• Amy B O'Donnell, Andre B Araujo, Irwin Goldstein, and John B McKinlay.
• New England Research Institutes, Watertown, MA 02472, USA.
• J Gen Intern Med. 2005 Jun 1; 20 (6): 515519515-9.

ObjectiveTo determine how well a single question of self-reported erectile dysfunction compares to a gold standard clinical urologic examination.Design And SettingClinical 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.MeasurementDuring an in-person interview, men were asked to respond to a single-question self-report of erectile dysfunction. A subsample of MMAS participants was then subjected to a clinical urologic examination to obtain a clinical diagnosis of erectile dysfunction.ParticipantsOne hundred thirty-nine men 55 to 85 years of age from the MMAS.ResultsComplete 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.ConclusionOur 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.

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