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J Urol. 2019 Feb 5. doi: 10.1097/JU.0000000000000140. [Epub ahead of print]

The Comprehensive Assessment of Self-Reported Urinary Symptoms (CASUS): A New Tool for Research on Subtypes of Patients with Lower Urinary Tract Symptoms.

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Duke University Medical Center, Durham, NC.
Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL.
Medical College of Wisconsin, Milwaukee, WI.
National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
Arbor Research Collaborative for Health, Ann Arbor, MI.
Washington University School of Medicine, St. Louis, MO.
University of Washington, Seattle, WA.
University of Michigan, Ann Arbor, MI.
University of Iowa, Carver College of Medicine, Department of Obstetrics and Gynecology, Iowa City, IA.



To improve the potential for finding clinically important subtypes of patients with lower urinary tract symptoms (LUTS), we describe the development of the Comprehensive Assessment of Self-reported Urinary Symptoms (CASUS) -and use it to present data on the experiences of LUTS in treatment-seeking women and men from a prospective observational cohort.


An initial list of LUTS as confirmed in 22 qualitative interviews with providers and 88 qualitative interviews with care-seeking and non-care-seeking women and men with LUTS. Items from extant measures were adopted and revised and new items were developed, and all were evaluated for understanding in 64 cognitive interviews. Items were administered to a prospective cohort of female and male LUTS patients seeking care and analyses were conducted to describe item response distributions and correlations among item responses separately for women and men.


A total of 444 males and 372 females provided responses to CASUS. There were several sets of items that had different relationships for women compared to men. In particular, the associations between sensation-related items and incontinence-related items were generally positive among females, but were often negative among males.


Using an intensive development process, the CASUS addresses a wide range of LUTS. It should help to identify clinically important subtypes of patients. Further, the collection of items can provide the foundation for shorter measures for use in the clinic and as trial endpoints.

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