Validation of a simplified method to assess hirsutism in the Iranian population

Abstract

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.

Keywords: Community-based study; Hirsutism; Iranian women; Modified Ferriman–Gallwey scoring system.