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Validation of A Computer Version of The Patient-Administered Danish Prostatic Symptom Score Questionnaire
Validation of A Computer Version of The Patient-Administered Danish Prostatic Symptom Score Questionnaire
and three for both presence of symptom and bothersomeness. These scores are then multiplied to give the
total score for the item. All scores for the 12 LUTS items
are then added to give the total score. The same
procedure is followed for the three questions on sexual
function (6). Until now the questionnaire has only been
administered in a paper version. It is usually mailed to the
patient or issued at the rst consultation. The physician
calculates the item and total scores by hand. To avoid
misunderstandings and mistakes in the answers (e.g.
indicating bother from a symptom not present), to
obviate the need to calculate the total score by hand
and to obtain computer registration of the data a patientadministered computerized questionnaire [for use on a
personal computer (PC)] was designed by one of the
authors (S.O.M.). Furthermore, we had noticed, in the
evaluation of the DAN-PSS system, a low response rate
to the three sexual questions, which we hoped to improve
by using a computer.
This study was performed to nd out whether the
computer model was reliable compared with the
previously validated paper version.
Scand J Urol Nephrol 35
197
RESULTS
198
H. L. Flyger et al.
DISCUSSION
A computerized questionnaire about LUTS has previously been used (7) in an interactive multimedia
prostate education program (MMP). In that study
patients rst completed a paper version of the IPSS
and then attended an education program before
completing a computer-administered IPSS. The study
showed a signi cant decrease in mean IPSS score as a
result of computerization of the questionnaire. This
study cannot be compared with our study because the
preconditions for the answers were different for the two
models. We did not see any difference in the answering
pattern depending on whether the paper or PC version
of the questionnaire was completed rst.
We found that all patients could handle the telephone keypad of the computer quickly and easily. A
likely explanation for this is that the rest of the
keyboard was covered so that patients only had 11
keys to choose from. This is corroborated by Maitland
& Mandel (8), who replaced the keyboard with a
numeric keypad, which the majority of their subjects
rated easy to use. Furthermore, they found that the
mean time to produce a computer report was signi cantly lower than that for a paper report (39 s vs 309 s).
We discovered that the older patients took longer to
answer but that the quality of the answers, judging by
the difference between paper and PC scores, was ageindependent; however, there was a large variation in
the results. Overall we observed a learning curve,
where the patients were three times faster on the last
question than on the rst (median 37 s vs 10 s).
Unfortunately it was not possible to register the time
used to answer the paper version.
In this study almost all subjects rated the computer
version favourably. This tendency is generally found in
studies where patients assess sensitive personal data
such as drug, alcohol and smoking habits (9), HIV/
AIDS risk (10) and sexual behaviour (11).
It seems that computer-based assessments are highly
Scand J Urol Nephrol 35
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