Clinical Practice Guidelines on the Diagnosis and Management of Polycystic Ovary Syndrome: A Systematic Review and Quality Assessment Study

Clinical Practice Guidelines on the Diagnosis and Management of Polycystic Ovary Syndrome: A Systematic Review and Quality Assessment Study

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 Acquisit...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism Vol. 106; no. 8; pp. 2436 - 2446
Main Authors: Al Wattar, Bassel H, Fisher, Maria, Bevington, Laura, Talaulikar, Vikram, Davies, Melanie, Conway, Gerrad, Yasmin, Ephia
Format: Journal Article
Language:English
Published: US Oxford University Press 01-08-2021
Subjects:
Acne
Adolescents
Cardiovascular diseases
Care and treatment
Clinical medicine
Clinical practice guidelines
Diagnosis
Disease Management
Evidence-Based Medicine
Female
Hirsutism
Humans
Medical research
Medicine, Experimental
Mental health
Meta-Analyses
Metabolic disorders
Metabolism
Ovarian hyperstimulation syndrome
Ovaries
Polycystic ovary syndrome
Polycystic Ovary Syndrome - diagnosis
Polycystic Ovary Syndrome - therapy
Practice Guidelines as Topic
Quality Assurance, Health Care
Quality control
Risk assessment
Stein-Leventhal syndrome
Type 2 diabetes
United Kingdom
AGREE tool
systematic review
polycystic ovary syndrome
clinical CPGs
quality
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Summary: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.
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ISSN:0021-972X
1945-7197
1945-7197
DOI:10.1210/clinem/dgab232