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Clinical practice guidelines on the diagnosis and management of polycystic ovary syndrome : a systematic review and quality assessment study
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Wattar, Bassel H. Al, Fisher, Maria, Bevington, Laura, Talaulikar, Vikram, Davies, Melanie, Conway, Gerrad and Yasmin, Ephia (2021) Clinical practice guidelines on the diagnosis and management of polycystic ovary syndrome : a systematic review and quality assessment study. The Journal of Clinical Endocrinology & Metabolism, 106 (8). pp. 2436-2446. doi:10.1210/clinem/dgab232 ISSN 0021-972X.
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Official URL: https://doi.org/10.1210/clinem/dgab232
Abstract
Context:
Clinical practice guidelines (CPGs) are key instruments to implement the practice of evidence-based medicine. We aimed to evaluate the methodological quality and variations in CPGs recommendations on the diagnosis and management of polycystic ovary syndrome (PCOS).
Evidence Acquisition:
We searched MEDLINE, EMBASE, and CENTRAL until December 2020 for all evidence-based CPGs and consensus statements on PCOS. We extracted data in duplicate to map clinical recommendations across prespecified disease domains and assessed CPGs methodological quality of using the Appraisal of Guidelines, Research & Evaluation II tool.
Evidence Synthesis:
We included 13 PCOS CPGs published between 2007 and 2018. CPGs recommendations were mostly focused on screening for and managing metabolic disease (12/13, 92%), followed by cardiovascular risk assessment (10/13, 77%). Mental health (8/13, 62%) and diagnosis in adolescents (7/13, 54%) were the least reported domains. Most CPGs had a high quality for scope and purpose description (12/13, 92%) while stakeholder’s involvement and applicability of recommendations to clinical practice were appropriate in only 2 CPGs (2/13, 15%). We identified inconsistency in recommendations on PCOS diagnosis in adolescents, optimal lifestyle interventions, hirsutism and acne treatments, interventions to reduce the risk of ovarian hyperstimulation syndrome, the frequency and screening criteria for metabolic and cardiovascular disease, and optimal screening tools for mental health illness in women with PCOS.
Conclusion:
Current CPGs on the diagnosis and management of PCOS vary in their scope and methodological quality, which may hinder evidence translation into clinical practice. We identified disease domains with existing evidence gap to guide future research and guideline updates.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RG Gynecology and obstetrics |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
SWORD Depositor: | Library Publications Router | ||||
Library of Congress Subject Headings (LCSH): | Polycystic ovary syndrome, Physician practice patterns, Systematic reviews (Medical research) | ||||
Journal or Publication Title: | The Journal of Clinical Endocrinology & Metabolism | ||||
Publisher: | The Endocrine Society | ||||
ISSN: | 0021-972X | ||||
Official Date: | 11 April 2021 | ||||
Dates: |
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Volume: | 106 | ||||
Number: | 8 | ||||
Page Range: | pp. 2436-2446 | ||||
DOI: | 10.1210/clinem/dgab232 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Date of first compliant deposit: | 14 September 2022 | ||||
Date of first compliant Open Access: | 15 September 2022 |
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