LUTS questionnaire validated in Japanese population

By Joanna Lyford, Senior medwireNews Reporter

The Core Lower Urinary Symptom Score (CLSS) questionnaire has been validated for use in Japanese patients and may be useful as a screening tool in both clinical or research settings, researchers report.

The CLSS was developed in 2008 and contains 10 questions concerning storage symptoms, voiding symptoms, pain, and burden associated with having lower urinary tract symptoms (LUTS).

In the latest research, Kikuo Okamura (Higashi Nagoya National Hospital, Japan) and co-authors sought to test the reliability and validity of the Japanese version of the CLSS using psychometric methods.

In all, 378 men and women from the general population attending educational lectures on LUTS in two cities were asked to complete the Japanese version of the CLSS.

The questionnaire response rates ranged from 63.3% to 84.5% at the two sites. The mean age of female respondents ranged from 65 to 68 years and the mean age of male respondents was 71 years at both sites.

In both men and women, the highest scoring item on the questionnaire was LUTS bother while the lowest scoring item was bladder and urethral pain. In men, stress incontinence scored at zero.

The Cronbach’s α coefficient was 0.721 in men and 0.733 in women, indicating that the CLSS had good internal consistency. Moreover, many of the 10 CLSS items significantly correlated with each other, suggesting that the questionnaire has both convergent and discriminant validity. This means that items that should have been related to each other were and that items that should not be related to each other were not.

Factor analysis determined that the CLSS has four domains: storage symptoms, voiding symptoms, pain and urinary incontinence; the latter included stress and urge incontinence in women but only stress incontinence in men.

These results support the “excellent constructive validity of the CLSS questionnaire in both sexes,” say the researchers.

When respondents were asked to identify their most burdensome symptom, just half choose one of their three core symptoms, however, raising doubts over the value and significance of this part of the questionnaire.

Writing in the International Journal of Urology, the authors say that their data confirm the validity and reliability of the Japanese version of the CLSS questionnaire. The questionnaire’s responsiveness to change over time remains to be determined in future work, they add.

The tool may prove useful “as screening tool for lower urinary tract symptoms in any clinical setting or epidemiological investigation,” Okamura et al conclude.

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