ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P329 | DOI: 10.1530/endoabs.63.P329

Randomised Controlled Trials in women with polycystic ovary syndrome do not represent the majority of patients who are in a primary care setting: systematic review and meta-analysis

Alexandros Leonidas Liarakos1,2, Miles Levy3 & Hamidreza Mani2


1Cumberland Infirmary, North Cumbria University Hospitals NHS Trust, Carlisle, UK; 2Diabetes and Endocrinology Department, Kettering General Hospital, Kettering, UK; 3Endocrinology Department, University Hospitals of Leicester, Leicester, UK.


Introduction: Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with important long term health consequences such as higher chance of developing Type 2 diabetes, reduced overall wellbeing with poor quality of life. Such a common condition is mainly treated and investigated in the primary care setting.We therefore set out to see if the randomized controlled trials (RCT) represent the most common setting of care.

Materials and Methods: We searched one major search engine (Pubmed) for ‘Polycystic Ovary Syndrome’ and extracted all the RCTs between 01/01/2010 and 31/12/2018. Only English language publications were included. Data on the source of recruitment and dropout rate from studies were extracted where available.

Results: Search yielded a total of 7380 abstracts on PCOS of which 287 RCTs met the criteria including 29460 women with PCOS. The most common source for recruitment was specialized departments and outpatient clinics (n=25317; 85.9%). Only 4.4% (n=1297) had been recruited from primary care and community advertisements or sites. Sources of recruitment were not clear in 9.7% (n=2846). The average dropout was 13.35% (27.69% for primary care and community advertisements or sites, and 12.61% for specialized departments and outpatient clinics).

Conclusion: The main pool of women with PCOS are in primary care and only a selected group are referred to specialist clinics. However, RCTs which inform the treatment guidelines have mainly recruited their patients from this selected group of patients in the secondary care setting. We suggest that clinical trials are needed in the primary care setting in order to better understanding the care for these patients in this more common clinical setting.

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