A single-question, self-report of erectile dysfunction: comparison with a gold-standard urologic examination

Purpose To determine how well a single-question self-report measure of erectile dysfunction (ED), consistent with an NIH consensus approach, compares with a complete urologic examination. Methods The Massachusetts Male Aging Study (MMAS) is an observational study of aging and health in a population-based random sample of men. An interviewer-administered questionnaire included a single-item self-assessment of ED with response options of none, minimal, moderate, or complete. Of the 855 participants who completed the full MMAS protocol, 134 (age range: 55–85 years; mean ± SD: 67.0 ± 7.3 years) participated in a substudy involving an evaluation by a urologist blind to participant responses on the single-question self-report. Accuracy of self-reports were assessed with sensitivity, specificity, and other screening measures (using the urologic evaluation as the gold standard). Results ED by self-report and independent urologic evaluation were strongly correlated (Spearman r = 0.80). Prevalence (%) estimates of ED were categorized by three cutpoints (self-report; urologic evaluation): minimal, moderate, or complete (74.6; 75.4); moderate or complete (49.3; 59.7); and complete (29.1; 39.6). Sensitivity (range 67.9–91.1%) and specificity (range 75.8–96.3%) were relatively high and depended on categorization chosen, indicating good agreement between the single ED question and the urologic examination. Conclusion Our single-question self-report of erectile dysfunction compares well with a complete urologic examination—the so-called gold standard. Its brevity allows for cost-efficient and valid information gathering when conducting epidemiologic research. Our single ED question is useful for international comparative studies. It also could be useful in everyday clinical practice.