Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome

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Fältnamn	Indikatorer	Metadata
000		11209naa a2201513 4500
001		oai:gup.ub.gu.se/330064
003		SwePub
008		240528s2023 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:153397271
024	7	a https://gup.ub.gu.se/publication/3300642 URI
024	7	a https://doi.org/10.1093/ejendo/lvad0962 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1533972712 URI
040		a (SwePub)gud (SwePub)ki
041		a eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Teede, Helena J.4 aut
245	1 0	a Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome
264	1	c 2023
520		a Study question: What is the recommended assessment and management of those with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? Summary answer: International evidence-based guidelines address prioritized questions and outcomes and include 254 recommendations and practice points, to promote consistent, evidence-based care and improve the experience and health outcomes in PCOS. What is known already: The 2018 International PCOS Guideline was independently evaluated as high quality and integrated multidisciplinary and consumer perspectives from 6 continents; it is now used in 196 countries and is widely cited. It was based on best available, but generally very low-to low-quality, evidence. It applied robust methodological processes and addressed shared priorities. The guideline transitioned from consensus-based to evidence-based diagnostic criteria and enhanced accuracy of diagnosis, whilst promoting consistency of care. However, diagnosis is still delayed, the needs of those with PCOS are not being adequately met, the evidence quality was low, and evidence-practice gaps persist. Study design, size, and duration: The 2023 International Evidence-based Guideline update re-engaged the 2018 network across professional societies and consumer organizations with multidisciplinary experts and women with PCOS directly involved at all stages. Extensive evidence synthesis was completed. Appraisal of Guidelines for Research and Evaluation II (AGREEII)-compliant processes were followed. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied across evidence quality, feasibility, acceptability, cost, implementation, and ultimately recommendation strength, and diversity and inclusion were considered throughout. Participants/materials, setting, and methods: This summary should be read in conjunction with the full guideline for detailed participants and methods. Governance included a 6-continent international advisory and management committee, 5 guideline development groups, and paediatric, consumer, and translation committees. Extensive consumer engagement and guideline experts informed the update scope and priorities. Engaged international society-nominated panels included paediatrics, endocrinology, gynaecology, primary care, reproductive endocrinology, obstetrics, psychiatry, psychology, dietetics, exercise physiology, obesity care, public health, and other experts, alongside consumers, project management, evidence synthesis, statisticians, and translation experts. Thirty-nine professional and consumer organizations covering 71 countries engaged in the process. Twenty meetings and 5 face-to-face forums over 12 months addressed 58 prioritized clinical questions involving 52 systematic and 3 narrative reviews. Evidence-based recommendations were developed and approved via consensus across 5 guideline panels, modified based on international feedback and peer review, independently reviewed for methodological rigour, and approved by the Australian Government National Health and Medical Research Council. Main results and the role of chance: The evidence in the assessment and management of PCOS has generally improved in the past 5 years but remains of low to moderate quality. The technical evidence report and analyses (∼6000 pages) underpin 77 evidence-based and 54 consensus recommendations, with 123 practice points. Key updates include the following: (1) further refinement of individual diagnostic criteria, a simplified diagnostic algorithm, and inclusion of anti-Müllerian hormone levels as an alternative to ultrasound in adults only; (2) strengthening recognition of broader features of PCOS including metabolic risk factors, cardiovascular disease, sleep apnoea, very high prevalence of psychological features, and high risk status for adverse outcomes during pregnancy; (3) emphasizing the poorly recognized, diverse burden of disease and the need for greater healthcare professional education, evidence-based patient information, improved models of care, and shared decision-making to improve patient experience, alongside greater research; (4) maintained emphasis on healthy lifestyle, emotional well-being, and quality of life, with awareness and consideration of weight stigma; and (5) emphasizing evidence-based medical therapy and cheaper and safer fertility management. Limitations and reasons for caution: Overall, recommendations are strengthened and evidence is improved but remains generally low to moderate quality. Significantly greater research is now needed in this neglected, yet common condition. Regional health system variation was considered and acknowledged, with a further process for guideline and translation resource adaptation provided. Wider implications of the findings: The 2023 International Guideline for the Assessment and Management of PCOS provides clinicians and patients with clear advice on best practice, based on the best available evidence, expert multidisciplinary input, and consumer preferences. Research recommendations have been generated, and a comprehensive multifaceted dissemination and translation programme supports the guideline with an integrated evaluation programme.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Allmänmedicin0 (SwePub)302242 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex General Practice0 (SwePub)302242 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Klinisk laboratoriemedicin0 (SwePub)302232 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Clinical Laboratory Medicine0 (SwePub)302232 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Endokrinologi och diabetes0 (SwePub)302052 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Endocrinology and Diabetes0 (SwePub)302052 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reproduktionsmedicin och gynekologi0 (SwePub)302202 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Obstetrics, Gynaecology and Reproductive Medicine0 (SwePub)302202 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Psykiatri0 (SwePub)302152 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Psychiatry0 (SwePub)302152 hsv//eng
653		a assessment
653		a evidence based
653		a GRADE
653		a guideline
653		a management
653		a polycystic ovary syndrome
700	1	a Tay, Chau Thien4 aut
700	1	a Laven, Joop J.E.4 aut
700	1	a Dokras, Anuja4 aut
700	1	a Moran, Lisa J.4 aut
700	1	a Piltonen, Terhi T.4 aut
700	1	a Costello, Michael F.4 aut
700	1	a Boivin, Jacky4 aut
700	1	a Redman, Leanne M.4 aut
700	1	a Boyle, Jacqueline A.4 aut
700	1	a Norman, Robert J.4 aut
700	1	a Mousa, Aya4 aut
700	1	a Joham, Anju E.4 aut
700	1	a Arlt, Wiebke4 aut
700	1	a Azziz, Ricardo4 aut
700	1	a Balen, Adam4 aut
700	1	a Bedson, Lisa4 aut
700	1	a Berry, Lorna4 aut
700	1	a Boivin, Jacky4 aut
700	1	a Boyle, Jacqueline4 aut
700	1	a Brennan, Leah4 aut
700	1	a Brown, Wendy4 aut
700	1	a Burgert, Tania4 aut
700	1	a Busby, Maureen4 aut
700	1	a Ee, Carolyn4 aut
700	1	a Garad, Rhonda M.4 aut
700	1	a Gibson-Helm, Melanie4 aut
700	1	a Harrison, Cheryce4 aut
700	1	a Hart, Roger4 aut
700	1	a Hopkins, Kim4 aut
700	1	a Hirschberg, Angelica Lindén4 aut
700	1	a Ho, Tuong4 aut
700	1	a Hoeger, Kathleen4 aut
700	1	a Jordan, Cailin4 aut
700	1	a Legro, Richard S.4 aut
700	1	a Li, Rong4 aut
700	1	a Lujan, Marla4 aut
700	1	a Ma, Ronald4 aut
700	1	a Mansfield, Darren4 aut
700	1	a Marsh, Kate4 aut
700	1	a Mocanu, Edgar4 aut
700	1	a Mol, Ben4 aut
700	1	a Mormon, Rachel4 aut
700	1	a Norman, Robert4 aut
700	1	a Oberfield, Sharon4 aut
700	1	a Patel, Malika4 aut
700	1	a Pattuwage, Loyal4 aut
700	1	a Peña, Alexia4 aut
700	1	a Redman, Leanne4 aut
700	1	a Rombauts, Luk4 aut
700	1	a Romualdi, Daniela4 aut
700	1	a Shah, Duru4 aut
700	1	a Spritzer, Poli Mara4 aut
700	1	a Stener-Victorin, Elisabet4 aut
700	1	a Tehrani, Fahimeh Ramezani4 aut
700	1	a Thangaratinam, Shakila4 aut
700	1	a Thondan, Mala4 aut
700	1	a Vanky, Eszter4 aut
700	1	a Wijeyaratne, Chandrika4 aut
700	1	a Witchel, Selma4 aut
700	1	a Yang, Dongzi4 aut
700	1	a Yildiz, Bulent4 aut
700	1	a Alesi, Simon4 aut
700	1	a Alur-Gupta, Snigdha4 aut
700	1	a Avery, Jodie4 aut
700	1	a Khomami, Mahnaz Bahri4 aut
700	1	a Benham, Jamie4 aut
700	1	a Bidstrup, Hugh4 aut
700	1	a Chua, Su Jen4 aut
700	1	a Cooney, Laura4 aut
700	1	a Coster, Thisara4 aut
700	1	a Fitz, Victoria4 aut
700	1	a Flanagan, Madeline4 aut
700	1	a Forslund, Maria,d 1978u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology4 aut0 (Swepub:gu)xforss
700	1	a Jiskoot, Geranne4 aut
700	1	a Kazemi, Maryam4 aut
700	1	a Kempegowda, Punith4 aut
700	1	a Louwers, Yvonne4 aut
700	1	a Melin, Johanna4 aut
700	1	a Melson, Eka4 aut
700	1	a Mengistu, Yitayeh Belsti4 aut
700	1	a Naderpoor, Negar4 aut
700	1	a Neven, Adriana4 aut
700	1	a Pastoor, Hester4 aut
700	1	a Rocha, Thais4 aut
700	1	a Sabag, Angelo4 aut
700	1	a Subramanian, Anuradhaa4 aut
700	1	a Tan, Katrina4 aut
710	2	a Göteborgs universitetb Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi4 org
773	0	t European Journal of Endocrinologyg 189q 189x 0804-4643x 1479-683X
856	4 8	u https://gup.ub.gu.se/publication/330064
856	4 8	u https://doi.org/10.1093/ejendo/lvad096
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:153397271

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Av författaren/redakt...: Teede, Helena J.; Tay, Chau Thien; Laven, Joop J.E.; Dokras, Anuja; Moran, Lisa J.; Piltonen, Terhi ...; visa fler...; Costello, Michae ...; Boivin, Jacky; Redman, Leanne M ...; Boyle, Jacquelin ...; Norman, Robert J ...; Mousa, Aya; Joham, Anju E.; Arlt, Wiebke; Azziz, Ricardo; Balen, Adam; Bedson, Lisa; Berry, Lorna; Boyle, Jacquelin ...; Brennan, Leah; Brown, Wendy; Burgert, Tania; Busby, Maureen; Ee, Carolyn; Garad, Rhonda M.; Gibson-Helm, Mel ...; Harrison, Cheryc ...; Hart, Roger; Hopkins, Kim; Hirschberg, Ange ...; Ho, Tuong; Hoeger, Kathleen; Jordan, Cailin; Legro, Richard S ...; Li, Rong; Lujan, Marla; Ma, Ronald; Mansfield, Darre ...; Marsh, Kate; Mocanu, Edgar; Mol, Ben; Mormon, Rachel; Norman, Robert; Oberfield, Sharo ...; Patel, Malika; Pattuwage, Loyal; Peña, Alexia; Redman, Leanne; Rombauts, Luk; Romualdi, Daniel ...; Shah, Duru; Spritzer, Poli M ...; Stener-Victorin, ...; Tehrani, Fahimeh ...; Thangaratinam, S ...; Thondan, Mala; Vanky, Eszter; Wijeyaratne, Cha ...; Witchel, Selma; Yang, Dongzi; Yildiz, Bulent; Alesi, Simon; Alur-Gupta, Snig ...; Avery, Jodie; Khomami, Mahnaz ...; Benham, Jamie; Bidstrup, Hugh; Chua, Su Jen; Cooney, Laura; Coster, Thisara; Fitz, Victoria; Flanagan, Madeli ...; Forslund, Maria, ...; Jiskoot, Geranne; Kazemi, Maryam; Kempegowda, Puni ...; Louwers, Yvonne; Melin, Johanna; Melson, Eka; Mengistu, Yitaye ...; Naderpoor, Negar; Neven, Adriana; Pastoor, Hester; Rocha, Thais; Sabag, Angelo; Subramanian, Anu ...; Tan, Katrina; visa färre...

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