Androtest: a structured interview for the screening of hypogonadism in patients with sexual dysfunction

Giovanni Corona; Luisa Petrone; Edoardo Mannucci; Alessandra D Fisher; Valerio Chairini; Giancarlo Balercia; Gianni Forti; Mario Maggi

P611

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Endocrine Abstracts (2007) 14 P611

ECE2007 Poster Presentations (1) (659 abstracts)

Androtest: a structured interview for the screening of hypogonadism in patients with sexual dysfunction

Giovanni Corona ¹ , Luisa Petrone ¹ , Edoardo Mannucci ² , Alessandra D Fisher ¹ , Valerio Chairini ³ , Giancarlo Balercia ⁴ , Gianni Forti ¹ & Mario Maggi ¹

Err

Author affiliations

¹Andrology Unit, University of Florence, Florence, Italy; ²Geriatric Unit, Diabetes Section, University of Florence, Florence, Italy; ³Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy; ⁴Endocrinology Unit, Polytechnic University of Marche, Ancona, Italy.

Objectives: Detecting hypogonadism is crucial in patients with sexual dysfunctions because hypogonadism can have a causal role for them and testosterone (T) substitution represents a milestone for the therapy. At present, three different inventories have been developed for screening of hypogonadism in aging male. All these instruments demonstrated a good sensitivity but low specificity. No inventories are available for the screening of hypogonadism in patients with sexual dysfunction. We wished to set up a brief structured interview providing scores useful for detecting hypogonadism defined as low total T (<10.4 nmol/L, 300 ng/dL) in a symptomatic population (sexual dysfunction).

Methods: A minimum set of items was identified within a larger structured interview through iterative ROC curve analysis, with assessment of sensitivity and specificity for hypogonadism in a sample of 215 patients. Sensitivity and specificity were verified in a further sample of 664 patients. Correlation of test scores with PSA, testis volume, and others clinical and psychological parameters, was assessed for concurrent validity.

Results: In the validation sample, the final 12-item version of the interview (ANDROTEST) had a sensitivity and specificity of 68% and 65% with an accuracy of 0.700+0.03 (P<0.0001), in detecting low total testosterone (<10.4 nmol/l) and of 71% and 65% with an accuracy of 0.716±0.03 (P<0.0001), in the screening for low free testosterone (<37 pmol/l). Furthermore, patients with pathological test (i.e score > 8) showed higher prevalence of hypogonadism related signs, such as lower testis volume and higher depressive symptoms. Finally, when younger patients only (<54 years, which represents the median age of the sample), were considered, Log10 [PSA] levels were significantly lower in those with ANDROTEST score >8.

Conclusion: ANDROTEST is a quick, and easy-to-administer interview that provides scores for the screening of male hypogonadism in patients with sexual dysfunction.