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Trends in standard workup performed by pediatric subspecialists for the diagnosis of adolescent polycystic ovary syndrome.

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Citation: Journal of Pediatric & Adolescent Gynecology. 28(1):43-6, 2015 Feb.PMID: 25555300Institution: MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: Medicine/Endocrinology | Obstetrics and Gynecology/Pediatric and AdolescentForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Adolescent Medicine/mt [Methods] | *Endocrinology/mt [Methods] | *Gynecology/mt [Methods] | *Pediatrics/mt [Methods] | *Polycystic Ovary Syndrome/di [Diagnosis] | *Practice Patterns, Physicians'/td [Trends] | Adolescent | Androgens/se [Secretion] | Child | Contraceptives, Oral/tu [Therapeutic Use] | Female | Hirsutism/et [Etiology] | Humans | Hypoglycemic Agents/tu [Therapeutic Use] | Menstruation Disturbances/et [Etiology] | Metformin/tu [Therapeutic Use] | Polycystic Ovary Syndrome/co [Complications] | Polycystic Ovary Syndrome/dt [Drug Therapy] | Retrospective Studies | Young AdultYear: 2015 Local holdings: Available online through MWHC library: 2002 - presentISSN:

1083-3188

Name of journal: Journal of pediatric and adolescent gynecologyAbstract: 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.Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.DESIGN: Retrospective chart review.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.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).SETTING: Tertiary care medical center.All authors: Gomez-Lobo V, Mehra R, Powers SE, Sullivan SD, Tuchman LK, Uliassi NWFiscal year: FY2015Digital Object Identifier:

http://dx.doi.org/10.1016/j.jpag.2014.03.002

Date added to catalog: 2016-05-24

Holdings ( 1 )
Title notes ( 8 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	25555300	Available		25555300

Available online through MWHC library: 2002 - present

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.Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

DESIGN: Retrospective chart review.

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.

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).

SETTING: Tertiary care medical center.

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