Linguistic and clinical validation of the Chinese version of the Acute Cystitis Symptom Score (ACSS) questionnaire in Taiwanese women with uncomplicated acute cystitis

Purpose: The Acute Cystitis Symptom Score (ACSS) questionnaire is designed to diagnose acute cystitis in women. By quantifying the severity of symptoms, ACSS provides objective diagnostic criteria. The aim of this study is to translate the ACSS questionnaire into a Chinese version and validate its clinical use for diagnosing acute cystitis in Taiwanese women. Materials and methods: After rigorously translating the ACSS questionnaire into traditional Chinese used by the Mandarin-speaking Taiwanese people, it was clinically validated. Women aged 20 and above with suspected acute cystitis were recruited as the patients, and healthy women undergoing health check-ups as controls. Discriminative ability was assessed by comparing ACSS scores between the 2 groups, and the optimal diagnostic cutoff was determined using receiver operating characteristics analysis. In the patient group, treatment response was evaluated as patient-reported outcome by comparing ACSS scores pretreatment and posttreatment. Results: A total of 89 and 43 participants were recruited for the patient and control groups, respectively. The total score of typical symptoms between the patient and the control groups was significantly different ( P < 0.001). After antibiotic treatment, the total score of typical symptoms in the patient group significantly decreased ( P < 0.001). Using receiver operating characteristics curve analysis, the best cutoff score for diagnosing acute cystitis was 4, with a sensitivity and a specificity of 75.3% and 95.3%, respectively. Conclusion: After clinical validation, the Chinese version of the ACSS questionnaire can now be used as a symptom-oriented diagnostic and patient-reported outcome tool for acute cystitis in the Mandarin-speaking female population in Taiwan.