Who should we trust in screening for lower urinary tract dysfunction in children: the parents or the child?

To investigate whether the child's and the parents' reports about lower urinary tract symptoms (LUTS) are reliable and correlate with each other.

A validated questionnaire, the International Consultation on Incontinence Questionnaire Pediatric Lower Urinary Tract Symptoms, including both children and parent versions, was completed by children (age 5-18 years) with and without LUTS (control) and their parents without assistance. All children were investigated with detailed history, bladder diary, urinalysis, and flowmetry with postvoid residual urine volume measurement. The data were stratified into 3 age groups (5-9, 10-13, and 14-18 years). The reliability of both versions was evaluated using Cronbach's α and ≥0.7 indicated acceptability. The correlation between the children's and parents' reports for each question was evaluated using Spearman correlation coefficients. The receiver operating characteristic curve was used to define the cutoff points, and the sensitivity and specificity were calculated. The principal component analysis method was used to explain the construct validity.

A total of 272 children (147 with and 125 without LUTS) and their parents completed the questionnaire. The children and parent versions of the questionnaire were both reliable (Cronbach's α 0.709 and 0.710, respectively). The sensitivity and specificity was 82.4% and 80.0% for the children version and 87.8% and 78.4% for the parent version, respectively. The reliability and acceptability of the children's reports were insufficient for the 5-9 year age group, and the parents' answers were unreliable for the 10-13 year age group. The correlation between the parent and children reports was the lowest for the 10-13 year age group.

The alteration in the reliability in the different age groups suggests that the combination of the parent and children versions is most appropriate for screening children with LUTS.