Pain and Urinary Symptoms Should Not Be Combined into a Single Score: Psychometric Findings from the MAPP Research Network

Overview

Journal J Urol

Publisher Wolters Kluwer

Specialty Urology

Date 2015 Nov 21

PMID 26585679

Citations 37

Authors

James W Griffith

Alisa J Stephens-Shields

Xiaoling Hou

Bruce D Naliboff

Michel Pontari

Todd C Edwards

David A Williams

J Quentin Clemens

Niloofar Afari

Frank Tu

R Brett Lloyd

Donald L Patrick

Chris Mullins

John W Kusek

Siobhan Sutcliffe

Barry A Hong

H Henry Lai

John N Krieger

Catherine S Bradley

Jayoung Kim

J Richard Landis

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to create symptom indexes, that is scores derived from questionnaires to accurately and efficiently measure symptoms of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, collectively referred to as urological chronic pelvic pain syndromes. We created these indexes empirically by investigating the structure of symptoms using exploratory factor analysis.

Materials And Methods: As part of the MAPP (Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain) Research Network 424 participants completed questionnaires, including GUPI (Genitourinary Pain Index), ICSI (Interstitial Cystitis Symptom Index) and ICPI (Interstitial Cystitis Problem Index). Individual items from questionnaires about bladder and pain symptoms were evaluated by principal component and exploratory factor analyses to identify indexes with fewer questions to comprehensively quantify symptom severity. Additional analyses included correlating symptom indexes with symptoms of depression, which is a known comorbidity of patients with pelvic pain.

Results And Conclusions: Exploratory factor analyses suggested that the 2 factors pain severity and urinary severity provided the best psychometric description of items in GUPI, ICSI and ICPI. These factors were used to create 2 symptom indexes for pain and urinary symptoms. Pain, but not urinary symptoms, was associated with symptoms of depression on multiple regression analysis, suggesting that these symptoms may impact patients with urological chronic pelvic pain syndromes differently (B ± SE for pain severity = 0.24 ± 0.04, 95% CI 0.16-0.32, β = 0.32, p <0.001). Our results suggest that pain and urinary symptoms should be assessed separately rather than combined into 1 total score. Total scores that combine the separate factors of pain and urinary symptoms into 1 score may be limited for clinical and research purposes.

Citing Articles

Relationship of Sex and Diagnosis With Symptoms and Illness Impact in Urologic Chronic Pelvic Pain; A Mapp Network Analysis.

Naliboff B, McWilliams T, Clemens J, Pontari M, Stephens-Shields A, Moldwin R Neurourol Urodyn. 2024; 44(2):400-408.

PMID: 39704257 PMC: 11788956. DOI: 10.1002/nau.25648.

This pain drives me crazy: Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome.

Mazza M, Margoni S, Mandracchia G, Donofrio G, Fischetti A, Kotzalidis G World J Psychiatry. 2024; 14(6):954-984.

PMID: 38984334 PMC: 11230088. DOI: 10.5498/wjp.v14.i6.954.

Validation of a simple body map to measure widespread pain in urologic chronic pelvic pain syndrome: A MAPP Research Network study.

Clemens J, Locke Jr K, Landis J, Kreder K, Rodriguez L, Yang C Neurourol Urodyn. 2024; 43(3):727-737.

PMID: 38270336 PMC: 10981467. DOI: 10.1002/nau.25400.

Neurobiology and long-term impact of bladder-filling pain in humans: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) research network study.

Schrepf A, Mawla I, Naliboff B, Gallop B, Moldwin R, Tu F Pain. 2023; 164(10):2343-2351.

PMID: 37278657 PMC: 10524087. DOI: 10.1097/j.pain.0000000000002944.

Clinically Important Differences for Pain and Urinary Symptoms in Urological Chronic Pelvic Pain Syndrome: A MAPP Network Study.

Stephens-Shields A, Lai H, Landis J, Kreder K, Rodriguez L, Naliboff B J Urol. 2023; 209(6):1132-1140.

PMID: 36848118 PMC: 11062515. DOI: 10.1097/JU.0000000000003394.

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