Validation of the Spanish Acute Cystitis Symptoms Score (ACSS) in native Spanish‐speaking women of Europe and Latin America

• Published in: Neurourology and urodynamics Vol. 42; no. 1; pp. 263 - 281
• Main Authors: Medina‐Polo, José, Arrébola‐Pajares, Ana, Corrales‐Riveros, Juan Guillermo, Alidjanov, Jakhongir F., Lorenzo‐Gómez, María F., Tapia, Ana‐María H., Martínez‐Berganza, María Lourdes, Ospina‐Galeano, Irma A., Padilla‐Fernández, Bárbara, Pilatz, Adrian, Naber, Kurt G., Wagenlehner, Florian M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-01-2023; John Wiley and Sons Inc
• Subjects: acute cystitis; Acute Disease; Adolescent; Clinical; Cognitive ability; Cystitis; Cystitis - diagnosis; Europe; Female; Humans; Latin America; Patients; patient‐reported outcome (PRO); Quality of Life; questionnaire; Questionnaires; Reproducibility of Results; Statistical analysis; Surveys and Questionnaires; Translations; urinary tract infection (UTI); women; Europe; Latin America; patient-reported outcome (PRO); questionnaire; urinary tract infection (UTI); acute cystitis; women
• ISSN: 0733-2467; 1520-6777; 1520-6777
• DOI: 10.1002/nau.25079

Introduction and Objectives
The Acute Cystitis Symptom Score (ACSS) is a patient self‐reporting questionnaire for clinical diagnostics and patient‐reported outcome (PRO), which may assess the symptoms and the effect on the quality of life in women with acute cystitis (AC). The current study aimed to create a validated Spanish version of the ACSS questionnaire.
Material and Methods
The process of linguistic validation of the Spanish version of the ACSS consisted of the independent forward and backward translations, revision and reconciliation, and cognitive assessment. Clinical evaluation of the study version of the ACSS was carried out in clinics in Spain and Latin America. Statistical tests included the calculation of Cronbach's α, split‐half reliability, specificity, sensitivity, diagnostic odds ratio, positive and negative likelihood ratio, and area under the receiver‐operating characteristic curve (AUC).
Results
The study was performed on 132 patients [age (mean;SD) 45.0;17.8 years] with AC and 55 controls (44.5;12.2 years). Cronbach's α of the ACSS was 0.86, and the split‐half reliability was 0.82. The summary scores of the ACSS domains were significantly higher in patients than in controls, 16.0 and 2.0 (p < 0.001), respectively. The predefined cut‐off point of ≥6 for a summary score of the “Typical” domain resulted in a specificity of 83.6% and a sensitivity of 99.2% for the Spanish version of the ACSS. AUC was 0.91 [0.85; 0.97].
Conclusions
The validated Spanish ACSS questionnaire evaluates the symptoms and clinical outcomes of patients with AC. It can be used as a patient's self‐diagnosis of AC, as a PRO measure tool, and help to rule out other pathologies in patients with voiding syndrome.