Construction and validation of a short-form benign prostatic hypertrophy health-related quality-of-life questionnaire

Objective To construct and validate a short-form benign prostatic hypertrophy (BPH) health-related quality-of-life (HRQL) questionnaire which is more practical in use and as informative as the 20-item visual analogue scale questionnaire (QOL20) previously validated in French. Patients and methods From the factorial structure of the QOL20, a nine-item questionnaire (QOL9) was constructed using stepwise linear regression and factorial analysis. The feasibility and reliability of the QOL9 were analysed in a cross-sectional case-control study and a longitudinal cohort study, including symptomatic patients with BPH treated for 6 months with an alpha(1)-blocker (alfuzosin). Results The reduction of the QOL20 to QOL9 showed a minimal loss of information (90 - 95% of the variance of QOL20 was explained by QOL9) and lead to a three-dimensional structure: well being, patients' perceived sexual-life status, and BPH interference with activities. The QOL9 was practical in use (completion rate 87 - 100%; duration of completion at inclusion 11.6, so 2.0 min), consistent (Cronbach's alpha > 0.7), reliable (intraclass correlation coefficient > 0.80) and responsive (effect-size index 0.9, so 0.01 in the longitudinal study). Conclusions The QOL9 is a good BPH HRQL questionnaire, including an assessment of patients' perceived sexual-life status; it easy to administer, accurate, reproducible and responsive to change with treatment. We suggest that the QOL9 be substituted for the QOL20 and administered in addition to the International Prostate Symptom Score to obtain a better assessment of the patients' perception of their disease.