VALIDATION OF THE SELF-ADMINISTERED DANISH PROSTATIC SYMPTOM SCORE (DAN-PSS-1) SYSTEM FOR USE IN BENIGN PROSTATIC HYPERPLASIA

Objective To validate the Danish Prostatic Symptom Score (DAN-PSS-1), a self-administered quality-of-life questionnaire comprising 12 questi ons related to voiding problems and the perceived bother of each indiv idual symptom. Methods Using published results from several comparison s of other symptom scoring systems with DAN-PSS-1, the test-retest rel iability, internal consistency, construct and content validity, and re sponsiveness of the DAN-PSS-1 system were assessed. Results The system was internally consistent (Cronbach's alpha = 0.73), the median test- retest reliability of answers to each question was 83.5% (range 0-99.7 %) and the questionnaire was well understood by the patients, The DAN- PSS-1 system demonstrated a high degree of construct validity, correla ting with the extensively used Madsen-Iversen score system (Spearman's correlation coefficient, r(s) = 0.51) and with the patients' answers to questions about how bothersome their symptoms were (r(s) = 0.71). T he DAN-PSS-I system discriminated clearly between patients with benign prostatic hyperplasia (BPH) and control subjects (an area under the r eceiver operating characteristic curve of 0.94), Finally, the DAN-PSS- 1 was sensitive to changes following intervention, with scores decreas ing from a median of 20 to zero 4 months after patients underwent tran surethral prostatectomy and from a median of 11.5 to 7.5 (65%) after p atients had received 4 months treatment with an alpha-blocker. Conclus ions The DAN-PSS-1 system is reliable, valid and responsive, and there fore can be recommended for assessing the severity of symptoms among p atients presenting with lower urinary tract complaints suggestive of B PH and in the follow-up after intervention.