Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 11, 2019
Date Accepted: Jan 27, 2020
Internet Use in Polycystic Ovary Syndrome and its Implications for Medical Education: A Retrospective Analysis
ABSTRACT
Background:
Polycystic ovary syndrome (PCOS) is a common reproductive-metabolic disorder of women but scientific advances in understanding of the reproductive, metabolic and psychological abnormalities of PCOS can exceed the general knowledge of many clinicians. Women with PCOS are dissatisfied with health-care providers, the diagnostic process and the initial treatment of PCOS and seek information through alternative sources. Such patient dissatisfaction with health-care providers regarding PCOS raises questions regarding the responsibilities of academic institutions to adequately train and maintain competence of clinicians as well as of government agencies to sufficiently support scientific investigation in this field. Acquiring medical information through the internet has affected the patient-physician relationship by allowing information, whether correct or not, to become accessible to patients and reshape the perspective of their healthcare.
Objective:
To evaluate internet use researching PCOS, and to estimate reproductive endocrinology & infertility (REI) training in Ob/Gyn residency.
Methods:
Retrospective analysis. Monthly Google absolute search volumes (ASVs) for PCOS- and fibroid-related search terms, another common disorder, were quantified with Google search trends (Jan/2004-Dec/2017, USA) and search engine optimization (SEO) StoryBase®, Linear regression calculated monthly ASV trends. Unpaired student’s t-test compared PCOS and fibroid ASVs. An online questionnaire (June/2015-March/2018) explored PCOS women’s healthcare experiences and internet use. REI rotation information in the U.S. was obtained.
Results:
Monthly ASVs for PCOS (R=0.89, P<0.05), but not fibroids (R=0.09, P=0.25), increased significantly. PCOS-related ASVs (384,423 88,756 searches) were significantly greater than fibroid-related ASVs (348,502 37,317 searches, Mean ± SD; P<0.05). Of 759 questionnaire respondents, 60.9% had PCOS diagnosed by an Ob/Gyn. 57.3% were dissatisfied with overall care and 42% with PCOS explanation. 98.2% searched for PCOS online; 18.8% joined an online PCOS support group/forum. Ob/Gyn residencies dedicated only 4.2% of total block time to REI whereas 7.5% did not offer REI rotations.
Conclusions:
PCOS is increasingly searched online, over other highly-prevalent gynecological disease. Simultaneously, patients demonstrate dissatisfaction with PCOS-related healthcare which calls for improved REI education in residency.
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