Serum-free androgen index for diagnosingPCOS

Significant differences in serum-free androgen index (FAI) exist between individuals with polycystic ovary syndrome (PCOS) and those without, and determining an appropriate cutoff value holds diagnostic value for PCOS. However, current research outcomes on FAI's diagnostic utility for PCOS lack consistency. 

A study investigated FAI's diagnostic value in PCOS – to assist clinicians in the future selection of appropriate diagnostic indicators.

The study entailed a search fromthe Cochrane Library, Medline, ExcerptaMedica Database, China National Knowledge Infrastructure, and China Wanfang databases – until July 2020. Seven high-quality clinical studies were included, and a meta-analysis using Stata15.0 software analyzed pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (−LR), and receiver operating characteristic (ROC) curves.

The meta-analysis results revealed pooled sensitivity of 0.76 (95% confidence interval [CI]: 0.69 ~ 0.82), specificity of 0.82 (95%CI: 0.69 ~ 0.90), +LR of 4.12 (95%CI: 2.12 ~ 4.03), −LR of 0.29 (95%CI: 0.22 ~ 0.38), DOR of 14.08 (95%CI: 7.13 ~ 27.83), and an area under the ROC of 0.84.

It was concluded that FAI exhibits a moderate diagnostic value for PCOS. Considering new experimental designs to identify the optimal cutoff value for FAI diagnosis may enhance diagnostic efficacy. The findings spell that FAI could serve as a valuable diagnostic tool for PCOS, with potential for improvement through refinement of cutoff values in future research.

Source: Wang L, Li J. Journal of Obstetrics and Gynaecology Research. 2021;47(4):1221-31.