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INTERNATIONAL EXPERIENCES WITH THE AGING MALES SYMPTOMS SCALE
Heinemann, L.A.J.
Center for Epidemiology and Health Research Berlin, Invalidenstr.
115, 10115 Berlin, Germany. heinemann@zeg-berlin.de
The scale was designed and standardized as a self-administered scale
to (a) to assess symptoms of aging (independent from
those which are disease-related) between groups of
males under different conditions, (b) to evaluate
the severity of symptoms over time, and (c) to measure
changes pre- and post androgen replacement therapy.
The AMS scale is short and easy to apply, has a very
simple evaluation scheme, and was internationally
well accepted (translated into 17 languages). Methodological
test characteristics: Reliability measures (internal
consistency and test-retest stability) were found
to be good across countries. Validity: The internal
structure of the AMS in healthy and androgen deficient
males, and across countries was sufficiently similar
to conclude that the scale really measures the same
phenomenon in different cultures. French experiences
even show that the scale similarly measures in younger
age groups below 40 years. This is important for investigations
in young hypogonadal men. In addition, population
reference values for AMS results seem to be pretty
similar across countries. The comparison of the AMS
with the two established screening instruments for
androgen deficiency (ADAM scale of Morley et al and
the screener of Smith et al.) showed sufficiently
good compatibility despite conceptual differences
with AMS. Thus, the AMS scale obviously measures similar
phenomena with a similar quality, although it was
not developed as a screening instrument. Clinicians
often consider validity as utility for outcome measurement.
The AMS scale showed a convincing ability to measure
treatment effects on quality of life across the full
range of severity of complaints before therapy. The
distribution of complaints of testosterone deficient
men before therapy almost returned to normal values
after 12 weeks of testosterone treatment. The AMS
scale was not developed or standardized as screening
instrument for androgen deficiency, and the association
of the AMS scale per se with testosterone level is
controversial in the literature. Research in Austria
(Kratzik et al) however indicated the possibility
that the combination of AMS results with BMI and age
might predict the presence of androgen deficiency
in aging males. A screening tool consisting of the
above mentioned three parameters was developed and
preliminarily tested together with Kratzik. The test
characteristics (sensitivity and specificity) are
promising and will be presented. Further research
and experience in practice is needed before this screening
scheme can finally be recommended for important screening
activities.
For more details see: www.aging-males-symptoms-scale.info.
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