Multi-specialty Physician Preferences and Perceptions in Treatment and Management of Polycystic Ovary Syndrome in China: Survey and Discrete Choice Experiment.

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common gynecological endocrine diseases in reproductive-aged women. Given the multifaceted nature of PCOS and the involvement of multiple disciplines, the diagnosis and treatment of PCOS vary among different specialties. Our study aimed to elicit preferences of physicians from multidisciplinary specialties for PCOS treatment and their perceptions of PCOS management to enhance the understanding of clinical practice in China.

Methods: A discrete choice experiment (DCE) was conducted to elicit the physicians' preferences of PCOS treatment, and a cross-sectional survey was performed to understand the perceptions in management of PCOS. Physicians from three hospital specialties (general gynecology, gynecological endocrinology, and reproductive endocrinology) in China were included.

Results: Responses from a total of 123 physicians were eligible for the final analysis, with 41 from each specialty. In DCE, the physicians mainly preferred the anti-androgen effect, lower probability of irregular bleeding, and additional benefits when selecting treatment for PCOS, and the decision making was found to be highly dependent on the presence of clinical hyperandrogenism. Regarding diagnostic criteria, polycystic ovary morphology (PCOM) was the most frequently used (39.84%), followed by menstrual dysfunction (37.40%) and clinical hyperandrogenism (30.08%). Fertility and menstruation regulation were selected as the most important treatment goals for PCOS by physicians. Similar preferences across the three specialties were observed.

Conclusion: The decision making by physicians on PCOS treatment largely relies on the presence of clinical hyperandrogenism across all three specialties, indicating the significance of hyperandrogenism assessment in clinical practice, and the role of biochemical hyperandrogenism in PCOS treatment may require further elucidation in future clinical guidelines. Furthermore, the results emphasize the urgent need to bridge the gap between the clinical practice and guidance recommendations for the diagnosis and treatment of PCOS in China.