New self-reporting questionnaire to assess urinary tract infections and differential diagnosis: acute cystitis symptom score

Urol Int. 2014;92(2):230-6. doi: 10.1159/000356177. Epub 2014 Jan 23.


Objective: Development and validation of a simple and standardized self-reporting questionnaire for acute uncomplicated cystitis (AUC) assessing typical and differential symptoms, quality of life and possible changes after therapy in female patients with AUC.

Materials and methods: Literature research, development and evaluation of the Acute Cystitis Symptom Score (ACSS), an 18-item self-reporting questionnaire including (a) six questions about 'typical' symptoms of AUC, (b) four questions regarding differential diagnoses, (c) three questions on quality of life and (d) five questions on additional conditions which may affect therapy. The ACSS was evaluated in 286 women (mean age 32.3 ± 12.3 years) in the Russian and Uzbek language. Measurements of reliability, validity, predictive ability and responsiveness were performed.

Results: Cronbach's alpha for the ACSS was 0.89, split-half reliability was 0.92 and correlation between halves was 0.85. Mann-Whitney test revealed significant difference scores of the 'typical' domain between patients and controls (10.75 vs. 2.02, p < 0.001). The optimal threshold score was 6 points, with a 94% sensitivity and 90% specificity to predict AUC. The symptom score decreased significantly when comparing before and after therapy (10.7 vs. 2.1, p < 0.001).

Conclusion: The new validated ACSS is accurate enough and can be recommended for clinical studies and practice for initial diagnosis and monitoring treatment of AUC. Evaluation in other languages is in progress.

Publication types

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

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Cystitis / diagnosis*
  • Cystitis / psychology
  • Diagnosis, Differential
  • Female
  • Humans
  • Middle Aged
  • Quality of Life
  • Reproducibility of Results
  • Self Report
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • Symptom Assessment
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / psychology
  • Young Adult