Analysis of the International Index of Erectile Function: psychometric evidence and measurement invariance across relationship status and age generations in a Chilean sample
Bibliographic record
Abstract
Background: The International Index of Erectile Function (IIEF) stands out for its utility and widespread use to measure sexual function in men. However, it lacks consistency in its internal latent structure across studies, has not been evaluated for measurement invariance, and has not undergone psychometric validation for its 15-item form in Spanish among South American countries. Aim: To examine the IIEF's psychometric evidence (ie, structural/criterion validity and reliability) in a sample of adult men and determine its measurement invariance across relationship status (single vs in a relationship) and age generations (generations Z, Y/millennials, and X). Methods: A sample of 650 sexually active males was derived from a broader Chilean study (Chilean Sex and Sexuality Study). We used a confirmatory factor analysis to determine the IIEF's structural validity, sexual satisfaction dimensions to establish its criterion-related validity, and Cronbach alpha and McDonald omega to assess the reliability of its scores. Outcomes: Measures of goodness of fit. Results: The evidence supported the 5-factor latent solution. Meanwhile, criterion-related validity revealed subtle yet significant differences in sexual satisfaction, with younger men displaying higher satisfaction in various sexual domains. In contrast, middle-aged men and those in a relationship showed better sexual function. Finally, the IIEF was invariant across age groups and relationship status at the factor covariance level. Clinical Translation: This study provides evidence that the IIEF is a valid, reliable, and invariant tool for the clinical practice in men's sexual health, particularly that associated with their sexual function and dysfunction. Strengths and Limitations: The study included a comprehensive validity analysis of the IIEF's psychometric properties, demonstrating its reliability and validity across diverse Chilean male subpopulations. The study also offered the IIEF's first assessment of measurement invariance and confirmed its suitability for clinical and research use in the Chilean population. Meanwhile, the study's limitations include a lack of clinical population and a sample predominantly younger, cisgender, and heterosexual. Conclusion: Our study provides evidence of the IIEF's 5-factor structure and measurement invariance across age generations and relationship status in Chilean men, supporting its validity for clinical use and research and broadening its applicability in global sexual health studies, particularly in the Spanish-speaking South American male population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".