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Validation of a simplified method to assess hirsutism in the Iranian population
Fahimeh Ramezani Tehrani1, Sonia Minooee1, Fereidoun Azizi2
1Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Objective:
Hirsutism may be a symptom of androgen excess but there is still no clear definition and criterion for its clinical evaluation. The aims of the present study were to develop a simpler diagnostic method for assessment of hirsutism which examines fewer body areas and to evaluate its sensitivity and specificity in among a general population of Iranian women.
Study Design:
The study was conducted among 1000 reproductive-age women recruited from the Tehran Lipid and Glucose Study, using random systematic sampling. It had two phases: (1) the discovery phase, which aimed at developing a simpler method according to the modified Ferriman-Gallwey (mFG) system and a new cut-off point to assess hirsutism, and (2) the validation phase, aimed at assessing the sensitivity and specificity of the simplified method in a non-dependent study, the Iranian PCOS Prevalence Study.
Results:
The sensitivity and specificity of the subset of lip, abdomen and thighs (cut-off point 4) were 91.5% and 92%, respectively, with the highest positive predictive value (72.2%) and concordance percentage (91.9%) in comparison to our gold standard of mFG score≥8.
Conclusion:
The three-area subset of lip, lower abdomen and thighs serves as a simple and less invasive method for hirsutism assessment and can be used in large epidemiologic studies.
