Validation of a new menstrual pictogram (superabsorbent polymer-c version) for use with ultraslim towels that contain superabsorbent polymers

Magnay, Julia L.; Nevatte, Tracy; O’Brien, Shaughn; Gerlinger, Christoph; Seitz, Christian

doi:10.1016/j.fertnstert.2013.10.051

Cited by 38 publications

(54 citation statements)

References 19 publications

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“…Reported quality parameters of the nine studies were generally satisfactory, and no studies were considered to have a very high risk of bias (Additional file 2). However, with one exception (Magnay et al 2014 [5]), it was unclear whether PBAC test scores were interpreted without knowledge of AH results, and vice versa (test review bias and reference review bias, respectively). Also, it was unclear whether clinical information would normally be available when the index test is used in practice (clinical review bias).…”

Section: Resultsmentioning

confidence: 99%

“…The sensitivity was 58-97%, the specificity was 7.5-95.5%, the LR+ was 1.1-13.8 and the LR− was 0.14-0.56. The DOR was in the range 2.6-52.4, with the menstrual pictogram (superabsorbent-polymer-containing [SAP-c] version) giving the highest value [5]. It is generally accepted that the greater the DOR, the better the discriminatory test performance.…”

Section: Resultsmentioning

confidence: 99%

“…Approximately 10-35% of women report heavy menstrual periods at some stage during their reproductive years, with 5% consulting a medical practitioner for investigation of HMB [1]. In research, HMB is defined as a measured menstrual blood loss (MBL) of > 80 mL per cycle, but studies have repeatedly shown that at least 40% of women seeking medical attention for heavy periods lose less than this volume [2][3][4][5]. In clinical practice, the decision to treat is usually based on a woman's self-reported symptoms and the effect of these symptoms on quality of life rather than any objective measurement, which concurs with current guidelines for management of HMB [6].…”

Section: Introductionmentioning

confidence: 99%

“…The AH technique is the most obvious comparator for the PBAC, but it only measures the blood fraction of menstrual discharge. Blood typically comprises approximately 50% of total menstrual volume, although this can vary widely on individual soiled sanitary items, particularly at extremes of menstrual loss [5,25,26]. However, feminine towels and tampons absorb all menstrual flow.…”

Section: Introductionmentioning

confidence: 99%

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Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review

Magnay¹,

O’Brien

Gerlinger

et al. 2020

BMC Women's Health

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Background: Pictorial blood loss assessment charts (PBACs) represent the most widely used method to assess menstrual blood loss (MBL) in clinical trials. The aims of this review were to: (1) determine the diagnostic accuracy of PBACs that have been validated against the reference alkaline hematin technique; (2) categorize the pitfalls of using obsolete and nonvalidated charts; (3) provide guidelines for development of a new PBAC or use of an existing chart to measure MBL in clinical trials; and (4) consider the feasibility of using pictorial charts in primary care. Methods: A literature review was conducted using Embase and MEDLINE databases. The review identified reports of women with self-perceived or actual heavy menstrual bleeding (HMB), bleeding disorders, abnormal uterine bleeding, leiomyomata (uterine fibroids) or endometriosis, and women undergoing treatment for HMB, as well as those with normal menstrual periods. Data were reviewed from studies that focused on the development and validation of PBACs and from those that used derivative noncertified charts to assess HMB. Results: Nine studies reported validation of PBAC scoring systems against the alkaline hematin technique. Across these studies, the sensitivity was 58-97%, the specificity was 7.5-95.5%, the positive and negative likelihood ratios were 1.1-13.8 and 0.14-0.56, respectively, and the diagnostic odds ratio was 2.6-52.4. The cut-off score above which the diagnosis of HMB was made ranged from 50 to 185. Several modifications of these PBACs were used in other studies; however, objective confirmation of their validity was not reported. Overall, there was widespread inconsistency of chart design, scoring systems, diagnostic cut-off limits and post-treatment outcome measures. Conclusions: PBACs are best suited to the controlled and specific environment of clinical studies, where clinical outcome parameters are defined. The current lack of standardization precludes widespread use of the PBAC in primary care. Review registration number: PROSPERO international prospective register of systematic reviews: CRD42016030083.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review

Magnay¹,

O’Brien

Gerlinger

et al. 2020

BMC Women's Health

Self Cite

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“…However, Magnay et al presented a new version of the traditional menstrual pictogram (the superabsorbent polymer-c or SAP-c version) which was designed to measure MBL on these widely used products (Always Ultra slim feminine towels BProctor & Gamble^). A validation study of this version yielded promising results when MBL was tested against alkaline hematin method and total menstrual fluid loss (MFL) against fluid weight [29,30]. Although initial results seem promising, implementation of this version among larger cohorts could help to recognize its feasibility, accuracy, and pitfalls and identify whether this version could be superior to the traditional PBLAC.…”

Section: Accuracy Of Pictorial Blood Assessment Chartmentioning

confidence: 99%

Pictorial blood loss assessment chart for quantification of menstrual blood loss: a systematic review

2015

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To evaluate the diagnostic accuracy of pictorial blood loss assessment chart (PBLAC) compared to objective measurements of menstrual blood loss (MBL), a systematic search of MEDLINE, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and EBM Reviews-Cochrane Central Register of Controlled Trials from inception until September 30, 2014 was performed. Terms referring to Bpictorial blood loss assessment chart,^Bmenstrual blood loss evaluation,^and Balkaline hematin^were used. The ability of PBLAC to predict significant blood loss, compared to alkaline hematin as a standard objective method, represents our primary outcome. Out of 255 reports identified by the primary search, seven reports were included in the review. Quality of these reports was assessed. Compared to alkaline hematin, PBLAC sensitivity and specificity ranged from 58 to 98 % and 7.5 to 97 %, respectively, with likelihood ratios (LR) for positive ranging from 1.1 to 7.8 and LR for negative tests ranging from 0.04 to 0.48. Diagnostic odds ratio ranged from 2.6 to 86.9. Although diagnostic testing was not always supportive in terms of sensitivity, specificity, and LRs, most studies support the use of PBLAC as a semi-objective method that can be implemented in research and clinical practice.

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How does the extent of fibrosis in adenomyosis lesions contribute to heavy menstrual bleeding?

Huang

Liu

Critchley

et al. 2022

Reprod Medicine & Biology

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Purpose To investigate how the extent of fibrosis in adenomyosis lesions contributes to heavy menstrual bleeding (HMB). Methods We recruited 57 women with histologically confirmed adenomyosis, 29 of whom reported moderate/heavy bleeding (MHB) (menstrual blood loss (MBL) ≥20 but <100 mL) and the remaining 28, excessive MBL (EXB; ≥100 mL). Lesional stiffness was measured by transvaginal elastosonography. Full‐thickness uterine tissue columns containing the lesion and its neighboring endometrial‐myometrial interface (EMI) and endometrial tissues were evaluated for tissue fibrosis and immunohistochemical analysis of HIF‐1α, COX‐2, EP2, and EP4. Results The lesional stiffness in the EXB group was significantly higher than that of MHB, and consistently, the extent of lesional fibrosis and the extent of tissue fibrosis in both EMI and eutopic endometrium were also significantly higher. In adenomyotic lesions and their neighboring EMI and eutopic endometrial tissues, the immunostaining of HIF‐1α, COX‐2, EP2, and EP4 was significantly reduced. The extent of fibrosis and the immunostaining levels of HIF‐1α, COX‐2, EP2, and EP4 were negatively correlated in all tissues. Conclusions Lesional fibrosis begets stiffening matrix, propagating fibrosis to neighboring EMI and eutopic endometrium, resulting in reduced PGE 2 and HIF‐1α signaling, and thus likely reduced hypoxia necessary for endometrial repair, leading to HMB.

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Validation of a new menstrual pictogram (superabsorbent polymer-c version) for use with ultraslim towels that contain superabsorbent polymers

Cited by 38 publications

References 19 publications

Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review

Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review

Pictorial blood loss assessment chart for quantification of menstrual blood loss: a systematic review

How does the extent of fibrosis in adenomyosis lesions contribute to heavy menstrual bleeding?

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