Skip to main content

Advertisement

SpringerLink
Log in

The validity of a single-question self-report of erectile dysfunction

Results from the massachusetts male aging study

  • Original Article
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: To determine how well a single question of self-reported erectile dysfunction compares to a gold standard clinical urologic examination.

DESIGN AND SETTING: Clinical validation study nested within the Massachusetts Male Aging Study (MMAS), which is an observational cohort study of aging and health in a population-based random sample of men.

MEASUREMENT: During an in-person interview, men were asked to respond to a single-question self-report of erectile dysfunction. A subsample of MMAS participants was then subjected to a clinical urologic examination to obtain a clinical diagnosis of erectile dysfunction.

PARTICIPANTS: One hundred thirty-nine men 55 to 85 years of age from the MMAS.

RESULTS: Complete data were available from 137 men. Erectile dysfunction (ED) measured by self-report and independent urologic examination were strongly correlated (Spearman r=.80). Receiver operating curve analysis showed that the self-reported ED item accurately predicts the clinician-diagnosed ED (area under the curve [AUC]=0.888). Stratum-specific likelihood ratios (95% confidence intervals) for self-reports predicting the gold standard were: no ED=0.11 (0.06 to 0.22), minimal ED=1.48 (0.67 to 3.26), moderate ED=8.57 (1.21 to 60.65), and complete ED=12.69 (1.81 to 88.79). These data indicate that men diagnosed with ED by urologic examination can be distinguished from men not diagnosed with ED by urologic examination if the respondent self-reported no, moderate, or complete ED.

CONCLUSION: Our single-question self-report accurately identifies men with clinically diagnosed ED, and may be useful as a referral screening tool in both research studies and general practice settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. NIH Consensus Conference. Impotence. (Speakers included McKinlay JB, The prevalence and demographics of impotence.) J Am Med Assoc. 1993;270:83–90. Also published as NIH Consensus Statement. 1992;10:1–31.

    Article  Google Scholar 

  2. Feldman HA, Goldstein I, McKinlay JB, Hatzichristou DG, Krane RJ. Impotence and its medical and psychosocial correlates in men aged 40–70: results of the Massachusetts Male Aging Study. J Urol. 1994;151:54–61.

    PubMed  CAS  Google Scholar 

  3. Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB. Incidence of erectile dysfunction in men ages 40–69: longitudinal results from the Massachusetts Male Aging Study. J Urol. 2000;163:460–3.

    Article  PubMed  CAS  Google Scholar 

  4. Sairam K, Kulinskaya E, Boustead GB, Hanbury DC, McNicholas TA. Prevalence of undiagnosed diabetes mellitus in male erectile dysfunction. BJU Int. 2001;88:68–71.

    Article  PubMed  CAS  Google Scholar 

  5. Sasayama S, Ishii N, Ishikura F, et al. Men’s Health Study: epidemiology of erectile dysfunction and cardiovascular disease. Circ J. 2003;67:656–9.

    Article  PubMed  Google Scholar 

  6. McKinlay JB. The worldwide prevalence and epidemiology of erectile dysfunction. Int J Impot Res. 2000;12(suppl 4):S6-S11.

    Article  PubMed  Google Scholar 

  7. Speel TG, van Langen H, Meuleman EJ. The risk of coronary heart disease in men with erectile dysfunction. Eur Urol. 2003;44:366–70.

    Article  PubMed  CAS  Google Scholar 

  8. Kirby M, Jackson G, Betteridge J, Friedli K. Is erectile dysfunction a marker for cardiovascular disease? Int J Clin Pract. 2001;55:614–8.

    PubMed  CAS  Google Scholar 

  9. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational study of the aging male (MSAM-7). Eur Urol. 2003;44:637–49.

    Article  PubMed  Google Scholar 

  10. Boyle P, Robertson C, Mazzetta C, et al. UrEpik Study Group. The association between lower urinary tract symptoms and erectile dysfunction in four centers: the UrEpik study. BJU Int. 2003;92:719–25.

    Article  PubMed  CAS  Google Scholar 

  11. Braun MH, Sommer F, Haupt G, Mathers MJ, Reinfenrath B, Engelmann UH. Lower urinary tract symptoms and erectile dysfunction: comorbidity or typical “Aging Male” symptoms? Results of the “Cologne Male Survey. Eur Urol. 2003;44:588–94.

    Article  PubMed  CAS  Google Scholar 

  12. Levine LA, Kloner RA. Importance of asking questions about erectile dysfunction. Am J Cardiol. 2000;86:1210–3.

    Article  PubMed  CAS  Google Scholar 

  13. Krane RJ, Goldstein I, Sáenz de Tejada I. Impotence. N Engl J Med. 1989;321:1648–59.

    Article  PubMed  CAS  Google Scholar 

  14. Guest JF, Das Gupta R. Health-related quality of life in a UK-based population of men with erectile dysfunction. Pharmacoeconomics. 2002;20:109–17.

    Article  PubMed  Google Scholar 

  15. Sanchez-Cruz JJ, Cabrera-Leon A, Martin-Morales A, Fernandez A, Burgos R, Rejas J. Male erectile dysfunction and health-related quality of life. Eur Urol. 2003;44:245–53.

    Article  PubMed  CAS  Google Scholar 

  16. O’Leary MP, Lenderking WR, Barber B, Sagnier PP, Guess HA, Barry MJ. A brief male sexual function inventory for urology. Urology. 1995;46:697–706.

    Article  PubMed  CAS  Google Scholar 

  17. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30.

    Article  PubMed  CAS  Google Scholar 

  18. Kleinman KP, Feldman HA, Johannes CB, McKinlay JB. A new surrogate variable for erectile dysfunction status in the Massachusetts Male Aging Study. J Clin Epidemiol. 2000;53:71–8.

    Article  PubMed  CAS  Google Scholar 

  19. Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12:439–45.

    Article  PubMed  CAS  Google Scholar 

  20. Peralta RL, Fleming MF. Screening for intimate partner violence in a primary care setting: the validity of “feeling safe at home” and prevalence results. J Am Board Fam Pract. 2003;16:525–32.

    Article  PubMed  Google Scholar 

  21. Derby CA, Araujo AB, Johannes CB, Feldman HA, McKinlay JB. Measurement of erectile dysfunction in population-based studies: the use of a single question self-assessment in the Massachusetts Male Aging Study. Int J Impot Res. 2000;12:197–204.

    Article  PubMed  CAS  Google Scholar 

  22. O’Donnell AB, Araujo AB, McKinlay JB. The health of normally aging men: the Massachusetts Male Aging Study (1987–2004). Exp Gerontol. 2004;39:975–84.

    Article  PubMed  Google Scholar 

  23. McKinlay JB, Feldman HA. Age-related variation in sexual activity and interest in normal men: results from the Massachusetts Male Aging Study. In: Rossi A, ed. Sexuality Across the Life Course: Proceedings of the MacArthur Foundation Research Network on Successful Mid-life Development. Chicago, IL: University of Chicago Press; 1994:261–85.

    Google Scholar 

  24. Rosen RC, Goldstein I, Heiman J, et al. The process of care model for evaluation and treatment of erectile dysfunction. Int J Impot Res. 1999;11:59–74.

    Article  Google Scholar 

  25. Lizza EF, Rosen RC. Definition and classification of erectile dysfunction: report of the Nomenclature Committee of the International Society of Impotence Research. Int J Impot Res. 1999;11:141–3.

    Article  PubMed  CAS  Google Scholar 

  26. Jardin A, Wagner G, Khoury S, et al. Recommendations of the 1st International Consultation on Erectile Dysfunction. In: Jardin A, Wagner G, Khoury S, Giuliano F, Padma-Nathan H, Rosen RC, eds. Erectile Dysfunction: 1st International Consultation on Erectile Dysfunction. Oxford: Health Publication Ltd.; 2000:711–26.

    Google Scholar 

  27. Deeks JJ, Altman DG. Diagnostic tests: likelihood ratios. BMJ. 2004;329:168–9.

    Article  PubMed  Google Scholar 

  28. Trude S. So much to do, so little time: physician capacity constraints, 1997–2001. Track Rep. 2003;8:1–4.

    PubMed  Google Scholar 

  29. Linzer M, Konrad TR, Douglas J, et al. Managed care, time pressure, and physician job satisfaction: results from the Physician Worklife Study. J Gen Intern Med. 2000;15:441–50.

    Article  PubMed  CAS  Google Scholar 

  30. Marwick C. Survey says patients expect little physician help on sex. JAMA. 1999;281:2173–4.

    Article  PubMed  CAS  Google Scholar 

  31. Amory JK, Watts NB, Easley KA, et al. Exogenous testosterone or testosterone with finasteride increases bone mineral density in older men with low serum testosterone. J Clin Endocrinol Metab. 2004;89:503–10.

    Article  PubMed  CAS  Google Scholar 

  32. Derby CA, Mohr B, Goldstein I, Feldman HA, Johannes CB, McKinlay JB. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000;56:302–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. New England Research Institutes, 9 Galen Street, 02472, Watertown, MA

    Amy B. O’Donnell MPH, Andre B. Araujo MA &  John B. McKinlay PhD

  2. Boston University School of Medicine, Boston, MA, USA

    Irwin Goldstein MD

Authors
  1. Amy B. O’Donnell MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andre B. Araujo MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Irwin Goldstein MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John B. McKinlay PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John B. McKinlay PhD.

Additional information

There are no conflicts of interest for any of the authors except IG who is a consultant for Pfizer, Bayer, Glaxo-Smith Klein, ICOS, Eli Lilly, AMS, and Mentor.

Information was presented at the American Urology Association annual meeting, San Francisco, CA, May 2004, and Society of Epidemiologic Research annual meeting, Salt Lake City, UT, June 2004.

This work was supported by the National Institute of Diabetes and Digestive and Kidney Disorders (grant DK44995).

Rights and permissions

Reprints and permissions

About this article

Cite this article

O’Donnell, A.B., Araujo, A.B., Goldstein, I. et al. The validity of a single-question self-report of erectile dysfunction. J GEN INTERN MED 20, 515–519 (2005). https://doi.org/10.1111/j.1525-1497.2005.0076.x

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1525-1497.2005.0076.x

Key Words

Search

Navigation