The 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 Calhoun, Michel A. Pontari, Richard B. Alexander, John T. Farrar, Michael P. O'Leary, Richard B. Alexander, J. Richard Landis, Mark S. Litwin, J. Curtis Nickel, Michael P. O'Leary, Michel A. Pontari, Anthony J. Schaeffer, Michael J. Barry, Charles L. Bennett, Wade Bushman, Elizabeth A. CalhounHoward Ceri, Denise Cifelli, James Duncan, John T. Farrar, Harold I. Feldman, Floyd J. Fowler, Duncan Hunter, Keith Jarvi, John Kusek, Mary McNaughton-Collins, Robert B. Nadler, Leroy M. Nyberg, Sathibalan Ponniah, Kathleen J. Propert, Michael R. Ruggieri, Daniel A. Shoskes

Research output: Contribution to journalArticle

666 Citations (Scopus)

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 (α = 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.

Original languageEnglish (US)
Pages (from-to)369-375
Number of pages7
JournalJournal of Urology
Volume162
Issue number2
DOIs
StatePublished - Aug 1999
Externally publishedYes

Fingerprint

Prostatitis
National Institutes of Health (U.S.)
Outcome Assessment (Health Care)
Quality of Life
Pelvic Pain
Validation Studies
Prostatic Hyperplasia
North America
Focus Groups
Research
Reproducibility of Results
Pain
Control Groups

Keywords

  • Health status
  • Pain
  • Pelvis
  • Prostatitis
  • Quality of life

ASJC Scopus subject areas

  • Urology

Cite this

Litwin, M. S., McNaughton-Collins, M., Fowler, F. J., Nickel, J. C., Calhoun, E., Pontari, M. A., ... Shoskes, D. A. (1999). The National Institutes of Health chronic prostatitis symptom index: Development and validation of a new outcome measure. Journal of Urology, 162(2), 369-375. https://doi.org/10.1016/S0022-5347(05)68562-X

The National Institutes of Health chronic prostatitis symptom index : Development and validation of a new outcome measure. / Litwin, Mark S.; McNaughton-Collins, Mary; Fowler, Floyd J.; Nickel, J. Curtis; Calhoun, Elizabeth; Pontari, Michel A.; Alexander, Richard B.; Farrar, John T.; O'Leary, Michael P.; Alexander, Richard B.; Landis, J. Richard; Litwin, Mark S.; Nickel, J. Curtis; O'Leary, Michael P.; Pontari, Michel A.; Schaeffer, Anthony J.; Barry, Michael J.; Bennett, Charles L.; Bushman, Wade; Calhoun, Elizabeth A.; Ceri, Howard; Cifelli, Denise; Duncan, James; Farrar, John T.; Feldman, Harold I.; Fowler, Floyd J.; Hunter, Duncan; Jarvi, Keith; Kusek, John; McNaughton-Collins, Mary; Nadler, Robert B.; Nyberg, Leroy M.; Ponniah, Sathibalan; Propert, Kathleen J.; Ruggieri, Michael R.; Shoskes, Daniel A.

In: Journal of Urology, Vol. 162, No. 2, 08.1999, p. 369-375.

Research output: Contribution to journalArticle

Litwin, MS, McNaughton-Collins, M, Fowler, FJ, Nickel, JC, Calhoun, E, Pontari, MA, Alexander, RB, Farrar, JT, O'Leary, MP, Alexander, RB, Landis, JR, Litwin, MS, Nickel, JC, O'Leary, MP, Pontari, MA, Schaeffer, AJ, Barry, MJ, Bennett, CL, Bushman, W, Calhoun, EA, Ceri, H, Cifelli, D, Duncan, J, Farrar, JT, Feldman, HI, Fowler, FJ, Hunter, D, Jarvi, K, Kusek, J, McNaughton-Collins, M, Nadler, RB, Nyberg, LM, Ponniah, S, Propert, KJ, Ruggieri, MR & Shoskes, DA 1999, 'The National Institutes of Health chronic prostatitis symptom index: Development and validation of a new outcome measure', Journal of Urology, vol. 162, no. 2, pp. 369-375. https://doi.org/10.1016/S0022-5347(05)68562-X
Litwin, Mark S. ; McNaughton-Collins, Mary ; Fowler, Floyd J. ; Nickel, J. Curtis ; Calhoun, Elizabeth ; Pontari, Michel A. ; Alexander, Richard B. ; Farrar, John T. ; O'Leary, Michael P. ; Alexander, Richard B. ; Landis, J. Richard ; Litwin, Mark S. ; Nickel, J. Curtis ; O'Leary, Michael P. ; Pontari, Michel A. ; Schaeffer, Anthony J. ; Barry, Michael J. ; Bennett, Charles L. ; Bushman, Wade ; Calhoun, Elizabeth A. ; Ceri, Howard ; Cifelli, Denise ; Duncan, James ; Farrar, John T. ; Feldman, Harold I. ; Fowler, Floyd J. ; Hunter, Duncan ; Jarvi, Keith ; Kusek, John ; McNaughton-Collins, Mary ; Nadler, Robert B. ; Nyberg, Leroy M. ; Ponniah, Sathibalan ; Propert, Kathleen J. ; Ruggieri, Michael R. ; Shoskes, Daniel A. / The National Institutes of Health chronic prostatitis symptom index : Development and validation of a new outcome measure. In: Journal of Urology. 1999 ; Vol. 162, No. 2. pp. 369-375.
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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 (α = 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.",
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T1 - The National Institutes of Health chronic prostatitis symptom index

T2 - Development and validation of a new outcome measure

AU - Litwin, Mark S.

AU - McNaughton-Collins, Mary

AU - Fowler, Floyd J.

AU - Nickel, J. Curtis

AU - Calhoun, Elizabeth

AU - Pontari, Michel A.

AU - Alexander, Richard B.

AU - Farrar, John T.

AU - O'Leary, Michael P.

AU - Alexander, Richard B.

AU - Landis, J. Richard

AU - Litwin, Mark S.

AU - Nickel, J. Curtis

AU - O'Leary, Michael P.

AU - Pontari, Michel A.

AU - Schaeffer, Anthony J.

AU - Barry, Michael J.

AU - Bennett, Charles L.

AU - Bushman, Wade

AU - Calhoun, Elizabeth A.

AU - Ceri, Howard

AU - Cifelli, Denise

AU - Duncan, James

AU - Farrar, John T.

AU - Feldman, Harold I.

AU - Fowler, Floyd J.

AU - Hunter, Duncan

AU - Jarvi, Keith

AU - Kusek, John

AU - McNaughton-Collins, Mary

AU - Nadler, Robert B.

AU - Nyberg, Leroy M.

AU - Ponniah, Sathibalan

AU - Propert, Kathleen J.

AU - Ruggieri, Michael R.

AU - Shoskes, Daniel A.

PY - 1999/8

Y1 - 1999/8

N2 - 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 (α = 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.

AB - 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 (α = 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.

KW - Health status

KW - Pain

KW - Pelvis

KW - Prostatitis

KW - Quality of life

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