Genitourinary syndrome of menopause symptom severity and impact outcome measures: are they reliable and correlated?

OBJECTIVE: The Most Bothersome Symptom Approach (MBSA) assesses symptom severity of genitourinary syndrome of menopause (GSM), and identifies the symptom with the greatest burden. The Atrophy Symptoms Questionnaire (ASQ) assesses the impact of GSM symptoms on the activities of daily living. The psychometric properties of these outcomes remain to be completely assessed. This study aimed to assess the test-retest reliability of the MBSA and the ASQ and their convergent validity. METHOD: One evaluator administered the outcomes twice 2 weeks apart to postmenopausal women with GSM and urinary incontinence. MBSA reliability was assessed with the graphical analysis of paired differences, Kappa coefficients and intraclass correlation coefficient (ICC), and the ASQ reliability, with paired t test and ICC. The convergent validity of both outcomes was investigated through their association with the Pearson correlation coefficient. RESULTS: Thirty-one women participated in the study. For the MBSA, the severity of the most bothersome symptom obtained a good reliability with 80% observed agreement between sessions, a substantial kappa (0.67 ± 0.12) and excellent ICC (0.88 [95% confidence interval 0.75-0.94]). For the ASQ, no significant difference was found between sessions (P = 0.146) and ICC indicated excellent reliability (0.85 [95% confidence interval 0.69-0.93]). There was a large, positive correlation between the severity of the most bothersome symptom selected by the participants in the MBSA and the ASQ total score for the two measurement sessions (T1: r = 0.587, P = 0.001 and T2: r = 0.601, P < 0.001). CONCLUSIONS: The MBSA and the ASQ are reliable outcome measures in postmenopausal women with GSM and urinary incontinence. Our findings support good convergent validity of those two outcomes as they showed a significant positive correlation between the severity of GSM symptoms and their impact on activities of daily living.