The international prostate symptom score: physician versus self-administration in the quantification of symptomatology

Urology. 1996 Mar;47(3):326-8. doi: 10.1016/s0090-4295(99)80447-6.


Objectives: The International Prostate Symptom Score (IPSS), originally known as the American Urological Association Score, is the most commonly used scoring system for the quantification of benign prostatic hyperplasia symptoms. One area that has remained unexplored is the stability of the questionnaire construct between different modes of administration. The objective of this study was to measure differences in IPSS when administered by the physician versus patient self-administration. The impact of order of administration was also examined.

Methods: Sixty-four patients completed two IPSS questionnaires during the same office visit, one self-administered and the other by physician interview. The influence of order of administration was examined by randomly allocating patients to either self-administration or physician-administration first. Total symptom scores (questions 1 to 7) and quality of life scores (question 8) were compared between the two modes of administration. Multivariate analysis of variance was performed to assess the effect of age, medical history (obtained from the IPSS form), order of administration, and physician (A and B) on the observed differences.

Results: The distribution of differences was similar between the two orders of administration. Overall, 26 patients had a higher total score with self-administration, 30 with physician-administration, and 8 had identical scores on both. Mean total symptom scores and quality of life assessments by physician- versus patient-administered questionnaires were similar (10.9 versus 10.4 and 1.8 versus 2.2, respectively). No statistically significant difference was observed. The order of administration did not show statistical significance (P > 0.05) by multivariate analysis. As well, no interaction was seen between the aforementioned variables.

Conclusions: There is no difference in the information obtained if patients self-administer the questionnaire as opposed to physician administration.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Humans
  • Male
  • Multivariate Analysis
  • Physicians
  • Prostatic Hyperplasia / diagnosis*
  • Quality of Life
  • Self Administration
  • Severity of Illness Index*
  • Surveys and Questionnaires