Neurourology and Urodynamics 24:211^214 (2005) A Randomized Crossover Trial to Examine Administration Techniques Related to the Bristol Female Lower Urinary Tract Symptom (BFLUTS) Questionnaire Mohid S. Khan, Charlotte Chaliha, Lucia Leskova, and Vik Khullar* Urogynaecology Unit, Faculty of Medicine, St Mary’s Hospital, Imperial College, Norfolk Place, London, United Kingdom Aims: To investigate whether two methods of assessing lower urinary tract symptoms, interview- assisted standardized questionnaires, and self-completed standardized questionnaires, were compar- able. Methods: Women referred to a tertiary urogynecology urodynamic clinic with lower urinary tract symptoms were recruited. The psychometrically robust Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire was used to assess urinary symptoms . A randomized crossover design for questionnaire completion was used: Group Aöan initial interview-assisted questionnaire at the urodynamic clinic with a follow-up postal questionnaire; or Group Böan initial pre-out- patient postal questionnaire followed up by a second interview-assisted questionnaire whilst attending a scheduled urodynamic clinic. Results: A total of 114 women were randomized for initial question- naire administration method to achieve 72 completed sets (63%). Total scores were higher on self- completion compared to interview, this di¡erence was not signi¢cant [t ¼1.951, P > 0.05]. No item had perfect agreement between postal and interview methods and generally, interview-assisted questions had lower scores, indicating better health status. The items with the worst agreement (slight or moderate) were those concerned with sexual health, with women giving lower scores, exaggerating health on interview. For example bother of vaginal discomfort (k w ¼ 0.09), compared to question assessing frequency (k w ¼ 0.65). Conclusions: This data suggests women respond dif- ferently to the BFLUTS questionnaire when data is collected by self-completion in the woman’s home compared to interviews. No individual question item had perfect agreement between the two methods of administration. Overall, individual question items were scored higher on self-com- pletion than interview. Neurourol. Urodynam. 24:211^214, 2005. ß 2005 Wiley-Liss, Inc. Key words: qualityoflife;symptomquestionnaires;urinaryincontinence INTRODUCTION There are several psychometrically validated question- naires to assess urinary symptoms and quality of life. However the method of questionnaire administration may di¡er and this may a¡ect data quality and the perception of the severity of incontinence.There is a wide variability in the prevalence of urinary incontinence measured in epidemiological studies. This may be partially due to the method of data collection as studies have used either interview or postal questionnaires, some not specifying and some mixing methods of administra- tion. Postal questionnaires are popular as they are cheap and not as time consuming as interviews. Studies using interviews have been suggested to underestimate prevalence compared to postal questionnaires [Lyons et al., 1999] but there is no evi- dence to demonstrate this in a randomized study. The aim of our study was to assess whether symptomatic women respond the same to a standardized questionnaire when administered by interview or self-completion. MATERIALS AND METHODS Women referred to a tertiary urogynecology urodynamic clinic with lower urinary tract symptoms were recruited. The psychometrically robust Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire was used to assess urin- ary symptoms [Jackson et al., 1996]. It is a questionnaire devel- oped in the UK, composed of domains for lower urinary tract symptomatology, sexual function, and quality of life (bother- someness and impact). It covers 8 questions relating to incon- tinence, and 12 other lower urinary tract symptoms. Response scales for symptoms range from ‘none’ to ‘always’ with ‘no *Correspondence to: Vik Khullar, Urogynaecology Unit, Department of Obstetrics & Gynaecology, Mint Wing, St Mary’s Hospital, Imperial Col- lege, Norfolk Place, LondonW2 1PG, UK. E-mail: vik.khullar@ic.ac.uk Received 15 September 2003; Accepted 29 October 2004 Published online 24 March 2005 inWiley InterScience (www.interscience.wiley.com) DOI 10.1002/nau.20100 ß 2005Wiley-Liss,Inc.