Physician and Adolescent Hirsutism Score Ratings and Their Concordance to Androgen Levels [ID 2683618

Abstract

INTRODUCTION: Hirsutism affects 5–15% of reproductive-aged women. The gold standard for quantifying hirsutism is the modified Ferriman–Gallwey (mFG) score. This study explores whether adolescent and physician ratings of hirsutism using the mFG score, correlate with androgen levels in the setting of confounders like depilation. METHODS: Hispanic adolescent females with irregular menstruation and suspected polycystic ovary syndrome (PCOS) were recruited from obstetrics and gynecology clinics at TTUHSC El Paso between September 2021 and May 2023. Patients completed an intake questionnaire, completed PCOS laboratory testing, and rated their hair growth using the mFG visual scoring method. Providers used same the methods for rating hirsutism during the same visit. We estimated Lin’s concordance correlation and Bland–Altman agreement between patient and provider mFG ratings. Linear regression explored factors affecting score changes. Statistical analysis was done by STATA 17.0. RESULTS: Forty females participated in this study. The average age at enrollment was 16.19 with a mean (SD) mFG score of 10.55 (5.95) (physicians) and 18.29 (5.78) (adolescents). Adolescents reported higher mean mFG scores than physicians. There is a low level of agreement between the two groups (−7.95; 95% CI: −23.02, 7.12). Specifically, physicians underrated hirsutism scores for arm hair. Using unadjusted linear regression, DHEAS and 17-hydroxyprogesterone levels demonstrate the hormonal influence on hirsutism. CONCLUSION: Preliminary findings indicate discordance between physicians’ and patients’ mFG scores, possibly influenced by examination precision and patient perception. Physician-scored mFG, and evaluation of androgen levels, may serve as precise hirsutism markers for Hispanic adolescents.