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International Index of Erectile Functioning-5: A Critical Appraisal

Background: Some studies have reported methodological flaws and shortcomings in the International Index of Erectile Functioning-5 (IIEF-5) which is a self-report measure for the assessment of erectile dysfunction (ED). Aim: The aim of this research is to point out methodological flaws and shortcomings in IIEF-5 when used with Pakistani men. Settings and Design: Two independent clinical trials were run to assess the efficacy of different forms of treatment for ED in young Pakistani men. Materials and Methods: The IIEF-5 in Urdu version was employed to diagnose and assess the severity of ED in young men at 3 time points. Results and Conclusions: Several flaws and shortcomings were noted including the unidimensionality of the scale, categorization of the scale into severity categories based on cutoff points, the inability of the scale to differentiate between organic and nonorganic ED, double barrel item statement, and lack of standardized translation in local or regional languages of Pakistan. The validity of IIEF-5 can be increased if the above-mentioned flaws and shortcomings are addressed.