Validation of Self-Report of Uterine Fibroid diagnosis using Trans-Vaginal Ultrasound Scan

Abstract Objective: Self-report of uterine fibroids (UF) has been used for epidemiologic research in different environments. Given the dearth of studies on the epidemiology of UF in Sub-Saharan Africa (SSA), it is valuable to evaluate its performance as a potential tool for much needed research on this commonest neoplasm in SSA women. Method: We conducted a cross-sectional study of self-report of UF compared with trans-vaginal ultra-sound diagnosis (TVUS) among 486 women who are members of the African Collaborative Center for Microbiome and Genomics Research(ACCME) Study Cohort in central Nigeria. We used log-binomial regression models to compute the classification, sensitivity, specificity, and predictive values of self-report adjusted for significant covariates. Results: The prevalence of UF on TVUS was 45.1% (219/486) compared to 5.4% (26/486) based on self-report of abdominal ultrasound scan and 7.2% (35/486) based on report of healthcare practitioner’s diagnosis. Self-report correctly classified 39.5% of the women in multivariable adjusted models compared to TVUS. The multivariable adjusted sensitivity of self-report of healthcare worker diagnosis was 38.8%, specificity was 74.5%, PPV was 55.6%, and NPV was 59.8%. For self-report of abdominal ultrasound diagnosis, the multivariable adjusted sensitivity was 40.6%, specificity 75.3%, PPV was 57.4%, and NPV was 60.6%. Conclusion: Self-report significantly under-reports the prevalence of UF and it is not accurate enough for epidemiological research of UF. Future studies of UF should use population-based designs and more accurate diagnostic tools such as TVUS.