The International Prostate Symptom Score [IPSS] Thai Version: Misunderstanding and Modi(cid:976)ication
Pat Saksirisampant MD1, Apirak Santingamkul MD1
Affiliation : 1 Division of Urology, Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
Objective : To explore and detect problems about misunderstanding/misinterpretation of the International Prostate Symptom
Score [IPSS] Thai version and attempt to (cid:976)ind a solution by developing a modi(cid:976)ied version.
Materials and Methods : Two exploratory surveys were conducted in populations supposed to have LUTS. In the (cid:976)irst survey, after
explanation, 49 participants were tested with the original IPSS Thai version and a new preliminary version A. They rated the level
of ease-dif(cid:976)iculty in understanding of both versions. In the second survey, with 135 respondents, three versions were tested; the
original, the preliminary version A and B, without explanation given. There were observers detecting respondents’ problems in
completing the questionnaires. The problems were evaluated using Student’s t-test, ANOVA, univariate, and multivariate analyses.
Results : In the (cid:976)irst survey, the preliminary version A was signi(cid:976)icantly easier to understand from the ease-dif(cid:976)iculty score, while the
second survey showed no difference among all three versions. Four problems were detected, which were rating number confusion,
proportional number misunderstanding, the second question misunderstanding, and preliminary versions doubt. With higher
ages, more problems existed, but with higher education, fewer misunderstandings appeared. Lower educated respondents, junior
high school, and primary school level or below were about 3 and 16 times more likely to experience problems, respectively. The
problems were almost 6-fold more likely to occur in respondents older than 70 years. With low education and old age occurring
together, problems were much more likely to appear (OR 91.00, 95% CI 10.59 to 781.63).
Conclusion : There were some misunderstandings and misinterpretation problems in the IPSS Thai version, which were more
likely to occur in low educated and/or elderly responders. The validity and reliability of the modi(cid:976)ied version of Thai IPSS will be
further studied.
Keywords : International Prostate Symptom Score, IPSS, Thai version, Misunderstanding/misinterpretation, Problem
