Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Wisconsin, Madison, WI, USA.
Gynecol Endocrinol. 2020 Oct;36(10):854-859. doi: 10.1080/09513590.2020.1746761. Epub 2020 Apr 6.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. A recent study found that many obstetrics and gynecology (ObGyn) practicing physicians are unaware of the Rotterdam criteria recommended for diagnosis. Our objective was to identify gaps in trainee knowledge of PCOS diagnostic criteria and management. An online survey was sent out to US ObGyn physicians-in-training in 2018. The primary outcomes were identification of at least one component of each Rotterdam criteria (Rot-3): (1) oligomenorrhea/amenorrhea, (2) clinical or biochemical hyperandrogenism, and (3) ovarian volume or antral follicle count, and identification of all five components (Rot-5). Secondary outcomes were identification of comorbidities and management of PCOS. Multivariable logistic regression was used controlling for gender, seniority (PGY) status, program type, completion of an REI rotation, and number of PCOS patients seen. 85.4% of 347 trainees completing the survey reported using Rotterdam criteria to diagnose PCOS. However, only 55% identified Rot-3 and less than 10% identified Rot-5. Seniority (PGY4 OR 2.2; 95% CI: 1.2-4.1; = .01) and completion of REI rotation (OR 1.8 95% CI: 1.2, 1.8; = .006) were associated with identifying Rot-3. Similar findings were noted with identifying Rot-5. Our study identified significant gaps in knowledge regarding PCOS, suggesting an urgent need for improving strategies for trainee education to increase patient satisfaction and provide comprehensive care.
多囊卵巢综合征（PCOS）是生殖期妇女最常见的内分泌疾病。最近的一项研究发现，许多妇产科医生（ObGyn）并不了解推荐用于诊断的鹿特丹标准。我们的目的是确定实习生对 PCOS 诊断标准和管理的知识差距。2018 年，我们向美国妇产科住院医师进行了在线调查。主要结果是确定每个鹿特丹标准（Rot-3）的至少一个组成部分：（1）稀发排卵/闭经，（2）临床或生化高雄激素血症，（3）卵巢体积或窦卵泡计数，以及确定所有五个组成部分（Rot-5）。次要结果是确定合并症和 PCOS 的管理。使用多变量逻辑回归控制性别、年资（PGY）状态、项目类型、接受 REI 轮训以及 PCOS 患者就诊次数进行分析。347 名完成调查的住院医师中有 85.4%报告使用 Rotterdam 标准诊断 PCOS。然而，只有 55%的人识别出 Rot-3，不到 10%的人识别出 Rot-5。年资（PGY4 或 2.2；95%CI：1.2-4.1； = .01）和接受 REI 轮训（OR 1.8 95%CI：1.2, 1.8； = .006）与识别 Rot-3 相关。类似的发现也与识别 Rot-5 相关。我们的研究发现，关于 PCOS 的知识存在明显差距，这表明迫切需要改善住院医师教育策略，以提高患者满意度并提供全面护理。
