Adult UrologyDiagnostic evaluation of the erectile function domain of the international index of erectile function
Section snippets
EF domain
The six items on the EF domain include detailed questions concerning erection frequency, erection firmness, penetration ability, maintenance frequency, maintenance ability, and erection confidence.1 All analyses were restricted to baseline (pretreatment) data. The enrolled samples in the analyses were composed of men who reported having had sexual activity at least once during the 4 weeks before their baseline responses to the questions. Each item was therefore based on a 5-point Likert scale.
Single cutoff scores
Table II shows the results for the different assumed prevalence rates of ED for the sample data. The optimal cutoff was 22 for prevalence rates of ED from 0.20 to 0.30, 25 for prevalence rates from 0.35 to 0.60, and 26 for a prevalence rate of 0.65. Diagnostic values for the optimal cutoff scores gave relatively high discrimination and, although the kappa values were lower for the lowest three prevalence rates, were generally similar across prevalence rates. All cross-validation results (not
Comment
The CART algorithm, which we applied to establish optimal cutoff scores, has been extensively applied to a wide range of clinical decision aids in published reports.9, 10 A cutoff score does not need to be optimal, however, to have adequate diagnostic characteristics; several cutoffs may be appropriate.8, 9, 10
We used only the EF domain of the IIEF to diagnose the presence and severity of ED. In general, favorable results were obtained that were easily interpreted. When the risk factors in
Conclusions
These data support the validity of the EF domain of the IIEF as a diagnostic tool in clinical settings for grading degrees of severity of ED and for distinguishing between men with and without the disorder. The IIEF is currently widely used in clinical trials of ED; the proposed classification would potentially enhance its use in both research and clinical settings. The proposed classification system, however, should not be viewed as a perfect diagnostic discriminator. The classifications are
Acknowledgements
To Drs. Murray C. Maytom, Frances Quirk, and Pierre A. Wicker, all from Pfizer Inc., for their helpful input.
References (19)
- et al.
The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction
Urology
(1997) - et al.
Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study
J Urol
(1994) - et al.
Construction of a surrogate variable for impotence in the Massachusetts Male Aging Study
J Clin Epidemiol
(1994) - et al.
A brief male sexual function inventory for urology
Urology
(1995) - et al.
The epidemiology of erectile dysfunction
Urol Clin North Am
(1995) - Goldstein I, Lue TF, Padma-Nathan H, et al: for the Sildenafil Study Group: Oral sildenafil in the treatment of...
- Goldstein I, and the Vasomax Study Group: Efficacy and safety of oral phentolamine (Vasomax) for the treatment of...
Impotence
JAMA
(1993)- et al.
Some developments on the International Index of Erectile Function (IIEF)
Drug Inf J
(1999)
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