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

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 sub-sample 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.