American Urological Association-symptom Index Lacks Internal Consistency for Measuring Storage Voiding Symptoms

Area of Science:

• Urology
• Clinical Assessment
• Patient Reported Outcomes

Background:

• The American Urological Association Symptom Index (AUA-SI) is widely used to evaluate lower urinary tract symptoms (LUTS).
• Its validity across diverse populations and symptom types requires ongoing examination.

Purpose of the Study:

• To assess the internal consistency and test-retest reliability of the AUA-SI.
• To examine the AUA-SI's correlation with other validated measures of urinary symptom severity.
• To evaluate the AUA-SI's performance in assessing LUTS in both men and women.

Main Methods:

• Assessed AUA-SI reliability in a US community-dwelling cohort (n=1551) and a national care-seeking cohort (n=1083).
• Correlated AUA-SI scores with the Lower Urinary Tract Symptoms tool (LUTS tool) and International Consultation on Incontinence Questionnaire-lower urinary tract symptoms (ICIQ-LUTS).

Main Results:

• Men reported more severe voiding symptoms; women reported more storage symptoms.
• AUA-SI demonstrated good internal consistency for voiding symptoms (>0.7) but poor consistency for storage symptoms (0.61 men, 0.56 women).
• Correlations between AUA-SI and other measures were poor, particularly for women and storage LUTS-related quality of life.

Conclusions:

• The AUA-SI is validated for men with benign prostatic hyperplasia but shows limitations in assessing storage LUTS and related quality of life, especially in women.
• Clinicians should exercise caution when using the AUA-SI for non-validated indications, particularly for female storage voiding dysfunction.
• Further research may be needed to develop or validate tools for comprehensive LUTS assessment in women.