Api Murat, Badoglu Beyhan, Akca Aysu, Api Olus, Gorgen Husnu, Cetin Ahmet
Department of Obstetrics and Gynecology, Haseki Education and Research Hospital, Istanbul, Turkey.
Arch Gynecol Obstet. 2009 Apr;279(4):473-9. doi: 10.1007/s00404-008-0747-8. Epub 2008 Aug 2.
The aim of the study was to evaluate the interobserver variability of modified Ferriman-Gallwey (mFG) hirsutism scores on each body area in a Turkish population.
A cross-sectional study of simultaneous mFG scoring design was used. Observers did not make any interview with the subjects and were masked to the previous score results. Analyses included percentage of agreement, kappa coefficients, the Bland and Altman plot, confidence intervals, minimum and maximum kappa coefficients.
The study was performed at a teaching and research hospital.
Hundred and twenty-one Turkish women without any complaints of excessive body hair were studied.
Interventions included two special trained physicians, simultaneous and independent mFG scoring.
The main outcome measures were mFG scores in each body area.
Agreement analysis demonstrated that the scores of the two physicians were quite concordant. The mean kappa value for nine body area was 0.744 and the highest kappa values from the upper back and the lowest kappa values from the upper lip revealed kappa=0.847, kappa=0.585, respectively. The highest (upper lip) and the lowest (arm) mean range scores for the two researchers among the 9 areas were 1.46-1.55 and 0.17-0.12, respectively. Only 68.6 and 67.8% of the mFG scores observed by each of the two observers were equal or below 8.
The mFG scoring system was found to be clinically useful. The upper lip was observed to have the highest score of androgen sensitive area of the body as well as the highest interobserver variability. The cut-off value to establish the diagnosis of hirsutism should be population-specific.
本研究旨在评估改良的费里曼-高尔韦（mFG）多毛症评分在土耳其人群各身体部位的观察者间变异性。
采用同步mFG评分设计的横断面研究。观察者未与受试者进行任何访谈，且对先前的评分结果不知情。分析包括一致性百分比、kappa系数、布兰德-奥特曼图、置信区间、最小和最大kappa系数。
研究在一家教学和研究医院进行。
对121名无任何体毛过多主诉的土耳其女性进行了研究。
干预包括两名经过专门培训的医生，同步且独立地进行mFG评分。
主要观察指标为各身体部位的mFG评分。
一致性分析表明，两位医生的评分相当一致。九个身体部位的平均kappa值为0.744，上背部的kappa值最高，上唇的kappa值最低，分别为kappa = 0.847和kappa = 0.585。在9个区域中，两位研究人员的最高（上唇）和最低（手臂）平均极差评分分别为1.46 - 1.55和0.17 - 0.12。两位观察者各自观察到的mFG评分中，只有68.6%和67.8%等于或低于8分。
发现mFG评分系统在临床上有用。观察到上唇是身体雄激素敏感区域评分最高的部位，也是观察者间变异性最高的部位。确立多毛症诊断的临界值应因人群而异。
