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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 465-471    DOI: 10.31083/j.ceog.2020.04.5240
Systematic Review Previous articles | Next articles
Clinical practice guidelines on polycystic ovary syndrome: a systematic review and comparative meta-analysis
J. Dun1, X. Wang2, J. Yang1, J. Xu1, *()
1Department of Traditional Chinese Medicine, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
2Department of Gynecology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, P.R. China
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Abstract  

Objective: This study used a systematic review to evaluate the clinical guidelines for polycystic ovary syndrome (PCOS) to guide clinical applications. Materials and Methods: PCOS guidelines were electronically retrieved from Medline, EMBASE, the Cochrane Library, CBM, CNKI, and VIP. The time span for the search extended until December 2016. Two researchers searched the literature according to the inclusion and exclusion criteria, and applied appraisal of guidelines research and evaluation II (AGREE II) to evaluate the quality of the guidelines. In the case of disagreement the results were discussed with experts in obstetrics and gynecology. Results: Sixteen clinical guidelines were included in this study. The study years ranged from 2004-2016. Average scores from five domains were 65.62%, 62.15%, 46.55%, 91.15%, and 41.01%. The data distribution in the sixth domain was abnormal. One guideline included “strongly recommended,” 13 guidelines included “revise and improve the recommendation,” and 2 guidelines included “not recommended.” Sixteen guidelines involved diagnoses of infertility, metabolic and cardiovascular diseases, health problems, and long-term complications. Conclusion: It has been suggested that an evidence-based medical approach be used to develop clinical guidelines. The quality of guidelines from China should help to develop and improve high-quality care and shorten the gap in the international development.

Key words:  Polycystic ovary syndrome      Guideline      Systematic review      AGREE II      Meta-analysis     
Submitted:  29 April 2019      Accepted:  22 July 2019      Published:  15 August 2020     
*Corresponding Author(s):  J. Xu     E-mail:  jinbangxu@yahoo.com

Cite this article: 

J. Dun, X. Wang, J. Yang, J. Xu. Clinical practice guidelines on polycystic ovary syndrome: a systematic review and comparative meta-analysis. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 465-471.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.5240     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/465

Figure 1.  — The flow chart of literature retrieval

Table 1  — The main characteristics of the included 16 guidelines.
Number Published
time
Organization Country or region No. of
authors
No. of
references
Pages
1 2004 Rotterdam ESHRE/ASRM-Sponsored PCOS
consensus workshop group [6]
Europe / U.S.A 33 95 7
2 2005 American Association of Clinical Endocrinologists (AACE) [7] U.S.A. 8 64 9
3 2006 The Androgen Excess and PCOS Society (AE-PCOS) [8] U.S.A. 11 97 9
4 2007 The Androgen Excess and PCOS Society (AE-PCOS)[9] U.S.A. 6 78 11
5 2007 The Chinese Medical Association Branch of Obstetrics and Gynecology [10] China 1 11 3
6 2008 European Society of Human Reproduction and Embryology/ American
Society for Reproductive Medicine (ESHRE/ ASRM) [11]
Europe / U.S.A 31 166 16
7 2009 The Androgen Excess and PCOS Society (AE-PCOS) [12] U.S.A. 11 303 33
8 2010 Society of Obstetricians and Gynaecologists of Canada (SOGC) [13] Canada 11 69 8
9 2010 The Androgen Excess and PCOS Society (AE-PCOS) [14] U.S.A. 10 139 12
10 2011 Polycystic Ovary Syndrome Association of Australia (POSAA) [15] Australia 111 331 126
11 2011 The Androgen Excess and PCOS Society (AE-PCOS) [16] U.S.A. 11 204 25
12 2012 European Society of Human Reproduction and Embryology/ American
Society for Reproductive Medicine (ESHRE/ ASRM) [17]
Europe / U.S.A 14 301 11
13 2013 The Endocrine Society (TES) [18] U.S.A. 7 296 29
14 2014 Royal College of Obstetricians and Gynaecologists (RCOG) [19] United Kingdom 19 94 15
15 2014 European Society of Endocrinology (ESE) [20] Europe 11 285 29
16 2016 Reproductive Endocrinology Group, Chinese Maternal&Child
Health Industry Association, National Association of Health Industry&Enterprise Management [21]
China 13 14 4
Table 2  — Scores of 16 guidelines in six domains.
Number Scope and purpose Stakeholder involvement Rigor of development Clarity and presentation Applicability Editorial independence
1 47.22 66.67 37.50 100 62.50 0
2 47.22 63.89 23.96 91.67 33.33 0
3 77.78 58.33 59.37 91.67 29.17 0
4 77.78 58.33 58.33 100 29.17 0
5 38.89 27.78 21.87 80.56 20.83 0
6 44.44 66.67 32.29 91.67 47.92 0
7 77.78 66.67 63.54 94.44 47.92 0
8 88.89 66.67 59.37 97.22 54.17 0
9 77.78 66.67 59.37 88.89 29.17 0
10 100 94.44 88.54 94.44 75.00 83.33
11 55.55 63.89 51.04 91.67 56.25 0
12 47.22 63.89 30.21 91.67 27.08 0
13 72.22 66.67 45.83 100 43.75 0
14 72.22 66.67 52.08 86.11 20.83 0
15 77.77 63.89 33.33 80.56 50.00 41.67
16 47.22 33.33 28.12 77.78 29.16 0
Total 65.62 ± 18.56 62.15 ± 14.69 46.55 ± 18.11 91.15 ± 6.97 41.01 ± 15.99 0 (0,83.33)
Table 3  — Numbers of score ≥ 60%, ≤ 30%, and overall assessments.
Number score ≥ 60%
Numbers of domain
score≤ 30%
Numbers of domain
Overall assessments
1 3 1 Recommend with modification
2 2 2 Recommend with modification
3 2 2 Recommend with modification
4 2 2 Recommend with modification
5 1 4 Not recommend
6 2 1 Recommend with modification
7 4 1 Recommend with modification
8 3 1 Recommend with modification
9 3 2 Recommend with modification
10 6 0 Strongly recommend
11 2 1 Recommend with modification
12 2 2 Recommend with modification
13 3 1 Recommend with modification
14 3 2 Recommend with modification
15 3 0 Recommend with modification
16 1 3 Not recommend
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