A simplified questionnaire for self-assessment of hirsutism in population-based studies

Abstract

Objective: The measurement of excess body hair is not straightforward. As the modified Ferriman–Gallwey (mFG) score is unsuitable for self-assessment and requires specialist training, a short, self-administered questionnaire to identify hirsutism was constructed and validated for large-scale application, particularly targeting population-based studies. Design: A validation study was conducted to assess a new hirsutism questionnaire. Methods: A total of 90 women aged 35–72 years who were enrolled in the Brazilian Longitudinal Study of Adult Health(ELSA-Brasil) were evaluated. A self-administered instrument containing four questions was designed to evaluate five body areas: upper lip, chin, chest, lower abdomen, and thighs with respect to the current distribution of body hair and that before 35 years of age. A score of 0–4 was attributed to each region based on drawings provided in the instrument. Test–retest reliability was evaluated by reformulating the initial questions. An independent medical examination was conducted to apply the gold standard, the mFG score. Results: The area under the receiver operating characteristic curve was 0.93 (95%CI: 0.87–0.99). A cut-off score of 5 showed the best balance between sensitivity (85%) and specificity (90%),with 88.9% accuracy. Spearman’s correlation between current and past body hair score was calculated at 0.82 (PZ0.000), and showed a test–retest reliability of 0.49, with a trend toward similar answers regarding changes in the quantity of body hair over time, irrespective of how the questions were asked (PZ0.000). Conclusion: The accuracy and internal consistency of this self-administered questionnaire for the identification of hirsutism were good. Therefore, this questionnaire represents a useful tool for self-assessment of hirsutism in population-based studies.