Validation of three early ejaculation diagnostic tools: a composite measure is accurate and more adequate for diagnosis by updated diagnostic criteria

PLoS One. 2013 Oct 15;8(10):e77676. doi: 10.1371/journal.pone.0077676. eCollection 2013.


Purpose: To validate three early ejaculation diagnostic tools, and propose a new tool for diagnosis in line with proposed changes to diagnostic criteria. Significant changes to diagnostic criteria are expected in the near future. Available screening tools do not necessarily reflect proposed changes.

Materials and methods: Data from 148 diagnosed early ejaculation patients (M age = 42.8) and 892 controls (M age = 33.1 years) from a population-based sample were used. Participants responded to three different questionnaires (Premature Ejaculation Profile; Premature Ejaculation Diagnostic Tool; Multiple Indicators of Premature Ejaculation). Stopwatch measured ejaculation latency times were collected from a subsample of early ejaculation patients. We used two types of responses to the questionnaires depending on the treatment status of the patients 1) responses regarding the situation before starting pharmacological treatment and 2) responses regarding current situation. Logistic regressions and Receiver Operating Characteristics were used to assess ability of both the instruments and individual items to differentiate between patients and controls.

Results: All instruments had very good precision (Areas under the Curve ranging from .93-.98). A new five-item instrument (named CHecklist for Early Ejaculation Symptoms - CHEES) consisting of high-performance variables selected from the three instruments had validity (Nagelkerke R (2) range .51-.79 for backwards/forwards logistic regression) equal to or slightly better than any individual instrument (i.e., had slightly higher validity statistics, but these differences did not achieve statistical significance). Importantly, however, this instrument was more in line with proposed changes to diagnostic criteria.

Conclusions: All three screening tools had good validity. A new 5-item diagnostic tool (CHEES) based on the three instruments had equal or somewhat more favorable validity statistics compared to the other three tools, but is more in line with recently proposed diagnostic criteria.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Ejaculation
  • Humans
  • Male
  • Premature Ejaculation / diagnosis*
  • Premature Ejaculation / physiopathology
  • Sensitivity and Specificity
  • Surveys and Questionnaires*

Grant support

This study was funded by a personal post-doctorate grant to Dr. Jern from the Academy of Finland (Grant No. 138291, web page The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.