title: Clinical scoring system for vulvar lichen sclerosus.
abstract: BACKGROUND
  Vulvar lichen sclerosus (LS) is a chronic inflammatory and mutilating disease, which goes often undetected for years. Advanced disease severely affects quality of life like sexual disorders and is also associated with an increased risk of vulvar cancer.
  
  
  OBJECTIVE
  To develop and validate a patient-administered symptom score and a physician-administered clinical score for the diagnosis and evaluation of vulvar LS.
  
  
  METHODS
  We included 24 patients with established LS diagnosis and 49 with other vulvar disease. The physician-administered score was based on six clinical features and the patient-administered score was a symptom-based four-item composite score. We determined inter-item correlations and internal consistency of both scores, and estimated sensitivities, specificities, likelihood ratios, and posttest probabilities for different cutoffs of the physician-administered score.
  
  
  METHODS
  Characteristics of patients with and without LS were compared using χ(2) and unpaired t-test as required. We then determined Cronbach's alpha as a measure of the overall consistency of scores and calculated positive and negative likelihoods.
  
  
  RESULTS
  Lack of redundancy of items (correlation coefficients < 0.90) and internal consistency (Cronbach's α ≥ 0.70) suggested that final composite scores were valid and yielded excellent power to rule in LS.
  
  
  CONCLUSIONS
  Scores may be useful for assessing symptoms of vulvar disorders, to ease diagnosis of LS and to evaluate treatment response over time.
authors: Department of Gynecology and Obstetrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland. andreas.guenthert@insel.ch
authors: Andreas R
authors: AR
authors: Günthert
authors: Kathleen
authors: K
authors: Duclos
authors: Boriana G
authors: BG
authors: Jahns
authors: Elke
authors: E
authors: Krause
authors: Esther
authors: E
authors: Amann
authors: Andreas
authors: A
authors: Limacher
authors: Michael D
authors: MD
authors: Mueller
authors: Peter
authors: P
authors: Jüni
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011537:Pruritus / Q000209:etiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D007724:Vulvar Lichen Sclerosus / Q000175:diagnosis*