Differences in the management of adolescents with polycystic ovary syndrome across pediatric specialties.
Differences in the management of adolescents with polycystic ovary syndrome across pediatric specialties.
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DOI：
10.1016/j.jpag.2013.03.007
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发表时间：
2013-08
影响因子：
1.8
通讯作者：
Hillman JB
中科院分区：
文献类型：
--
作者：
Auble B;Elder D;Gross A;Hillman JB
Evaluate for differences in the management of adolescents with polycystic ovarian syndrome (PCOS) across three pediatric specialties Retrospective review of medical records Academic children’s hospital 181 adolescents seen between July 2008 – June 2010 by providers in Pediatric Endocrinology (PEndo), Adolescent Medicine (AMed), or Pediatric and Adolescent Gynecology (PGyn) identified via billing data (ICD-9 code for PCOS, 256.4) None (1) Percentage of adolescents with a billing diagnosis of PCOS who met diagnostic criteria; (2) Percentage of individuals screened for co-morbidities and differences across specialties; (3) Differences in treatment recommendations across specialties; (4) Factors associated with recommendation for metformin and hormonal contraceptives. Thirteen percent of PEndo patients did not meet diagnostic criteria for PCOS; 20% of AMed and PGyn patients did not meet criteria. There were significant differences in rates of screening for obesity, insulin resistance, and Type 2 diabetes. There were significant differences in treatment recommendations for lifestyle changes, metformin, and anti-androgen therapy across specialties. Specialty and obesity were significant predictors of metformin recommendation; specifically PEndo predicted metformin recommendation. PGyn and AMed specialties predicted hormonal contraceptive recommendation. The variability observed among specialties may be due to differences in training, accounting for a range of comfort with aspects of PCOS. Formulation of consensus guidelines for diagnosis and management of PCOS are needed, along with broad educational efforts. By correctly diagnosing, screening for co-morbidities, and managing PCOS appropriately during adolescence providers may reduce the risk for long-term consequences.
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