Comparison of screening questionnaires for the diagnosis of hypogonadism
Abstract
Three questionnaires, the St. Louis University Androgen Deficiency in Aging Male (ADAM), the Aging Male Survey (AMS) and the Massachusetts Male Aging Study (MMAS), have been developed as potential screening tools for hypogonadism in older males. We compared these questionnaires in 148 males aged 23-80 years using bioavailable testosterone as the "biochemical gold standard" for diagnosis of hypogonadism. The sensitivity for the ADAM was 97%, for the AMS 83% and the MMAS 60%. Specificity was 30% for the ADAM, 59% for the MMAS and 39% for AMS. Both bioavailable testosterone and the calculated free testosterone correlated significantly with a number of the individual questions. Total testosterone correlated poorly with most of the questions. In conclusion, the ADAM and AMS may be useful screening tools for hypogonadism across the adult lifespan, but both are relatively nonspecific.
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One study found the MMAS inferior as a screening modality for low bioavailable testosterone because of relatively lower sensitivity (60%).
“In comparing the AMS, ADAM, and MMAS scales on ability to identify low bioavailable T levels, one study noted inferiority of the MMAS scale as a screening modality due to a relatively lower sensitivity (60%).”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [115]
The MMAS and ANDROTEST questionnaires have better specificity (53-65%) but lower sensitivity (60-71%).
“The MMAS and ANDROTEST questionnaires exhibit improved specificity (53–65%), with loss of overall sensitivity (60–71%).”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [115]
Among hypogonadism questionnaires, the AMS and ADAM scales show the highest sensitivity (81-97%) but poor specificity (19-39%).
“The sensitivity and specificity of the various scales have been reported, with overall findings demonstrating the highest sensitivities with the AMS and ADAM questionnaires (81–97%) with concomitant poor specificity (19–39%).”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [115]
Available hypogonadism questionnaires correlate with aging and diabetes mellitus, but their associations with total and free testosterone are variable.
“Available questionnaires demonstrate correlations with aging and DM with variable associations noted with TT and fT levels.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [115]
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- Authors
- Morley, J. E., Perry, H. M., Kevorkian, R. T., & Patrick, P.
- Affiliations
- St. Louis VA Medical Center (US)
- Corresponding author
- Morley, John E.
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2006-03
- Volume
- 53
- Issue
- 4
- Pages
- 424-429
- ISSN
- 0378-5122 (ISSN-L)
- OpenAlex
- W2010090922
- Cited by
- 168
- References
- 39
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 10 · 2023: 7 · 2022: 2 · 2021: 5 · 2020: 5 · 2019: 2 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 10 · 2014: 10 · 2013: 11 · 2012: 13
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Maturitas (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- hypogonadism, screening questionnaire, Massachusetts Male Aging Study, bioavailable testosterone, free testosterone, total testosterone, sensitivity and specificity, older men, androgen deficiency
- MeSH terms
- Adult, Aged, Aged, 80 and over, Humans, Hypogonadism, Male, Middle Aged, Surveys and Questionnaires, Sensitivity and Specificity, Testosterone, Biomarkers
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