Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome
Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome
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DOI：
10.1016/j.fertnstert.2017.04.011
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发表时间：
2017-06-01
影响因子：
6.7
通讯作者：
Teede, Helena
中科院分区：
文献类型：
--
作者：
Dokras, Anuja;Saini, Shailly;Teede, Helena
目的：为了确定北美医生在多囊卵巢综合征（PCOS）知识和实践模式方面的差距，以应对PCOS妇女对其诊断和治疗经验的显着不满。设计：通过美国妇产科学院（ObGyn）和美国生殖医学会生殖内分泌学家进行的在线调查（REI-ObGyn）在2015- 16年。设置：不适用。患者：无。干预措施：无。主要结局指标：使用的诊断标准，PCOS的主要特征，管理实践。结果：在完成的630项调查中，70.2%为ObGyn，64.4%为女性。总体而言，27.7%的受访者不知道他们使用的PCOS诊断标准。在一项多变量分析中，包括医生类型、年龄、性别和每年就诊的PCOS患者数量，与ObGyn相比，REI-ObGyn不太可能报告不知道他们使用的标准（调整后的比值比，0.08; 95%置信区间，0.04，0.16）。REI-ObGyn更可能使用鹿特丹标准（比值比，2.26; 95%置信区间，1.33，3.82）。大多数受访者认识到与PCOS相关的临床特征;然而，超过三分之一的人将“卵巢囊肿”与PCOS联系起来。大多数应答者（> 85%）知道心脏代谢合并症;然而，很少有ObGyn知道相关的抑郁症，焦虑症和生活质量下降。与ObGyn相比，更多REI-ObGyn建议改变生活方式（56.4%对41.6%）。结论：我们的大规模PCOS调查，针对患者对诊断和治疗的担忧进行，突出了医生教育的机会。重点领域包括针对国际公认的鹿特丹标准的知识，并确保在PCOS的生殖，代谢和心理特征方面遵循循证指南进行一致的护理。（C）2017年由美国生殖医学学会。
Objective: To identify gaps in polycystic ovary syndrome (PCOS) knowledge and practice patterns among physicians in North America in response to significant dissatisfaction identified among women with PCOS regarding their diagnosis and treatment experience.Design: Online survey conducted via American College of Obstetrics and Gynecology of gynecologists (ObGyn) and American Society of Reproductive Medicine of reproductive endocrinologists (REI-ObGyn) in 2015- 16.Setting: Not applicable.Patient(s): None.Intervention(s): None.Main Outcome Measure(s): Diagnostic criteria used, key features of PCOS, management practices.Result(s): Of the 630 surveys completed, 70.2% were ObGyn and 64.4% were females. Overall 27.7% respondents did not know which PCOS diagnostic criteria they used. In a multivariable analysis including physician type, age, gender, and number of patients with PCOS seen annually, REI-ObGyn were less likely compared with ObGyn to report not knowing which criteria they used (adjusted odds ratio, 0.08; 95% confidence interval, 0.04, 0.16). REI-ObGyn were more likely to use the Rotterdam criteria (odds ratio, 2.26; 95% confidence interval, 1.33, 3.82). The majority of respondents recognized the clinical features associated with PCOS; however, over one-third associated ``cysts on ovaries'' with PCOS. The majority of responders (> 85%) were aware of cardiometabolic comorbidities; however, fewer ObGyn were aware of associated depression, anxiety disorders, and reduced quality of life. More REI- ObGyn recommended lifestyle changes compared with ObGyn (56.4% vs. 41.6%).Conclusion(s): Our large-scale PCOS survey, conducted in response to patient concerns regarding diagnosis and treatment, highlights opportunities for physician education. Focus areas include targeting knowledge of internationally accepted Rotterdam criteria and ensuring consistent care informed by evidence-based guidelines across the reproductive, metabolic, and psychological features of PCOS. (C)2017 by American Society for Reproductive Medicine.