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November, 2017 >>

Content validation of the Urdu version of international prostate symptom score

Muhammad Salman  ( Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan, & Doctoral Student, Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains, Penang )

Amer Hayat Khan, Syed Azhar Syed Sulaiman  ( Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains, Penang, Malaysia. )


Madam, International Prostate Symptoms Score (IPSS)1 is frequently used to assess the severity of lower urinary tract symptoms (LUTS) both in the clinical and community based research. The tool was principally designed for men suffering from benign prostatic hyperplasia. However, it is extensively used as non-disease and non-sex-specific.2-5 IPSS is an 8-item questionnaire (7-items to assess the frequency and severity of LUTS and one Quality of life question) and has been translated and validated into various languages other than Urdu (national language of Pakistan). For that very reason, we conducted a prospective pilot study to assess the clarity, relevance and interpretation of each question of IPSS-Urdu and its response option. IPSS was translated into Urdu by two translation experts. Discrepancies were settled and this IPSS-Urdu version was checked by two Urologists and 4 non-urology doctors. It was translated back into English by two independent reviewers. Individuals for this pilot testing were recruited by convenient sampling (50 patients with LUTS and 50 normotensive individuals). All individuals were administered the IPSS-Urdu and additional questions regarding understandability of questions and response options, relevancy with urinary problems and personal interpretation of questions and response options were also asked. The mean age of the study participants was 48.56±15.01 years (LUTS patients 53.68±17.78 vs normotensives 43.44±9.55, p=0.001). Majority of the study participants had secondary level education (44.0%) followed by primary (31.0%). All the participants stated that they understood the questions completely and all questions were relevant to LUTS. However, a wide majority of the study participants (85.0%) stated that they were not able to understand the response options of first 6-items of IPSS -that is, "less than 1 times in 5, less than half of the time, almost half time, more than half the time"-. However, all of them completely understood the response options of item number 7 and 8. Moreover, all respondents were only able to complete the first 6-items of IPSS-Urdu with the help of a researcher who used appropriate Urdu adverbs and expressions (not at all, seldom/rarely, sometimes, often, usually and almost always) to clarify what was meant by these response options. Keeping in view of the findings of this study, we concluded that for the first 6-items of IPSS-Urdu a 6-point Likert-scale of "not at all", "seldom", "sometimes", "often", "usually" and "almost always" would better serve the purpose of assessing the severity of LUTS in Pakistani population.

Acknowledgment: The authors are grateful to the translation experts and doctors who contributed to the translation of IPSS into IPSS-Urdu. The authors are also grateful to MAPI Research Trust, Lyon, France for granting us the permission to use IPSS.

Disclaimer: Nil.
Conflict of Interest: Nil.
Funding Disclosure: Nil.


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