The PISQ-IR: Considerations in scale scoring and development

Todd H. Rockwood, Melissa L. Constantine, Olusola Adegoke, Rebecca G. Rogers, Elektra McDermott, G. Willy Davila, Claudine Domoney, Swati Jha, Dorothy Kammerer-Doak, Emily S. Lukacz, Mitesh Parekh, Rachel Pauls, Joan Pitkin, Fiona Reid, Beri Ridgeway, Ranee Thakar, Peter K. Sand, Suzette E. Sutherland, Montserrat Espuna-Pons

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29 Scopus citations


Introduction This paper provides a detailed discussion of the psychometric analysis and scoring of a revised measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Methods Standard tools for evaluating item distributions, relationships, and psychometric properties were used to identify sub-scales and determine how the sub-scales should be scored. The evaluation of items included a nonresponse analysis, the nature of missingness, and imputation methods. The minimum number of items required to be answered and three different scoring methods were evaluated: simple summation, mean calculation, and transformed summation. Results Item nonresponse levels are low in women who are sexually active and the psychometric properties of the scales are robust. Moderate levels of item nonresponse are present for women who are not sexually active, which presents some concerns relative to the robustness of the scales. Single imputation for missing items is not advisable and multiple imputation methods, while plausible, are not recommended owing to the complexity of their application in clinical research. The sub-scales can be scored using either mean calculation or transformed summation. Calculation of a summary score is not recommended. Conclusion The PISQ-IR demonstrates strong psychometric properties in women who are sexually active and acceptable properties in those who are not sexually active. To score the PISQ-IR sub-scales, half of the items must be answered, imputation is not recommended, and either mean calculation or transformed sum methods are recommended. A summary score should not be calculated.

Original languageEnglish (US)
Pages (from-to)1105-1122
Number of pages18
JournalInternational Urogynecology Journal
Issue number7
StatePublished - Jul 2013

Bibliographical note

Funding Information:
Acknowledgements This study was reviewed and approved by the University of Minnesota IRB #0908 M70626. This study was funded by the International Urogynecological Association. University of Minnesota, Grant Award Number CON000000021500, Todd H Rockwood, PhD, PI.


  • Anal incontinence
  • Pelvic organ prolapse
  • Psychometric analysis
  • Scale development
  • Sexual function questionnaire
  • Urinary incontinence


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