chronic Prostatitis Collaborative Research Network; Sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases. Principal investigators: Richard B. Alexander, J. Richard Landis, Mark S. Litwin, J. Curtis Nickel, Michael P. O'Leary, Michael A. Pontari and Anthony J. Schaeffer. Co-investigators: Michael J. Barry, Charles L. Bennett, Wade Bushman, Elizabeth A. Calhoun, Howard Ceri, Denise Cifelli, James Duncan, John T. Farrar, Harold I. Feldman, Floyd J. Fowler, Jr., Duncan Hunter, Keith Jarvi, John Kusek, Mary McNaughton-Collins, Robert B. Nadler, Leroy M. Nyberg, Sathibalan Ponniah, Kathleen J. Propert, Michael R. Ruggieri and Daniel A. Shoskes.© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLai H, Thu J, Moh F, Paradis A and Vetter J (2019) Clustering of Patients with Interstitial Cystitis/Bladder Pain Syndrome and Chronic Prostatitis/Chronic Pelvic Pain SyndromeJournal of Urology, VOL. 202, NO. 3, (546-551), Online publication date: 1-Sep-2019.Qin Z, Zang Z, Zhou K, Wu J, Zhou J, Kwong J and Liu Z (2018) Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Sham Acupuncture Controlled TrialJournal of Urology, VOL. 200, NO. 4, (815-822), Online publication date: 1-Oct-2018.Awad M, Gaither T, Murphy G, Chumnarnsongkhroh T, Metzler I, Sanford T, Sutcliffe S, Eisenberg M, Carroll P, Osterberg E and Breyer B (2017) Cycling, and Male Sexual and Urinary Function: Results from a Large, Multinational, Cross-Sectional StudyJournal of Urology, VOL. 199, NO. 3, (798-804), Online publication date: 1-Mar-2018.Shoskes D, Wang H, Polackwich A, Tucky B, Altemus J and Eng C (2016) Analysis of Gut Microbiome Reveals Significant Differences between Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome and ControlsJournal of Urology, VOL. 196, NO. 2, (435-441), Online publication date: 1-Aug-2016.Nickel J, Mills I, Crook T, Jorga A, Smith M, Atkinson G and Krieger J (2015) Tanezumab Reduces Pain in Women with Interstitial Cystitis/Bladder Pain Syndrome and Patients with Nonurological Associated Somatic SyndromesJournal of Urology, VOL. 195, NO. 4 Part 1, (942-948), Online publication date: 1-Apr-2016.Lai H, Krieger J, Pontari M, Buchwald D, Hou X and Landis J (2015) Painful Bladder Filling and Painful Urgency are Distinct Characteristics in Men and Women with Urological Chronic Pelvic Pain Syndromes: A MAPP Research Network StudyJournal of Urology, VOL. 194, NO. 6, (1634-1641), Online publication date: 1-Dec-2015.Zhang R, Sutcliffe S, Giovannucci E, Willett W, Platz E, Rosner B, Dimitrakoff J and Wu K (2015) Lifestyle and Risk of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health ProfessionalsJournal of Urology, VOL. 194, NO. 5, (1295-1300), Online publication date: 1-Nov-2015.Polackwich A, Li J and Shoskes D (2015) Patients with Pelvic Floor Muscle Spasm Have a Superior Response to Pelvic Floor Physical Therapy at Specialized CentersJournal of Urology, VOL. 194, NO. 4, (1002-1006), Online publication date: 1-Oct-2015.Hanno P, Erickson D, Moldwin R and Faraday M (2015) Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome: AUA Guideline AmendmentJournal of Urology, VOL. 193, NO. 5, (1545-1553), Online publication date: 1-May-2015.Clemens J, Clauw D, Kreder K, Krieger J, Kusek J, Lai H, Rodriguez L, Williams D, Hou X, Stephens A and Landis J (2014) Comparison of Baseline Urological Symptoms in Men and Women in the MAPP Research CohortJournal of Urology, VOL. 193, NO. 5, (1554-1558), Online publication date: 1-May-2015.Davis S, Binik Y, Amsel R and Carrier S (2013) A Subtype Based Analysis of Urological Chronic Pelvic Pain Syndrome in MenJournal of Urology, VOL. 190, NO. 1, (118-123), Online publication date: 1-Jul-2013.Schaeffer E (2013) Re: α-Blockers, Antibiotics and Anti-Inflammatories have a Role in the Management of Chronic Prostatitis/Chronic Pelvic Pain SyndromeJournal of Urology, VOL. 189, NO. 6, (2130-2131), Online publication date: 1-Jun-2013.FitzGerald M, Anderson R, Potts J, Payne C, Peters K, Clemens J, Kotarinos R, Fraser L, Cosby A, Fortman C, Neville C, Badillo S, Odabachian L, Sanfield A, O'Dougherty B, Halle-Podell R, Cen L, Chuai S, Landis J, Mickelberg K, Barrell T, Kusek J and Nyberg L (2018) Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for the Treatment of Urological Chronic Pelvic Pain SyndromesJournal of Urology, VOL. 189, NO. 1S, (S75-S85), Online publication date: 1-Jan-2013.Davis S, Binik Y, Amsel R and Carrier S (2012) Is a Sexual Dysfunction Domain Important for Quality of Life in Men with Urological Chronic Pelvic Pain Syndrome? 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publication date: 1-Mar-2002.MEHIK A, HELLSTRÖM P, NICKEL J, KILPONEN A, LESKINEN M, SARPOLA A and LUKKARINEN O (2018) THE CHRONIC PROSTATITIS-CHRONIC PELVIC PAIN SYNDROME CAN BE CHARACTERIZED BY PROSTATIC TISSUE PRESSURE MEASUREMENTSJournal of Urology, VOL. 167, NO. 1, (137-140), Online publication date: 1-Jan-2002.COLLINS M, O’LEARY M, CALHOUN E, PONTARI M, ADLER A, EREMENCO S, CHANG C, ODOM L and LITWIN M (2018) THE SPANISH NATIONAL INSTITUTES OF HEALTH-CHRONIC PROSTATITIS SYMPTOM INDEX: TRANSLATION AND LINGUISTIC VALIDATIONJournal of Urology, VOL. 166, NO. 5, (1800-1803), Online publication date: 1-Nov-2001.NICKEL J, DOWNEY J, JOHNSTON B and CLARK J (2018) PREDICTORS OF PATIENT RESPONSE TO ANTIBIOTIC THERAPY FOR THE CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME: A PROSPECTIVE MULTICENTER CLINICAL TRIALJournal of Urology, VOL. 165, NO. 5, (1539-1544), Online publication date: 1-May-2001.Nickel J, Downey J, Hunter D and Clark J (2018) PREVALENCE OF PROSTATITIS-LIKE SYMPTOMS IN A POPULATION BASED STUDY USING THE NATIONAL INSTITUTES OF HEALTH CHRONIC PROSTATITIS SYMPTOM INDEXJournal of Urology, VOL. 165, NO. 3, (842-845), Online publication date: 1-Mar-2001. Volume 162Issue 2August 1999Page: 369-375 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information MARK S. LITWIN More articles by this author MARY McNAUGHTON-COLLINS More articles by this author FLOYD J. FOWLER More articles by this author J. CURTIS NICKEL More articles by this author ELIZABETH A. CALHOUN More articles by this author MICHEL A. PONTARI More articles by this author RICHARD B. ALEXANDER More articles by this author JOHN T. FARRAR More articles by this author MICHAEL P. O'LEARY More articles by this author Expand All Advertisement PDF downloadLoading ...