Gibson-Helm Melanie, Dokras Anuja, Karro Helle, Piltonen Terhi, Teede Helena J
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
Semin Reprod Med. 2018 Jan;36(1):19-27. doi: 10.1055/s-0038-1667155. Epub 2018 Sep 6.
To inform knowledge translation by identifying evidence-practice gaps in polycystic ovary syndrome (PCOS) care and variations between disciplines and across world regions via an online, anonymous, devised questionnaire distributed via professional societies and completed by 1,495 physicians (2015-2016).
Multivariable logistic regression analyses generated adjusted odds ratios (OR) and 95% confidence intervals (CI) for associations between outcome measures and world region, specialty, annual patients with PCOS, age, and sex.
Features corresponding to Rotterdam diagnostic criteria were well recognized (e.g., irregular menstrual cycles by 99% of physicians), but psychological implications were recognized only by 29 to 64%. Reproductive endocrinologists were more likely to use Rotterdam diagnostic criteria (OR: 3.1; 95% CI: 2.3-4.3; < 0.007) than obstetrician-gynecologists. Reproductive (OR: 2.0; 95% CI: 1.5-2.8; < 0.007) and medical endocrinologists (OR: 3.1; 95% CI: 1.7-5.7; < 0.007) were more likely to recommend lifestyle management than obstetrician-gynecologists. Physicians in Europe (OR: 4.7; 95% CI: 3.5-6.1; < 0.007) and other regions (OR: 4.0; 95% CI: 2.8-5.9; < 0.007) were more likely to use Rotterdam diagnostic criteria than physicians in North America.
Knowledge gaps in PCOS care to be addressed internationally include physician awareness of the breadth of PCOS features, application of diagnostic criteria, and recommending lifestyle management effectively.
通过一份在线、匿名、专门设计的问卷来识别多囊卵巢综合征(PCOS)护理中的证据 - 实践差距以及不同学科和全球各地区之间的差异,以促进知识转化。该问卷通过专业协会分发,于2015 - 2016年由1495名医生完成。
多变量逻辑回归分析得出调整后的优势比(OR)和95%置信区间(CI),用于衡量结局指标与世界地区、专业、每年PCOS患者数量、年龄和性别之间的关联。
符合鹿特丹诊断标准的特征得到了很好的认知(例如,99%的医生认可月经周期不规律),但心理影响仅被29%至64%的医生所认识。生殖内分泌学家比妇产科医生更有可能使用鹿特丹诊断标准(OR:3.1;95%CI:2.3 - 4.3;<0.007)。生殖科医生(OR:2.0;95%CI:1.5 - 2.8;<0.007)和医学内分泌学家(OR:3.1;95%CI:1.7 - 5.7;<0.007)比妇产科医生更有可能推荐生活方式管理。欧洲的医生(OR:4.7;95%CI:3.5 - 6.1;<0.007)和其他地区的医生(OR:4.0;95%CI:2.8 - 5.9;<0.007)比北美医生更有可能使用鹿特丹诊断标准。
在国际上需要解决的PCOS护理知识差距包括医生对PCOS特征范围的认识、诊断标准的应用以及有效推荐生活方式管理。