Patient and partners' reported outcomes in sexual dysfunction

Article type
Authors
Guillén V1, Ballesteros J1, Santos B1, Gonzalez-Fraile E2, Corcuera J1, Martinez E1
1University of the Basque Country
2International University of La Rioja
Abstract
Background: In Cochrane, patient-reported outcomes methods focus on outcomes that are self-reported by participants. These outcomes may include health status, quality of life, adherence to treatment recommendations and satisfaction with treatment. Sexual dysfunction is highly prevalent but half of published articles are focused on the male population. Total or partial scores for sexual dysfunction (confidence, maintenance of erection and satisfaction), measured by means of validated questionnaires (e.g. the International Index of Erectile Function (IIEF)), are accepted as primary or secondary outcomes in Cochrane Reviews. However, standardisation is required.

Objectives: This study provides an overview of validated rating scales for measuring sexual dysfunction in males and females. We analyse the domains of these scales in the validation studies.

Methods: We carried out electronic searches for relevant trials and reviews in the PubMed and Cochrane databases. We excluded self-esteem and relationship questionnaires.

Results: The results reflect the diversity of the published studies. In general, we publish twice as much about male than female sexual dysfunction, however Cochrane Reviews are balanced between males and females. In total, we identified 16 rating scales for multi-domain evaluation of sexual dysfunction. Two scales were exclusively for females, 10 were for males and 4 were for both sexes. In the application studies, we counted the number of times each of the scales was used. We used data from the validation studies to distil the psychometric characteristics of the rating scales. We obtained psychometric characteristics, described in terms of the reliability and validity of the most-used scales: the Arizona Sexual Experience Scale and the Cosmin Checklist. We meta-analysed the pooled results for the psychometric properties of the four most-used scales. These approaches remain vulnerable to differential variability in populations and many medical outcomes are related to sexual dysfunction.

Conclusions: Scales for males mainly used the domains erectile function, orgasmic function, sexual desire, intercourse satisfaction and global satisfaction. Scales for both males and females were a little bit different, measuring domains such as interest, desire, arousal, lubrication, orgasm, satisfaction and pain.