Abstract To evaluate the diagnostic accuracy of pictorial blood loss assessment chart (PBLAC) compared to objective measurements of menstrual blood loss (MBL), a systematic search of MEDLINE, EMBASE, Cumulative Index to Nurs-ing & Allied Health Literature (CINAHL), Web of Science, and EBM Reviews-Cochrane Central Register of Controlled Trials from inception until September 30, 2014 was per-formed. Terms referring to Bpictorial blood loss assessment chart,^Bmenstrual blood loss evaluation,^andBalkaline
hematin^were used. The ability of PBLAC to predict signif-icant blood loss, compared to alkaline hematin as a standard objectivemethod, represents our primary outcome. Out of 255 reports identified by the primary search, seven reports were
included in the review. Quality of these reports was assessed.
Compared to alkaline hematin, PBLAC sensitivity and spec-ificity ranged from 58 to 98 % and 7.5 to 97 %, respectively, with likelihood ratios (LR) for positive ranging from1.1 to 7.8
and LR for negative tests ranging from 0.04 to 0.48. Diagnos-tic odds ratio ranged from 2.6 to 86.9. Although diagnostic testing was not always supportive in terms of sensitivity, spec-ificity, and LRs, most studies support the use of PBLAC as a semi-objective method that can be implemented in research and clinical practice