Disparity among Endocrinologists and Gynaecologists in the Diagnosis of Polycystic Ovarian Syndrome

Abstract

Objectives: This study aimed to compare endocrinologists’ versus gynaecologists’ approaches in using the Rotterdam criteria to diagnose polycystic ovarian syndrome (PCOS). Methods: This cross-sectional study was conducted at Physiology Department, King Saud University, Riyadh, Saudi Arabia, between December 2017 and April 2018. A validated self-administered questionnaire in English was used to obtain information from endocrinologists and gynaecologists regarding their approaches to diagnosing PCOS. Each group’s diagnostic use of the Rotterdam criteria, association between years of experience and clinical decision-making, clinical features leading to diagnosis and considerations in the diagnosis of biochemical parameters that define hyperandrogenism were evaluated. Results: A total of 132 physicians were included in this study (response rate: 27%); 77 (58.3%) were endocrinologists and 55 (41.7%) were gynaecologists. Most of the respondents (79.5%) had ≤20 years of experience. A statistically significant difference was detected between the endocrinologists and gynaecologists (98.7% versus 81.8%; P = 0.001) in their consideration of hyperandrogenism in the diagnosis. The gynaecologists relied more on ovarian morphology than the endocrinologists did (76.4% versus 45.5%, P <0.0001). Physicians with more experience used ovarian ultrasonography more compared to those with less experience (P = 0.006). Conclusion: There was disparity in the diagnostic approaches of endocrinologists, who rely more on androgen levels for diagnosis of PCOS versus gynaecologists, who more frequently use an ovarian morphology assessment. Increased years of experience increased the rate of ultrasonography use for PCOS diagnosis in both groups.

Keywords: Polycystic Ovary Syndrome; Gynecology; Endocrinology; Diagnosis; Hyperandrogenism; Hirsutism; Healthcare Disparities; Saudi Arabia.