Validation of the erection hardness score Journal Article


Authors: Mulhall, J. P.; Goldstein, I.; Bushmakin, A. G.; Cappelleri, J. C.; Hvidsten, K.
Article Title: Validation of the erection hardness score
Abstract: Introduction. Erection hardness is a fundamental component of erectile function, and is a very specific and easily monitored outcome. The Erection Hardness Score (EHS) is a single-item, patient-reported outcome (PRO) for scoring erection hardness. Aims. The aim of this article is to report the psychometric validation of the EHS. Methods. The dataset (N = 307) was from a multinational sildenafil trial (efficacy in the treatment of erectile dysfunction [ED]) with a 2-week screening phase, a 6-week double-blind, placebo-controlled treatment phase, and a 6-week open-label extension. Main Outcome Measures. Test-retest reliability (intraclass correlation coefficient), quality and distribution of responses, known-groups validity (ability to differentiate between ED severity groups defined by the International Index of Erectile Function [IIEF] questionnaire), convergent validity (Pearson correlation coefficients with domain scores of the IIEF and the Quality of Erection Questionnaire [QEQ]), treatment responsiveness, and clinically important difference. Results. The EHS demonstrated good test-retest reliability, acceptable quality and distribution of responses, known-groups validity against the IIEF (including clear differentiation between normal and impaired erectile function), moderate-to-strong convergent validity against the prespecified domains of the IIEF and QEQ, and high treatment responsiveness. Conclusion. The EHS has desirable measurement properties, including being highly responsive to treatment. This one-item PRO is robust and easy to use for evaluating erection hardness. Psychometric analysis supports the use of the EHS as a simple, reliable, and valid tool for the assessment of erection hardness in clinical trials research. © 2007 International Society for Sexual Medicine.
Keywords: adult; controlled study; treatment response; middle aged; major clinical study; clinical trial; drug efficacy; validation process; research design; sensitivity and specificity; quality control; reproducibility of results; quality of life; controlled clinical trial; questionnaires; questionnaire; disease severity; correlation coefficient; severity of illness index; scoring system; open study; test retest reliability; screening test; double blind procedure; erectile dysfunction; penile erection; sildenafil; sexual behavior; psychometrics; psychometry; penis erection; clinical assessment tool; sexual dysfunctions, psychological; patient-reported outcome; erection hardness score; erection hardness
Journal Title: Journal of Sexual Medicine
Volume: 4
Issue: 6
ISSN: 1743-6095
Publisher: Elsevier Inc.  
Date Published: 2007-11-01
Start Page: 1626
End Page: 1634
Language: English
DOI: 10.1111/j.1743-6109.2007.00600.x
PUBMED: 17888069
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 40" - "Export Date: 17 November 2011" - "Source: Scopus"
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  1. John P Mulhall
    601 Mulhall