Validity and performance of the new Guide for the Assessment of Menopausal Symptoms (GAMS) scale, based on the Greene Climacteric Scale: A population survey of French women

Abstract

Objective

The validity of the Greene Climacteric Scale (GCS) is supported by evidence demonstrating a strong correlation with other measures of menopausal symptoms and quality of life. However, this score, developed 60 years ago, may not be fully applicable the current menopausal population. The purpose of this study was to evaluate the validity of the GCS in a French population and to determine whether an alternative construction of the scale could improve its performance. This led to the development of a new tool: the Guide for the Assessment of Menopausal Symptoms (GAMS) scale.

Methods

The 21 questions of the GCS were distributed to French women via social media. The performance of the GCS score in identifying menopausal status was ascertained. Subsequently, the GAMS scale was developed using a training dataset and was validated on a separate dataset.

Results

The training dataset included data from 14,518 participants, of whom 3722 (26.64 %) were classified as menopausal. The validation dataset consisted of 3629 participants, of whom 852 (23.48 %) were menopausal. The GCS demonstrated an AUC of 0.53, with a median score of 20 [IQR: 14–27] for menopausal cases and a maximum probability of correct classification of 38 %. In comparison, the GAMS scale achieved an AUC of 0.63, with a median score of 4 [IQR: 2–7] and a maximum probability of correct classification of 70 %.

Conclusion

The performance of the GCS in identifying menopausal status is low. Applying weighting coefficients in the GAMS scale improves its performance. Further research is essential to develop tailored and specific menopausal scales that better address women's symptoms and improve their care.