ORIGINAL RESEARCH–OUTCOMES ASSESSMENT: Evaluation of the Psychometric Properties of the Life Satisfaction Checklist as a Screening Tool for Erectile Dysfunction

Authors


Ignacio Moncada, MD, Department of Urology, Hospital Gregorio Marañón, Dr. Esquerdo, 46, Madrid 28007 Spain. Tel: +34629057026; Fax: +34913833059; E-mail: ignacio@moncada.name

ABSTRACT

Introduction.  There is a need for a more feasible and acceptable screening tool for erectile dysfunction (ED) in our health context. The Fugl-Meyer's Life Satisfaction Checklist (LISAT-8) has been shown to be a simple and good instrument for assessing the satisfaction of ED patients in different aspects of their lives and has also shown acceptable psychometric properties to be used in the Spanish population with ED. Furthermore, this checklist has been used as a screening tool in patients with and without ED, showing valid and reliable properties for detection of ED.

Aim.  To evaluate the validity and feasibility of LISAT-8 checklist as a screening tool to detect ED.

Methods and Main Outcome Measures.  A cross-sectional, multicenter, and observational study was conducted including 6,986 Spanish men aged over 18 years. Patients completed the International Index of Erectile Function (IIEF), Sexual Health Inventory for Men (SHIM) and LISAT-8 checklists. Questions about the simplicity of SHIM and LISAT-8 and time to complete them were used for feasibility evaluation. We used logistic regression analysis to select the best predictors for ED among the different items of LISAT-8 and the receiver operating characteristic (ROC) curve analysis to select the best cutoff value discriminating ED vs. non-ED subjects. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), along with kappa agreement coefficient, were also estimated.

Results.  A total of 6,986 patients were included. Among the patients, 71.2% preferred LISAT-8 to SHIM. Time to completion of checklist was 0.5 minute less with LISAT-8 than with SHIM (P < 00001). Items 2 (sexual life), 5 (contacts with friends and acquaintances), and 3 (partner relationship) of LISAT–8 were selected as predictors for ED. ROC curve analysis showed a cutoff point ≥15 with a sensitivity of 81.7% (95% confidence intervals: 80.5–82.9), a specificity of 79.2% (77.5–80.8), and PPV of 88.7% (87.6–89.8%) and NPV of 72.0% (70.0–73.0%). Kappa agreement coefficients were 0.57 (LISAT-8 vs. SHIM) and 0.60 (LISAT-8 vs. IIEF).

Conclusions.  LISAT-8 and its composite variable (formed by items 2 + 3 + 5) showed acceptable psychometric properties, and it could be a valid screening tool for ED in daily clinical practice. Moncada I, Micheltorena CF, Martínez-Sánchez EM, and Rejas Gutiérrez J. Evaluation of the psychometric properties of the LISAT-8 checklist as a screening tool for erectile dysfunction. J Sex Med 2008;5:83–91.

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