Table 2:
Diagnostic accuracy of symptoms, signs and composite measures for hypogonadism*
| Finding | No. of studies (no. of patients)† | Sensitivity (95% CI) | Specificity (95% CI) | Positive LR (95% CI) | Negative LR (95% CI) |
|---|---|---|---|---|---|
| Symptoms | |||||
| Hot flushes | 1 (434) | 0.35 (0.25–0.46) | 0.83 (0.79–0.87) | 2.0 (1.4–3.0) | 0.79 (0.66–0.93) |
| Decreased concentration | 1 (434) | 0.54 (0.46–0.62) | 0.70 (0.64–0.75) | 1.8 (1.4–2.3) | 0.66 (0.54–0.80) |
| Erectile dysfunction | 11 (6918) | 0.52 (0.39–0.65) | 0.67 (0.50–0.80) | 1.5 (1.3–1.8) I2 = 74% |
0.83 (0.76–0.91) I2 = 44% |
| Depression | 2 (550) | 0.26–0.54 | 0.69–0.91 | 1.7–2.8 | 0.66–0.82 |
| Limited walking | 2 (5712) | 0.11–0.23 | 0.88–0.93 | 1.7–2.0 | 0.87–0.95 |
| Decreased libido | 10 (8676) | 0.51 (0.35–0.67) | 0.68 (0.54–0.79) | 1.6 (1.3–1.9) I2 = 72% |
0.72 (0.58–0.85) I2 = 83% |
| Inability to bend | 1 (3120) | 0.09 (0.06–0.12) | 0.94 (0.93–0.95) | 1.5 (1.1–2.1) | 0.97 (0.94–1.0) |
| Decreased vigour | 1 (434) | 0.88 (0.84–0.91) | 0.38 (0.30–0.46) | 1.4 (1.2–1.6) | 0.32 (0.22–0.46) |
| Decreased physical activity | 5 (7971) | 0.36 (0.26–0.48) | 0.74 (0.65–0.82) | 1.4 (1.3–1.6) I2 = 10% |
0.85 (0.79–0.91) I2 = 36% |
| Impaired sleep | 3 (2971) | 0.25 (0.12–0.49) | 0.78 (0.66–0.87) | 1.1 (0.63–2.1) I2 = 92% |
0.94 (0.75–1.2) I2 = 92% |
| Signs | |||||
| Decreased pubic hair | 1 (99) | 0.63 (0.28–0.87) | 0.74 (0.64–0.82) | 2.4 (1.3–4.5) | 0.51 (0.21–1.3) |
| Inability to complete chair stands | 1 (2587) | 0.05 (0.04–0.07) | 0.98 (0.97–0.98) | 2.4 (1.5–3.8) | 0.97 (0.95–0.99) |
| Inability to perform power rigs | 1 (2587) | 0.03 (0.02–0.04) | 0.99 (0.98–0.99) | 2.1 (1.1–3.9) | 0.99 (0.97–1.0) |
| Decreased axillary hair | 1 (100) | 0.50 (0.20–0.80) | 0.73 (0.63–0.81) | 1.8 (0.85–4.0) | 0.69 (0.34–1.4) |
| Elevated BMI | 7 (6517) | 0.50 (0.34–0.66) | 0.71 (0.62–0.80) | 1.8 (1.6–1.9) I2 = 0% |
0.71 (0.62–0.83) I2 = 85% |
| Impaired balance | 1 (2587) | 0.13 (0.11–0.16) | 0.93 (0.91–0.94) | 1.8 (1.4–2.3) | 0.94 (0.91–0.97) |
| Decreased grip strength | 1 (2587) | 0.02 (0.01–0.04) | 0.98 (0.97–0.98) | 1.0 (0.56–1.8) | 1.00 (0.99–1.0) |
| Combinations of findings | |||||
| ANDROTEST | 2 (879) | 0.68–0.76 | 0.65–0.66 | 1.9–2.2 | 0.37–0.49 |
| ANDROX | 2 (1387) | 0.48–0.70 | 0.64–0.74 | 1.8–2.0 | 0.47–0.70 |
| ADAM | 9 (8327) | 0.84 (0.81–0.87) | 0.29 (0.22–0.38) | 1.2 (1.0–1.4) I2 = 93% |
0.57 (0.37–0.85) I2 = 86% |
| MMAS | 2 (3330) | 0.53–0.71 | 0.53–0.59 | 1.3–1.5 | 0.55–0.79 |
| AMS | 5 (1853) | 0.74 (0.57–0.85) | 0.49 (0.28–0.69) | 1.5 (0.94–2.4) I2 = 93% |
0.59 (0.27–1.1) I2 = 89% |
Note: ADAM = Androgen Deficiency in Aging Males, AMS = Aging Males’ Symptoms, BMI = body mass index, CI = confidence interval, I2 = heterogeneity, LR = likelihood ratio, MMAS = Massachusetts Male Aging Study.
*
For the results from individual studies, see Appendices 5 and 7, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.150262/-/DC1.
†
For variables with 4 or more studies, a bivariable model was used; for variables with 3 studies, a univariable model was used; and for variables with 2 studies, a range is displayed.