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Research methodologist Andrew Vickers offers some suggestions on how to improve questionnaires about erectile function. The more information that’s shared, the easier it is to make a definitive diagnosis.
Widely used as a tool in the diagnosis of erectile dysfunction, the International Index of Erectile Function is a self-administered questionnaire that gives medical professionals insights into a patient’s degree of ED.
The IIEF-6 is confined to six of the 15 questions in the full IIEF and is referred to as the erectile function portion of IIEF. Those six questions focus on erection firmness, confidence level, and ability to penetrate and maintain hardness. However, this widely used gauge of male impotence fails to ask some important questions, according to research methodologist Andrew Vickers.
Why These Questions Matter
In a presentation at the annual meeting of the American Urological Association in November 2019, Vickers said answers to these missing questions could better confirm a diagnosis of ED and indicate the level of dysfunction.
As reported at UrologyTimes.com, Vickers, attending research methodologist with Memorial Sloan Kettering Cancer Center, also took particular issue with the time frame for questions within the IIEF. Respondents to the questionnaire are asked to report on their experiences during sexual activity in the preceding four weeks. The questionnaire offers no opportunity for respondents who were not sexually active in the preceding four weeks to explain why. Rather they are automatically presumed to be suffering from ED if they report no sexual activity during that period.
Vickers’ Recommendations
To make the IIEF-6 more helpful to diagnosticians, Vickers recommends the addition of three questions or areas for additional comment.
1. Allow those reporting no sexual activity in the preceding four weeks to explain why. The absence of sexual activity in this fairly limited period is hardly definitive proof of male impotence. The respondent could be recovering from an unrelated illness or surgery, mourning the loss of a partner or family member, or otherwise unavailable for sexual activity.
2. Ask all respondents whether they are using sexual aids to overcome symptoms of male impotence. These would include not just Viagra and the other oral ED drugs known as PDE5 inhibitors but also other ED treatments such as penile injection therapy or penile implants.
3. For those who report using ED treatments to overcome their symptoms of impotence, allow them to rate their level of sexual function when using such sexual aids.
Full Disclosure Key
In a statement to UrologyTimes.com, Vickers said, “Too often, a man who says he is not having sex is automatically defined as having ED when that may not be true. If someone is not having sexual activity, you cannot assume that a person has ED. You must ask additional questions.” The additional questions he proposes hopefully would fill that gap.
Vickers’ presentation at the AUA meeting underlines the importance of full disclosure when discussing problems of sexual dysfunction with a medical professional. You should be as open and informative as possible when answering the doctor’s questions because every detail matters and can affect the way the physician recommends the problem be treated.
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