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会诊次数对多囊卵巢综合征评估与治疗的影响

Effect of Consultation Number on the Assessment and Treatment of Polycystic Ovary Syndrome.

作者信息

Wang Yue, Chen Jie, Dong Han, Ma Rui-Lin, Zou Ying, Wang Wei, Zheng Qingmei, Feng Ying, Tan Zhangyun, Zeng Xiaoqin, Zhao Yinqing, Deng Yan, Wang Yanfang, Gu Bei, Sun Aijun

机构信息

National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People's Republic of China.

Department of Obstetrics and Gynecology, Women and Children's Hospital of Jinzhou, Jinzhou, Liaoning, 121000, People's Republic of China.

出版信息

Int J Womens Health. 2024 Mar 25;16:527-541. doi: 10.2147/IJWH.S445568. eCollection 2024.

Abstract

BACKGROUND

The basic medical education stage is not enough to support physicians to fully diagnose and evaluate polycystic ovary syndrome (PCOS). The study aims to discover the difference in treatment choice between participants with different annual consultation number of PCOS, to promote lifelong learning, and drive balanced development within healthcare.

METHODS

This is a multicenter cross-sectional survey. Participants' basic information, knowledge of PCOS and treatment options were collected online. According to the annual consultation number of patients with PCOS, physicians were divided into three groups: 0-50 people/yr, 50-200 people/yr, and >200 people/yr, and the results were derived from χ test, Fisher exact test, and multivariate logistic regression analysis.

RESULTS

The study analyzed 1689 questionnaires, and 1206 physicians (71.4%) received less than 50 women per year, 388 physicians (30.0%) with an annual number of 50-200 women, and 95 physicians (5.6%) with patient turnover for more than 200 people. Reproductive endocrinologists generally have higher access to the clinic. As the number of visits increases, more and more physicians would perceive patients as more likely to have abnormal blood glucose and heavy weight. Physicians with large numbers of consultations are more likely to use Asian or Chinese standards to assess obesity. The multivariate analysis involved variables such as age, hospital level, specialty, and patient turnover annually, and more young doctors actively assessed lipid profile (odds ratio (OR) 1.56, 95% confidence interval (CI) (1.16, 2.16)), and primary hospitals (OR 0.65 CI (0.44, 0.89)) chose OGTT for blood glucose assessment less than tertiary hospitals. Physicians in secondary hospitals are more aggressive in evaluating androgens.

CONCLUSION

Our survey found differences in endocrine assessment, metabolic screening, and treatment in PCOS women in terms of the number of obstetrician-gynecologists who received different patient consultation numbers. The importance of continuing education for physicians is emphasized, to promote lifelong learning.

摘要

背景

基础医学教育阶段不足以支持医生对多囊卵巢综合征(PCOS)进行全面的诊断和评估。本研究旨在发现不同PCOS年诊量的参与者在治疗选择上的差异,以促进终身学习,并推动医疗保健领域的均衡发展。

方法

这是一项多中心横断面调查。通过在线收集参与者的基本信息、对PCOS的了解以及治疗选择。根据PCOS患者的年诊量,医生被分为三组:每年0 - 50人、每年50 - 200人以及每年>200人,结果来自χ检验、Fisher精确检验和多因素逻辑回归分析。

结果

该研究分析了1689份问卷,1206名医生(71.4%)每年接待少于50名女性患者,388名医生(30.0%)年诊量为50 - 200名女性,95名医生(5.6%)年患者周转量超过200人。生殖内分泌科医生通常有更高的门诊量。随着就诊次数的增加,越来越多的医生会认为患者更有可能出现血糖异常和体重超标。大量接诊的医生更倾向于使用亚洲或中国标准来评估肥胖。多因素分析涉及年龄、医院级别、专业以及每年的患者周转量等变量,更多年轻医生积极评估血脂情况(优势比(OR)1.56,95%置信区间(CI)(1.16,2.16)),并且基层医院(OR 0.65,CI(0.44,0.89))选择口服葡萄糖耐量试验(OGTT)进行血糖评估的比例低于三级医院。二级医院的医生在评估雄激素方面更为积极。

结论

我们的调查发现,不同患者年诊量的妇产科医生在PCOS女性的内分泌评估、代谢筛查和治疗方面存在差异。强调了医生继续教育的重要性,以促进终身学习。

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