Michael Costello|Marie Misso|Adam Balen|J Boyle|Luigi Devoto|Rhonda Garad|Roger Hart|Louise Johnson|Cailin Jordan|Richard S. Legro|Robert J. Norman|Edgar Mocanu|Jie Qiao|Raymond J. Rodgers|Luk Rombauts|Eliza C. Tassone|Shakila Thangaratinam|Eszter Vanky|Helena Teede
Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility
UNSW Sydney|Monash University|Leeds Teaching Hospitals NHS Trust|Monash University|University of Chile|National Health and Medical Research Council|Monash University|University of Western Australia|Victorian Aboriginal Health Service|Victorian Aboriginal Health Service|Pennsylvania State University|University of Adelaide|National Health and Medical Research Council|Monash University|Rotunda Hospital|Peking University|Peking University Third Hospital|University of Adelaide|Monash University|Monash University|Queen Mary University of London|Norwegian University of Science and Technology|Monash University|National Health and Medical Research Council
abstract study question recommended assessment management infertile women polycystic ovary syndrome pcos based best available evidence clinical expertize consumer preference summary answer international evidencebased guidelines including 44 recommendations practice points addressed prioritized questions promote consistent evidencebased care improve experience health outcomes infertile women pcos known already previous guidelines pcos lacked rigorous evidencebased processes failed engage consumer multidisciplinary perspectives outdated assessment management infertile women pcos inconsistent needs women pcos adequately met evidence practice gaps persist participantsmaterials setting methods governance included six continent international advisory project board multidisciplinary international guideline development group gdg consumer translation committees extensive health professional consumer engagement informed guideline scope priorities engaged international societynominated panel included endocrinology gynaecology reproductive endocrinology obstetrics public health experts alongside consumers project management evidence synthesis translation experts thirtyseven societies organizations covering 71 countries engaged process extensive online communication two facetoface meetings 15 months addressed 19 prioritized clinical questions involving nine evidencebased reviews 10 narrative reviews evidencebased recommendations ebrs formulated prior consensus voting within guideline panel study design size duration international evidencebased guideline development engaged professional societies consumer organizations multidisciplinary experts women pcos directly involved stages agree iicompliant processes followed extensive evidence synthesis grading recommendations assessment development evaluation grade framework applied across evidence quality desirable undesirable consequences feasibility acceptability cost implementation ultimately recommendation strength guideline peerreviewed special interest groups across partner collaborating societies consumer organizations independently assessed agree ii criteria underwent methodological review guideline approved members gdg approved nhmrc main results role chance quality evidence qoe ebrs assessment management infertility pcos included low n 1 low n 9 moderate n 4 quality ebrs based highquality evidence guideline provides 14 ebrs 10 clinical consensus recommendations ccrs 20 clinical practice points assessment management infertility pcos key changes guideline include emphasizing evidencebased fertility therapy including cheaper safer fertility management limitations reasons caution overall evidence generally low moderate quality requiring significantly greater research neglected yet common condition regional health systems vary process adaptation guideline provided wider implications findings international guideline assessment management infertility pcos provides clinicians clear advice best practice based best available evidence expert multidisciplinary input consumer preferences research recommendations generated comprehensive multifaceted dissemination translation program supports guideline integrated evaluation program study fundingcompeting interests guideline primarily funded australian national health medical research council australia nhmrc supported partnership eshre american society reproductive medicine asrm gdg members receive payment travel expenses covered sponsoring organizations disclosures conflicts interest declared outset updated throughout guideline process aligned nhmrc guideline processes dr costello declared shares virtus health past sponsorship merck serono conference presentations prof norman declared minor shareholder interest ivf unit fertility sa travel support merck grants ferring prof norman also scientific advisory board duties ferring remaining authors conflicts interest declare article externally peerreviewed human reproduction open