Difficulties in the evaluation of hirsutism using the modified Ferriman-Gallwey scale

Abstract

Inconsistences in hirsutism evaluation using The Modified Ferriman- Gallwey scale (mFG) between different evaluators and need for hirsutism diagnostics standardization has been reported in numerous publications. The aim of the study was to determine the differences in the evaluation of female hirsutism between researchers. Materials and methods The study was conducted during the period March to June of 2013. The study was carried out by six physicians – one specialist in female hyperandrogenism (an expert physician), and five – with no such experience. At the beginning of the study, the expert physician trained other researchers in the evaluation of terminal hair growth using mFG scale. The study included 90 women who presented to the endocrinologist’s consultation due to different reasons except hyperandrogenism and met the inclusion criteria. The subjects underwent anthropometric measurements, and were asked to perform self-evaluation of hirsutism according to the mFG scoring method. Following that, hirsutism was evaluated by the physicians-researchers using the same mFG scoring method. Results The study included healthy 20–34 year old (mean age 25.2 years, 95% CI 23.8– 26.5) women with regular menstrual cycles. The total mean score of the subjects’ self-evaluation was 7.0, 95% CI 4.6–9.3. The total mean score of the evaluation given by the researchers was 2.81, 95% CI 1.5–4.2. The odds ratio for erroneous evaluation of hirsutism on the upper lip was 1.31 (95% CI 1.02–1.69), on the lower abdomen and the thigh – 5.44 (95% CI 4.23–7.02), and on the chest – 0.02 (95% CI 0.02–0.04). Conclusions A discrepancy was found between the evaluations submitted by the expert physician and one of evaluators, whereas the differences between the evaluations presented by the other researchers were not significant. The women who participated in the study significantly more frequently submitted higher mFG sc