Trends in Standard Workup Performed by Pediatric Subspecialists for the Diagnosis of Adolescent Polycystic Ovary Syndrome
Abstract Objective The purpose of this study is to identify trends in the clinical workup, diagnosis, and treatment of polycystic ovary syndrome by pediatric endocrinologists, pediatric gynecologists, and adolescent medicine specialists. Design Retrospective chart review. Setting Tertiary care medic...
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| Veröffentlicht in: | Journal of pediatric & adolescent gynecology 2015-02, Vol.28 (1), p.43-46 |
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| creator | Powers, Sarah E., BA Uliassi, Nicole W., MD Sullivan, Shannon D., MD, PhD Tuchman, Lisa K., MD, MPH Mehra, Rinku, MD Gomez-Lobo, Veronica, MD |
| description | Abstract Objective The purpose of this study is to identify trends in the clinical workup, diagnosis, and treatment of polycystic ovary syndrome by pediatric endocrinologists, pediatric gynecologists, and adolescent medicine specialists. Design Retrospective chart review. Setting Tertiary care medical center. Participants Females aged 11-18 y who were evaluated for PCOS from June 2009 to October 2011 were included. Any patients with coexisting diagnoses of other primary etiology for amenorrhea were excluded. Patients were identified by ICD-9 codes for PCOS, hypersecretion of ovarian androgens, irregular menses, hirsutism, oligomenorrhea, or amenorrhea. 261 patients were included: 144 from endocrinology, 9 from gynecology, and 108 from adolescent pediatric practices. Results There were no significant differences in the androgen labs ordered by the subspecialties. Gynecologists ordered pelvic ultrasonography for 89% (n = 8) of patients, compared to 9% (n = 10) by adolescent medicine specialists and 24% (n = 34) by endocrinologists ( P |
| doi_str_mv | 10.1016/j.jpag.2014.03.002 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1642608007</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1083318814001648</els_id><sourcerecordid>1642608007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-4c0094c3b875f76762fcaa848555deb7ebfacfa1b95daaa78652ce4e7cd8470f3</originalsourceid><addsrcrecordid>eNp9kVFr1jAUhosobk7_gBeSS29aT5q0zUCEMZ0OBht8Ey9DmpzMdP2SmrSD_vulfNOLXZibkwPv-3LOc4riPYWKAm0_DdUwqbuqBsorYBVA_aI4pqJjJWesfpn_IFjJqBBHxZuUBgDomla8Lo7qJj8GcFystxG9ScR5spuVNyoa8ivE-2UiNxhtiHs0pF9zY5yao9Nkt_RpQu3U6NKcSJaQ-TeSr07d-ZBcIsGSMxNGTBr9TG7CuOo1zdl5_aDiSnarNzHs8W3xyqox4bunelL8vPh2e_6jvLr-fnl-dlVqTulccg1wyjXrRdfYru3a2mqlBBd5A4N9h71V2iranzZGKdWJtqk1cuy0EbwDy06Kj4fcKYY_C6ZZ7l0ebRyVx7AkSVtetyAymyytD1IdQ0oRrZyi2-ehJQW5IZeD3JDLDbkEJjPybPrwlL_0GdY_y1_GWfD5IMC85YPDKJN26HUmGlHP0gT3__wvz-x6dN5pNd7jimkIS_SZn6Qy1RLkbjv6dnPKISdywR4BKKapmQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1642608007</pqid></control><display><type>article</type><title>Trends in Standard Workup Performed by Pediatric Subspecialists for the Diagnosis of Adolescent Polycystic Ovary Syndrome</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Powers, Sarah E., BA ; Uliassi, Nicole W., MD ; Sullivan, Shannon D., MD, PhD ; Tuchman, Lisa K., MD, MPH ; Mehra, Rinku, MD ; Gomez-Lobo, Veronica, MD</creator><creatorcontrib>Powers, Sarah E., BA ; Uliassi, Nicole W., MD ; Sullivan, Shannon D., MD, PhD ; Tuchman, Lisa K., MD, MPH ; Mehra, Rinku, MD ; Gomez-Lobo, Veronica, MD</creatorcontrib><description>Abstract Objective The purpose of this study is to identify trends in the clinical workup, diagnosis, and treatment of polycystic ovary syndrome by pediatric endocrinologists, pediatric gynecologists, and adolescent medicine specialists. Design Retrospective chart review. Setting Tertiary care medical center. Participants Females aged 11-18 y who were evaluated for PCOS from June 2009 to October 2011 were included. Any patients with coexisting diagnoses of other primary etiology for amenorrhea were excluded. Patients were identified by ICD-9 codes for PCOS, hypersecretion of ovarian androgens, irregular menses, hirsutism, oligomenorrhea, or amenorrhea. 261 patients were included: 144 from endocrinology, 9 from gynecology, and 108 from adolescent pediatric practices. Results There were no significant differences in the androgen labs ordered by the subspecialties. Gynecologists ordered pelvic ultrasonography for 89% (n = 8) of patients, compared to 9% (n = 10) by adolescent medicine specialists and 24% (n = 34) by endocrinologists ( P < .0001). Endocrinologists were most likely to treat patients who met diagnostic criteria for PCOS with metformin (58%, n = 66), compared to gynecologists (14%, n = 1) and adolescent medicine specialists (5%, n = 3) ( P < .0001). Gynecologists (43%, n = 3) and adolescent medicine specialists (58%, n = 39) were more likely than endocrinologists (24%, n = 27) to treat patients with oral contraceptive pills ( P < .0001). Conclusions Inconsistent diagnosis and treatment strategies for young women with PCOS are evident among pediatric subspecialties, reflecting lack of standardized care for adolescents. Quantifying outcomes based on diagnostic and therapeutic approaches are important next steps.</description><identifier>ISSN: 1083-3188</identifier><identifier>EISSN: 1873-4332</identifier><identifier>DOI: 10.1016/j.jpag.2014.03.002</identifier><identifier>PMID: 25555300</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adolescent medicine ; Adolescent Medicine - methods ; Adolescents ; Androgens - secretion ; Child ; Contraceptives, Oral - therapeutic use ; Diagnosis ; Endocrinology ; Endocrinology - methods ; Female ; Gynecology ; Gynecology - methods ; Hirsutism - etiology ; Humans ; Hypoglycemic Agents - therapeutic use ; Menstruation Disturbances - etiology ; Metformin - therapeutic use ; Obstetrics and Gynecology ; Pediatrics ; Pediatrics - methods ; Polycystic ovary syndrome ; Polycystic Ovary Syndrome - complications ; Polycystic Ovary Syndrome - diagnosis ; Polycystic Ovary Syndrome - drug therapy ; Practice Patterns, Physicians' - trends ; Retrospective Studies ; Specialization ; Therapeutics ; Young Adult</subject><ispartof>Journal of pediatric & adolescent gynecology, 2015-02, Vol.28 (1), p.43-46</ispartof><rights>North American Society for Pediatric and Adolescent Gynecology</rights><rights>2015 North American Society for Pediatric and Adolescent Gynecology</rights><rights>Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-4c0094c3b875f76762fcaa848555deb7ebfacfa1b95daaa78652ce4e7cd8470f3</citedby><cites>FETCH-LOGICAL-c411t-4c0094c3b875f76762fcaa848555deb7ebfacfa1b95daaa78652ce4e7cd8470f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpag.2014.03.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25555300$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Powers, Sarah E., BA</creatorcontrib><creatorcontrib>Uliassi, Nicole W., MD</creatorcontrib><creatorcontrib>Sullivan, Shannon D., MD, PhD</creatorcontrib><creatorcontrib>Tuchman, Lisa K., MD, MPH</creatorcontrib><creatorcontrib>Mehra, Rinku, MD</creatorcontrib><creatorcontrib>Gomez-Lobo, Veronica, MD</creatorcontrib><title>Trends in Standard Workup Performed by Pediatric Subspecialists for the Diagnosis of Adolescent Polycystic Ovary Syndrome</title><title>Journal of pediatric & adolescent gynecology</title><addtitle>J Pediatr Adolesc Gynecol</addtitle><description>Abstract Objective The purpose of this study is to identify trends in the clinical workup, diagnosis, and treatment of polycystic ovary syndrome by pediatric endocrinologists, pediatric gynecologists, and adolescent medicine specialists. Design Retrospective chart review. Setting Tertiary care medical center. Participants Females aged 11-18 y who were evaluated for PCOS from June 2009 to October 2011 were included. Any patients with coexisting diagnoses of other primary etiology for amenorrhea were excluded. Patients were identified by ICD-9 codes for PCOS, hypersecretion of ovarian androgens, irregular menses, hirsutism, oligomenorrhea, or amenorrhea. 261 patients were included: 144 from endocrinology, 9 from gynecology, and 108 from adolescent pediatric practices. Results There were no significant differences in the androgen labs ordered by the subspecialties. Gynecologists ordered pelvic ultrasonography for 89% (n = 8) of patients, compared to 9% (n = 10) by adolescent medicine specialists and 24% (n = 34) by endocrinologists ( P < .0001). Endocrinologists were most likely to treat patients who met diagnostic criteria for PCOS with metformin (58%, n = 66), compared to gynecologists (14%, n = 1) and adolescent medicine specialists (5%, n = 3) ( P < .0001). Gynecologists (43%, n = 3) and adolescent medicine specialists (58%, n = 39) were more likely than endocrinologists (24%, n = 27) to treat patients with oral contraceptive pills ( P < .0001). Conclusions Inconsistent diagnosis and treatment strategies for young women with PCOS are evident among pediatric subspecialties, reflecting lack of standardized care for adolescents. Quantifying outcomes based on diagnostic and therapeutic approaches are important next steps.</description><subject>Adolescent</subject><subject>Adolescent medicine</subject><subject>Adolescent Medicine - methods</subject><subject>Adolescents</subject><subject>Androgens - secretion</subject><subject>Child</subject><subject>Contraceptives, Oral - therapeutic use</subject><subject>Diagnosis</subject><subject>Endocrinology</subject><subject>Endocrinology - methods</subject><subject>Female</subject><subject>Gynecology</subject><subject>Gynecology - methods</subject><subject>Hirsutism - etiology</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Menstruation Disturbances - etiology</subject><subject>Metformin - therapeutic use</subject><subject>Obstetrics and Gynecology</subject><subject>Pediatrics</subject><subject>Pediatrics - methods</subject><subject>Polycystic ovary syndrome</subject><subject>Polycystic Ovary Syndrome - complications</subject><subject>Polycystic Ovary Syndrome - diagnosis</subject><subject>Polycystic Ovary Syndrome - drug therapy</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Retrospective Studies</subject><subject>Specialization</subject><subject>Therapeutics</subject><subject>Young Adult</subject><issn>1083-3188</issn><issn>1873-4332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kVFr1jAUhosobk7_gBeSS29aT5q0zUCEMZ0OBht8Ey9DmpzMdP2SmrSD_vulfNOLXZibkwPv-3LOc4riPYWKAm0_DdUwqbuqBsorYBVA_aI4pqJjJWesfpn_IFjJqBBHxZuUBgDomla8Lo7qJj8GcFystxG9ScR5spuVNyoa8ivE-2UiNxhtiHs0pF9zY5yao9Nkt_RpQu3U6NKcSJaQ-TeSr07d-ZBcIsGSMxNGTBr9TG7CuOo1zdl5_aDiSnarNzHs8W3xyqox4bunelL8vPh2e_6jvLr-fnl-dlVqTulccg1wyjXrRdfYru3a2mqlBBd5A4N9h71V2iranzZGKdWJtqk1cuy0EbwDy06Kj4fcKYY_C6ZZ7l0ebRyVx7AkSVtetyAymyytD1IdQ0oRrZyi2-ehJQW5IZeD3JDLDbkEJjPybPrwlL_0GdY_y1_GWfD5IMC85YPDKJN26HUmGlHP0gT3__wvz-x6dN5pNd7jimkIS_SZn6Qy1RLkbjv6dnPKISdywR4BKKapmQ</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Powers, Sarah E., BA</creator><creator>Uliassi, Nicole W., MD</creator><creator>Sullivan, Shannon D., MD, PhD</creator><creator>Tuchman, Lisa K., MD, MPH</creator><creator>Mehra, Rinku, MD</creator><creator>Gomez-Lobo, Veronica, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>Trends in Standard Workup Performed by Pediatric Subspecialists for the Diagnosis of Adolescent Polycystic Ovary Syndrome</title><author>Powers, Sarah E., BA ; Uliassi, Nicole W., MD ; Sullivan, Shannon D., MD, PhD ; Tuchman, Lisa K., MD, MPH ; Mehra, Rinku, MD ; Gomez-Lobo, Veronica, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-4c0094c3b875f76762fcaa848555deb7ebfacfa1b95daaa78652ce4e7cd8470f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adolescent medicine</topic><topic>Adolescent Medicine - methods</topic><topic>Adolescents</topic><topic>Androgens - secretion</topic><topic>Child</topic><topic>Contraceptives, Oral - therapeutic use</topic><topic>Diagnosis</topic><topic>Endocrinology</topic><topic>Endocrinology - methods</topic><topic>Female</topic><topic>Gynecology</topic><topic>Gynecology - methods</topic><topic>Hirsutism - etiology</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Menstruation Disturbances - etiology</topic><topic>Metformin - therapeutic use</topic><topic>Obstetrics and Gynecology</topic><topic>Pediatrics</topic><topic>Pediatrics - methods</topic><topic>Polycystic ovary syndrome</topic><topic>Polycystic Ovary Syndrome - complications</topic><topic>Polycystic Ovary Syndrome - diagnosis</topic><topic>Polycystic Ovary Syndrome - drug therapy</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Retrospective Studies</topic><topic>Specialization</topic><topic>Therapeutics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Powers, Sarah E., BA</creatorcontrib><creatorcontrib>Uliassi, Nicole W., MD</creatorcontrib><creatorcontrib>Sullivan, Shannon D., MD, PhD</creatorcontrib><creatorcontrib>Tuchman, Lisa K., MD, MPH</creatorcontrib><creatorcontrib>Mehra, Rinku, MD</creatorcontrib><creatorcontrib>Gomez-Lobo, Veronica, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric & adolescent gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Powers, Sarah E., BA</au><au>Uliassi, Nicole W., MD</au><au>Sullivan, Shannon D., MD, PhD</au><au>Tuchman, Lisa K., MD, MPH</au><au>Mehra, Rinku, MD</au><au>Gomez-Lobo, Veronica, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in Standard Workup Performed by Pediatric Subspecialists for the Diagnosis of Adolescent Polycystic Ovary Syndrome</atitle><jtitle>Journal of pediatric & adolescent gynecology</jtitle><addtitle>J Pediatr Adolesc Gynecol</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>28</volume><issue>1</issue><spage>43</spage><epage>46</epage><pages>43-46</pages><issn>1083-3188</issn><eissn>1873-4332</eissn><abstract>Abstract Objective The purpose of this study is to identify trends in the clinical workup, diagnosis, and treatment of polycystic ovary syndrome by pediatric endocrinologists, pediatric gynecologists, and adolescent medicine specialists. Design Retrospective chart review. Setting Tertiary care medical center. Participants Females aged 11-18 y who were evaluated for PCOS from June 2009 to October 2011 were included. Any patients with coexisting diagnoses of other primary etiology for amenorrhea were excluded. Patients were identified by ICD-9 codes for PCOS, hypersecretion of ovarian androgens, irregular menses, hirsutism, oligomenorrhea, or amenorrhea. 261 patients were included: 144 from endocrinology, 9 from gynecology, and 108 from adolescent pediatric practices. Results There were no significant differences in the androgen labs ordered by the subspecialties. Gynecologists ordered pelvic ultrasonography for 89% (n = 8) of patients, compared to 9% (n = 10) by adolescent medicine specialists and 24% (n = 34) by endocrinologists ( P < .0001). Endocrinologists were most likely to treat patients who met diagnostic criteria for PCOS with metformin (58%, n = 66), compared to gynecologists (14%, n = 1) and adolescent medicine specialists (5%, n = 3) ( P < .0001). Gynecologists (43%, n = 3) and adolescent medicine specialists (58%, n = 39) were more likely than endocrinologists (24%, n = 27) to treat patients with oral contraceptive pills ( P < .0001). Conclusions Inconsistent diagnosis and treatment strategies for young women with PCOS are evident among pediatric subspecialties, reflecting lack of standardized care for adolescents. Quantifying outcomes based on diagnostic and therapeutic approaches are important next steps.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25555300</pmid><doi>10.1016/j.jpag.2014.03.002</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adolescent medicine Adolescent Medicine - methods Adolescents Androgens - secretion Child Contraceptives, Oral - therapeutic use Diagnosis Endocrinology Endocrinology - methods Female Gynecology Gynecology - methods Hirsutism - etiology Humans Hypoglycemic Agents - therapeutic use Menstruation Disturbances - etiology Metformin - therapeutic use Obstetrics and Gynecology Pediatrics Pediatrics - methods Polycystic ovary syndrome Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - diagnosis Polycystic Ovary Syndrome - drug therapy Practice Patterns, Physicians' - trends Retrospective Studies Specialization Therapeutics Young Adult |
| title | Trends in Standard Workup Performed by Pediatric Subspecialists for the Diagnosis of Adolescent Polycystic Ovary Syndrome |
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