PD20-06 EVALUATION OF VULVAR HEALTH FROM PHOTOGRAPHS
Bibliographic record
Abstract
You have accessJournal of UrologySexual Function/Dysfunction: Female (PD20)1 Apr 2019PD20-06 EVALUATION OF VULVAR HEALTH FROM PHOTOGRAPHS Irwin Goldstein*, James Simon, Andrew Kaunitz, Corrado Altomare, Yuki Yoshida, Julie Zhu, Samuel Schaffer, and Graziella Soulban Irwin Goldstein*Irwin Goldstein* More articles by this author , James SimonJames Simon More articles by this author , Andrew KaunitzAndrew Kaunitz More articles by this author , Corrado AltomareCorrado Altomare More articles by this author , Yuki YoshidaYuki Yoshida More articles by this author , Julie ZhuJulie Zhu More articles by this author , Samuel SchafferSamuel Schaffer More articles by this author , and Graziella SoulbanGraziella Soulban More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555738.52489.74AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: A multicenter, randomized, double-blind, placebo-controlled trial assessed efficacy and safety of ospemifene 60 mg QD in 631 postmenopausal women (age 40-80) with moderate to severe vaginal dryness as the most bothersome symptom (MBS) of VVA due to menopause. The primary aim was validation of vulvar photography as an objective measure of vulvar health. The secondary aim was to compare Vulvar Imaging Assessment Scale (VIAS) data from photographs to visual study measures assessed by investigators at each site, including Vaginal Health Index (VHI), and Vulvar Health Index (VuHI). METHODS: Photographs from sites were sent to a central monitoring system, uploaded to a dedicated website and accessed by three expert reviewers who independently assessed vulvar blinded images using a calibrated standardized monitor. Photographs were graded (none/mild/moderate/severe 0-3, cannot evaluate) for 9 criteria: labia majora loss, labia minora loss, clitoris size, urethral glans prominence, introital stenosis, introital pallor, introital erythema, introital moisture, mucosal inflammation. VHI evaluated vaginal fluid secretion, overall elasticity, pH, condition of epithelial mucosa, moisture as normal/mild/moderate/severe. VuHI rated vulvar appearance of labia majora, labia minora, clitoris, introitus appearance/elasticity, color, discomfort, pain as normal/mild/moderate/severe. RESULTS: 316 ospemifene and 315 placebo subjects were randomized. VIAS, range 0-27, was graded at baseline (ospemifene, 13.8; placebo, 14.1) and week 12, lower values showing better vulvovaginal health. The difference between treatment groups in least square (LS) mean change from baseline was -1.0 (p = 0.0118) at week 12, representing a greater decrease in the ospemifene group relative to placebo. VHI, range 5-25, was graded at baseline (13.0 in both groups) and week 12, higher values being better vaginal health. The difference between groups in LS mean change from baseline was week 4: 2.5, week 8: 2.9, week 12: 2.8 (all p < 0.0001), with greater increases in the ospemifene group. VuHI, range 0-21, was graded at baseline and week 12, with lower values indicating better vulvar health. The mean VuHI total score at baseline (ospemifene, 7.6; placebo, 7.7) was similar in both groups. The difference between groups in LS mean change from baseline was -0.8 (p = 0.0002) at week 4 and -1.1 to -1.2 at weeks 8 and 12 (both p < 0.0001), a statistically significant decrease in the ospemifene group compared to placebo. CONCLUSIONS: Evaluation of vulvar health from photograph images to assess MBS of menopausal women should be considered for future trials. Source of Funding: Duchesnay, Inc. San Diego, CA; Washington, DC; Jacksonsille, FL; Florham Park, FL; Florham Park, NJ; Blainville, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e379-e379 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Irwin Goldstein* More articles by this author James Simon More articles by this author Andrew Kaunitz More articles by this author Corrado Altomare More articles by this author Yuki Yoshida More articles by this author Julie Zhu More articles by this author Samuel Schaffer More articles by this author Graziella Soulban More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.390 | 0.083 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".