Perspectives on Polycystic Ovary Syndrome: Is Polycystic Ovary Syndrome Research Underfunded?

Brakta, Soumia; Lizneva, Daria; Mykhalchenko, Kateryna; Imam, Adonis; Walker, Walidah; Diamond, Michael P.; Azziz, Ricardo

doi:10.1210/jc.2017-01415

Cited by 58 publications

(35 citation statements)

References 19 publications

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“…Delayed diagnosis and ineffective treatment because of insufficient understanding of the diverse features of PCOS, inadequate support for quality research, and a lack of standard guidelines. [ 7 ] Quality of reporting has been recognized as a key measure for successful translation of evidence to practice, reducing overall waste in research and eliminating non-replicable studies, [ 8 ] but the reporting quality of CPGs seems low, [ 9 ] and the existing used tools do not accurately address quality assessment and reporting in a single statement. In 2010, Chen et al from the WHO established the RIGHT checklist (Reporting Items for Practice Guidelines in Healthcare) which focused on using presentation format.…”

Section: Introductionmentioning

confidence: 99%

Reporting quality of polycystic ovary syndrome practice guidelines based on the RIGHT checklist

Li¹,

Zhang

et al. 2020

Medicine

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Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder involving hyperandrogenism, menstrual disorder, metabolic problems, infertility, obesity, and acne. The main aim of this study was to assess the reporting quality of clinical practice guidelines (CPGs) in the field of PCOS to provide a reporting specification for this study. Methods: We evaluated the reporting quality of clinical guidelines of PCOS using the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist. Nine databases and 3 medical associations were searched. These included Medline, Embase, PubMed, National Institute for Health and Care Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), China National Knowledge Infrastructure, Wanfang and Chinese Science, and Technology Journal Database (VIP). Three medical associations included the European Society of Human Reproduction and Embryology, the American Society for Reproductive Medicine and the Agency for Healthcare Research and Quality. Two independent authors assessed the reporting quality of PCOS CPGs by the RIGHT checklist, and Spearman's correlation was used to assess inter-rater reliability. Results: Twelve PCOS CPGs were included. On average, 20.0 (57.1%) of the 35 items in the RIGHT checklist were reported. All items were fully reported by one of these CPGs. The number of reported items ranged from 10 (28.6%) to 35 (100%). Overall, 16.7%, 66.7%, and 16.7% of included guidelines were of high, medium, and low quality, respectively. The reporting proportions of the 7 domains (i.e., Basic information, Background, Evidence, Recommendations, Reviewand quality assurance, Funding and declaration and management of interests, and Other information) in the RIGHT checklist were 62.0%, 69.1%, 53.3%, 60.7%, 33.3%, 31.2%, and 69.4%, respectively. Conclusions: The evaluation of these CPGs by the RIGHT checklist revealed that the reporting quality varied among guidelines. Low quality items were the processes of evidence decision and the declaration of funding in most included CPGs. Guideline developers should pay more attention to these items to disseminate and implement better guidelines in near future. Trial registration number: registration at PROSPERO CRD42020163435

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Section: Introductionmentioning

confidence: 99%

Reporting quality of polycystic ovary syndrome practice guidelines based on the RIGHT checklist

Li¹,

Zhang

et al. 2020

Medicine

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“…Clinically, there is considerable variation in care and evidence of confusion around diagnostic criteria 11 , 14 . Researchers are frustrated with inadequate priority and funding in PCOS, especially given the prevalence, disease and economic burden 15 . These challenges are exacerbated by inconsistent guideline quality and recommendations.…”

Section: Boxmentioning

confidence: 99%

Translation and implementation of the Australian‐led PCOS guideline: clinical summary and translation resources from the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Teede

Misso

Boyle

et al. 2018

Medical Journal of Australia

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Introduction: We have developed the first international evidence‐based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian‐led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will enable practice benchmarking and feedback to further inform evidence‐based practice. We propose that this methodology could be used in developing and implementing guidelines for other women's health conditions and beyond. Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non‐fertility indications; and assessment and treatment of infertility. Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow‐up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple pregnancies compared with clomiphene citrate.

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“…Professional society position statements or clinical practice guidelines are more limited in scope, do not follow AGREE II process, involve more limited expertise and geographical representation, and are often conflicting in recommendations. 18,19 Here, we have updated and expanded the scope and evidence contained in the Australian guideline 9 and, where appropriate, the WHO guideline 17 to create one clear, rigorous, and robust EBG which can be used across nations.…”

Section: Establish Need For New or Adapted Guidelinesmentioning

confidence: 99%

Large-Scale Evidence-Based Guideline Development Engaging the International PCOS Community

et al. 2018

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The evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS) integrates the best available evidence with international, multidisciplinary clinical expertise and consumer preferences to provide health professionals, consumers, and policy makers with high-quality, comprehensive guidance about diagnosing and managing PCOS. Here, we outline the rigorous and systematic process, defined and documented to be reproducible, to minimize bias and maintain transparency, in alignment with the Appraisal of Guidelines for Research and Evaluation (AGREE II) criteria and incorporating the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework that render this PCOS evidence-based guideline credible, trustworthy, reliable, and useable.

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Perspectives on Polycystic Ovary Syndrome: Is Polycystic Ovary Syndrome Research Underfunded?

Cited by 58 publications

References 19 publications

Reporting quality of polycystic ovary syndrome practice guidelines based on the RIGHT checklist

Reporting quality of polycystic ovary syndrome practice guidelines based on the RIGHT checklist

Translation and implementation of the Australian‐led PCOS guideline: clinical summary and translation resources from the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Large-Scale Evidence-Based Guideline Development Engaging the International PCOS Community

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