Summary of the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome: an Australian perspective

IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Journal of Australia Pub Date : 2024-09-02 DOI:10.5694/mja2.52432
Helena J Teede, Aya Mousa, Chau T Tay, Michael F Costello, Leah Brennan, Robert J Norman, Alexia S Pena, Jacqueline A Boyle, Anju Joham, Lorna Berry, Lisa Moran
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Abstract

Introduction

The Australian-led 2023 International evidence-based guideline for the assessment and management of polycystic ovary syndrome was based on best available evidence, clinical expertise and consumer preference. It followed best practice, involved extensive evidence synthesis and applied relevant frameworks across evidence quality, feasibility, acceptability, cost and implementation. Thirty-nine societies and organisations covering 71 countries were engaged. The evidence in the assessment and management of polycystic ovary syndrome (PCOS) has generally improved in the past five years, but remains of low to moderate quality. The technical evidence report, 52 systematic reviews and analyses (approximately 6000 pages) underpin 77 evidence-based and 54 consensus recommendations, with 123 practice points.

Main recommendations

Changes include:
  • refinement of individual diagnostic criteria, a simplified diagnostic algorithm and inclusion of anti-Müllerian hormone levels as an alternative to ultrasound in adults only, and differentiation of adolescent and adult criteria;
  • strengthening the recognition of broad features of PCOS including metabolic effects, cardiovascular disease, dermatological symptoms, sleep apnoea, a high prevalence of psychological features and a high risk of adverse pregnancy outcomes;
  • emphasising the poorly recognised, diverse burden of disease, the vital need for greater health professional education, evidence-based patient information, improved models of care, shared decision making and research efforts to improve patient experience;
  • maintained emphasis on healthy lifestyle, emotional wellbeing and quality of life, with awareness and consideration of weight stigma; and
  • emphasising evidence-based medical therapy and cheaper and safer fertility management.

Changes in management as a result of this guideline

The 2023 guideline is approved by the National Health and Medical Research Council and provides clinicians and patients with clear advice on best practice in a common and neglected condition, based on the best available evidence, expert multidisciplinary input and consumer preferences. It provides vital, extensive patient and provider resources to enhance evidence-based care.

The full guideline is available at www.monash.edu/medicine/mchri/pcos/guideline.

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2023 年多囊卵巢综合征评估与管理国际循证指南摘要:澳大利亚视角。
导言:由澳大利亚牵头制定的《2023 多囊卵巢综合症评估与管理国际循证指南》以现有最佳证据、临床专业知识和消费者偏好为基础。该指南遵循最佳实践,进行了广泛的证据综合,并在证据质量、可行性、可接受性、成本和实施方面应用了相关框架。覆盖 71 个国家的 39 个学会和组织参与了这项工作。在过去五年中,多囊卵巢综合症(PCOS)评估和管理方面的证据总体上有所改善,但质量仍处于中下水平。技术证据报告、52 项系统回顾和分析(约 6000 页)支持 77 项循证建议和 54 项共识建议,以及 123 项实践要点:变化包括完善单个诊断标准,简化诊断算法,将抗缪勒氏管激素水平作为成人超声检查的替代方法,并区分青少年和成人标准;加强对 PCOS 广泛特征的认识,包括代谢影响、心血管疾病、皮肤病症状、睡眠呼吸暂停、高发的心理特征和不良妊娠结局的高风险;强调对疾病的认识不足、疾病负担多样化、亟需加强卫生专业人员教育、循证患者信息、改进护理模式、共同决策和研究工作,以改善患者体验;继续强调健康的生活方式、情感福祉和生活质量,认识并考虑体重耻辱感;强调循证医学治疗以及更便宜、更安全的生育管理。本指南带来的管理变化:2023 年指南由国家健康与医学研究委员会批准,根据现有最佳证据、多学科专家意见和消费者偏好,为临床医生和患者提供了有关这一常见且被忽视疾病的最佳实践的明确建议。该指南提供了大量重要的患者和医疗服务提供者资源,以加强循证护理。指南全文见 www.monash.edu/medicine/mchri/pcos/guideline。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medical Journal of Australia
Medical Journal of Australia 医学-医学:内科
CiteScore
9.40
自引率
5.30%
发文量
410
审稿时长
3-8 weeks
期刊介绍: The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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