Research is Not Just for Lab Rats!

I wanted to provide you with a brief introduction/update on my research. The title of research project is “The Current Description and Future Implications of Comprehensive Multidisciplinary PCOS Clinics.” 

What is PCOS?

PCOS stands for Polycystic Ovary Syndrome. PCOS occurs in about 5-10% of women of childbearing age. Currently, there is no cure for PCOS, but the symptoms can usually be managed.

Common symptoms of PCOS include:

  • Irregular periods
  • Weight gain/obesity
  • Excess hair
  • Acne,
  • Hair thinning or balding
  • Ovarian cysts
  • Depression/anxiety
  • Fatigue

These symptoms are thought to stem from the underlying issues of high androgen levels, insulin resistance, and the presence of the ovarian cysts.

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It is important to know that individuals with PCOS are at an increased risk for:

  • Infertility
  • Miscarriages
  • Sleep apnea
  • Diabetes
  • Obesity
  • Endometrial cancer
  • High blood pressure
  • High cholesterol
  • Cardiovascular disease
  • Stroke
  • Hypothyroidism

 Treatment will vary depending on the symptoms presented and the goals of the individual.

 Common treatment options for PCOS include:

  • Regular exercise
  • Healthy diet
  • Smoking cessation
  • Weight loss (if necessary)
  • Medications:
    • Birth control – can normalize hormone levels
    • Spironolactone – can lower blood pressure and reduce androgen levels
    • Metformin – can increase insulin sensitivity

Research Objectives

Objective 1 – To assess the prevalence of PCOS according to geographical location, race/ethnicity, and health disparity

Objective 2 – To describe the current and future description of multidisciplinary PCOS clinics

Literature Reviews

Between August and November I began locating research articles and identifying multidisciplinary PCOS clinics that currently exist. Once I had located all the research articles and clinics that I could, I moved on to researching the prevalence.

By December, I had exhausted the literature on PCOS prevalence (objective 1) and drafted up my literature review. My lit review is currently going through revisions and then will be submitted for publication. To make a long story short, the prevalence of PCOS is widely unknown due to three main factors: inconsistent diagnostic criteria, high prevalence of individuals who are undiagnosed, and the lack of large-scale studies. The prevalence of PCOS ranges from 1% to 23% depending on the location, sample, diagnostic criteria, and methods.

Around winter break I fully shifted my focus on to researching objective 2. I picked back up the literature I had identified and began writing my comprehensive literature review. Shortly after beginning, I realized my research question could not be answered without an investigative approach leading me to adapt my previous “problem statement” into a full thesis. In order to fully answer this question I needed input from key practitioners who interact with PCOS patients on a regular basis. These individuals may include dietitians, endocrinologist, gynecologists, dermatologist, other physicians, fertility specialists, social workers, exercise physiologists and many others. Because PCOS is such a multifaceted syndrome, it will be best treated by a multidisciplinary team.

Proposal

Back in February, I did my proposal with my committee members to introduce my research design. My committee consists of Dr. Olfert, DrPH, MS, RD, LD, who is my advisor, Dr. Murray, MD, MPH, who works as a physician in adolescent medicine, and Dr. Clemmer, PhD who works at the Center for Reproductive Medicine in the IVF lab and is a specialist in reproductive physiology. This gave me the approval that I needed to continue on with my project.

Recruitment

After flushing out my research design and making the decision to do a survey it was time for recruitment. For the past month I have been working to identify a sample of about 200 informants to ensure that I get back at least 50-75 responses. My committee members were gracious enough to post a request on multiple listservs for the associations that they belong to that would target people working with PCOS. From that I received about 50 email responses with the names and contact information of individuals who were interested in participating. In order to boost my sample size I began researching the literature I have previously identified for contact names and did a “snowball” approach for names from there by searching existing clinics, faculty members, and LinkedIn groups. Currently, I have identified about 150!

Survey Development

Developing a survey that needs to gather an immense amount of information but must be able to be completed on a physician’s schedule (i.e. 15 minutes MAX) is no easy task. Originally, I had planned to look at clinics only in the United States until recently because I have gotten a large number of responses from individuals from Canada, Australia, India, and even Israel.  As of now, I am not limiting my involvement because I think they could have very valuable feedback. I am currently in the revisions stage for my survey and I plan to send it out within the next two weeks.

Data Analysis

Once I receive the completed surveys back it will be time to run the statistics. Most of my data will be qualitative with the exceptions of basic descriptive statistics and the possibility of a few t-test depending on the results. All my statistics will be ran using SAS. I plan to spend the month May on this section.

Thesis Write-Up

Once all my data is analyzed it will be time to officially start drafting. The plan is to start the write-up before I start my rotations in June and finish by April of 2015.

Dissemination

Currently, the plan is to submit a poster presentation with the results of my study to the North American Society of Pediatrics and Gynecology (NASPAG) Annual Conference, which takes place in Philadelphia, PA during the end of April. I will also be submitting multiple papers for publication to journals and then defending in April.

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