The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index; none of the 99 sources its claims cite is checked for support yet.
The Diagnosis of Polycystic Ovary Syndrome during Adolescence
Open accessAbstract
Background/Aims: The diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescence are controversial, primarily because the diagnostic pathological features used in adult women may be normal pubertal physiological events. Hence, international pediatric and adolescent specialty societies have defined criteria that have sufficient evidence to be used for the diagnosis of PCOS in adolescents. Methods: The literature has been reviewed and evidence graded to address a series of questions regarding the diagnosis of PCOS during adolescence including the following: clinical and biochemical evidence of hyperandrogenism, criteria for oligo-anovulation and polycystic ovary morphology, diagnostic criteria to exclude other causes of hyperandrogenism and amenorrhea, role of insulin resistance, and intervention. Results and Conclusion: Features of PCOS overlap normal pubertal development. Hence, caution should be taken before diagnosing PCOS without longitudinal evaluation. However, treatment may be indicated even in the absence of a definitive diagnosis. While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls.
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53 Not checked yet · 18 Own interpretation · 6 No basis given · 2 Own method
In the paper
“The diagnostic criteria for PCOS in adolescence are controversial, primarily because the diagnostic pathological features used in adult women, e.g.acne, irregular menses, and PCOM, may be normal pubertal physiological events [18]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Introduction
What the sources say
- Not checked yetcites [18] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“With the exception of one published recommendation, none of the current definitions of PCOS in adolescent or adult women include insulin resistance/hyperinsulinemia as a diagnostic criterion [1, 10-12, 18, 19, 112]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“It is important to realize that about half of otherwise asymptomatic mild hirsutism is not associated with hyperandrogenemia [22,24]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, mild or focal hirsutism may be a sign of hyperandrogenemia in young women when associated with other evidence of PCOS, i.e., menstrual irregularity [29][30][31][32]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [29][30][31][32]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Insulin resistance and hyperinsulinemia are intrinsic to PCOS in adults and adolescents, lean or obese.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The severity of hirsutism does not correlate well with circulating androgen concentrations [26]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [26] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Hyperinsulinemia is believed to exacerbate the hyperandrogenism and the reproductive and metabolic manifestations of PCOS in adolescents.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“All adult PCOS criteria consider hirsutism as evidence of clinical hyperandrogenism.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [10][11][12]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Features of PCOS overlap normal pubertal development.”
- Also stated in: § Introduction · hedged
“the diagnostic pathological features used in adult women, e.g.acne, irregular menses, and PCOM, may be normal pubertal physiological events [18]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Abstract
What the sources say
- Not checked yetcites [18] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · hedged
In the paper
“hCG-stimulated testosterone concentration was increased in the presence of insulin resistance/hyperinsulinism [132]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [132] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The most frequent differential diagnosis is between PCOS and nonclassic forms of congenital adrenal hyperplasia (NCAH) because the phenotypic features are very similar [97,98]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 5: What Diagnostic Procedures Are Appropriate in Adolescents to Exclude Other Causes of Hyperandrogenism and Amenorrhea?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“AMH concentrations should not be used to characterize PCOM (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Available data are inconsistent regarding the usefulness of anti-Müllerian hormone in the diagnosis of polycystic ovary syndrome among adolescent girls.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, in healthy girls with regular menstrual cycles and without hyperandrogenism, PCOM does not indicate a diagnosis of PCOS (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, testosterone levels increase as adolescent anovulatory cycles lengthen in both asymptomatic and symptomatic anovulatory schoolgirls [55][56][57]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [55][56][57]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In another series, hyperandrogenemia detected in girls with menstrual disorders frequently persisted over a 2-to 7-year follow-up period [60]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [60] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“When molecular genetic testing is performed, mutations on both CYP21A2 alleles are usually identified found when the stimulated 17-OHP exceeds 1,500 ng/dl [107]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 5: What Diagnostic Procedures Are Appropriate in Adolescents to Exclude Other Causes of Hyperandrogenism and Amenorrhea?
What the sources say
- Not checked yetcites [107] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Follow-up of these oligomenorrheic girls from 15 to 18 years showed that the body mass index (BMI) predicted ongoing menstrual abnormality better than androgen levels [52]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [52] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These data, like earlier studies on variation in menstrual cycle length, indicate that complete maturation of the hypothalamic-pituitary-ovarian axis can take up to 5 years after menarche [64][65][66][67]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
What the sources say
- Not checked yetcites [64][65][66][67]
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Both Metcalf et al. [62] and Apter [63] reported that anovulatory cycles can persist until nearly 5 years after menarche.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“For those with NCAH, ACTH-stimulated 17-OHP values usually exceed 1,500-10,000 ng/dl [106]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 5: What Diagnostic Procedures Are Appropriate in Adolescents to Exclude Other Causes of Hyperandrogenism and Amenorrhea?
What the sources say
- Not checked yetcites [106] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In general, for an assay using an extraction step, total testosterone concentrations >55 ng/dl are likely consistent with hyperandrogenism [18]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [18] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Testosterone levels have long been known to rise during puberty to reach a peak approximating adult levels within a few years after menarche [51][52][53][54]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [51][52][53][54]
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Elevated anti-Müllerian hormone (AMH) levels have been a consistent hormonal finding associated with PCOM in healthy girls [90,91]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Fasting insulin and 24-hour insulin concentrations as well as stimulated insulin responses to intravenous glucose are elevated in adolescent girls at risk for PCOS even after adjusting for BMI [113]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [113] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“among nonobese Catalan adolescents with a history of premature pubarche, exaggerated adrenarche, and low birth weight, treatment with metformin or rosiglitazone, either prior to puberty or during adolescence, was reported to attenuate hyperandrogenism [138]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [138] source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The insulin resistance of PCOS is inherent to the syndrome and is over and above that conferred by obesity, since obese adolescents at risk for PCOS had a 50% lower in vivo peripheral insulin sensitivity when measured by the hyperinsulinemic-euglycemic clamp and compared with BMI-, body composition-, and visceral adiposity-matched obese peers [114]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [114] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“This insulin resistance is compensated by an increased insulin secretion [114]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [114] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Morning 17-OHP values >200 ng/dl appear to detect most adult women with NCAH [108,109]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 5: What Diagnostic Procedures Are Appropriate in Adolescents to Exclude Other Causes of Hyperandrogenism and Amenorrhea?
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Southam and Richart [71] demonstrated that approximately 50% of girls with persistent oligomenorrhea or abnormal uterine bleeding for 1 year remained oligomenorrheic during an 8-year follow-up period.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
What the sources say
- Not checked yetcites [71] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Abdominal ultrasound in adolescents, particularly obese girls, may yield inadequate information (Level C).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“Available data are inconsistent regarding the usefulness of AMH in the diagnosis of PCOS among adolescent girls [92][93][94][95][96]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
What the sources say
- Not checked yetcites [92][93][94][95][96]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Menstrual intervals persistently shorter than 20 days or greater than 45 days in individuals 2 or more years after menarche are evidence of oligo-anovulation (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Recommendations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Indeed, after 6 years of follow-up, 59% of the adolescents who had presented with oligomenorrhea at the beginning of the study remained oligomenorrheic and fulfilled the criteria for PCOS [70]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
What the sources say
- Not checked yetcites [70] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As such, consecutive menstrual intervals greater than 90 days are rare and require further investigation regardless of years after menarche (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The few reports that have evaluated the hormonal correlates of PCOM in healthy nonhirsute adolescents using transabdominal ultrasonography have found similar levels of androgens, insulin, and indexes of insulin sensitivity in girls with and without PCOM [80,82]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, most trials have been limited by their short duration (less than 6 months).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Lastly, intractable childhood obesity with insulin resistance/hyperinsulinemia is reported as a precursor of PCOS in some adolescents [9,[142][143][144][145]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [9,[142][143][144][145]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Intervention trials in adolescents with PCOS have shown benefits with respect to decreased androgen levels [89,[148][149][150][151]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
What the sources say
- Not checked yetcites [89,[148][149][150][151]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Other disorders associated with irregular menses or hyperandrogenism need to be excluded from diagnostic consideration (Level A).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Summary Recommendations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Fortunately, metaanalyses have shown that medications commonly used in the management of women and adolescents with PCOS have a low risk of severe adverse effects [160]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
What the sources say
- Not checked yetcites [160]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the other hand, overdiagnosis of PCOS can lead to unnecessary labeling and unwarranted interventions.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The overlap between normal pubertal development and characteristic features of PCOS may confound an accurate diagnosis of PCOS among adolescent girls (Level A).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Summary Recommendations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls (Level A).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Summary Recommendations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overdiagnosis can also lead to an overuse of treatments such as metformin and oral contraceptive pills.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Adequately powered, randomized, double blind, placebo-controlled trials are lacking.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“There has been a steady increase in prescribing metformin over the last 10 years particularly in obese adolescent girls between 16 and 18 years, despite metformin being 'off-label' or unlicensed in many countries for the treatment of PCOS or obesity [162,163]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
What the sources say
- Not checked yetcites [162]
- Not checked yetcites [163]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“PCOS is a common heterogeneous phenotype with features overlapping some features characteristic of normal pubertal development.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Summary
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Rapid postnatal catch-up growth and adiposity seem to increase the risk of excessive androgen secretion and precocious pubarche with a higher predilection to develop features suggestive of PCOS in adolescence [4,140,141]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 12
- It may state two separate claims as one. 21
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, insulin resistance and/ or hyperinsulinemia should not be used to diagnose PCOS among adolescent girls.”
- Also stated in: § Recommendations · plain
“Although prevalent among adolescents at risk for PCOS, insulin resistance and hyperinsulinemia should not be utilized as diagnostic criteria (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Introduction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Also stated in: § Recommendations · plain
None of the sources cited for this claim have been checked yet.
In the paper
“Upper lip scores of 3-4 were found in <3% of Black and White US adolescents, though scores of 1-2 rose in prevalence from 7.3% at <2 years after menarche to 28.2% at >2 years after menarche [40,41]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Even though hirsutism is common among women with hyperandrogenism, the latter can occur in the absence of cutaneous manifestations [2,3]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Biochemical evidence of hyperandrogenism, as indicated by persistent elevation of serum total and/or free testosterone levels and determined in a reliable reference laboratory, provides the clearest support for the presence of hyperandrogenism in an adolescent girl with symptoms of PCOS (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Recommendations
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“PCOM, variously defined, has been reported with a prevalence of 30-40% (range between 26 and 54%) and has been described in healthy girls [82]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Is the Prevalence of PCOM in Adolescents?
What the sources say
- Not checked yetcites [82] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“weight loss, treatment with metformin, or treatment with rosiglitazone were associated with improved insulin sensitivity and attenuation of hyperandrogenemia in some studies [133][134][135][136][137]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [133][134][135][136][137]
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Further, a multifollicular pattern, which is defined by the presence of large follicles distributed throughout the ovary, does not have a relationship with hyperandrogenism, is more common in adolescents, and should not be considered a pathological finding (Level C).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a population-based study from Australia of adolescents considered to have PCOS in which increased free testosterone concentration was the factor most predictive of insulin resistance, while menstrual irregularities and polycystic ovaries were not associated with insulin resistance [127]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 6: What Is the Role of Insulin Resistance/Hyperinsulinemia in the Diagnosis of PCOS in Adolescents?
What the sources say
- Not checked yetcites [127] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Menstrual irregularity is common among adolescents and is generally the result of anovulatory cycles.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although morning 17-OHP concentrations (>200 ng/dl) have been reported as being more common in women with CAH (87%), over 20% of women with PCOS had elevated morning 17-OHP values [110]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 5: What Diagnostic Procedures Are Appropriate in Adolescents to Exclude Other Causes of Hyperandrogenism and Amenorrhea?
What the sources say
- Not checked yetcites [110] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Regular cycles (21-45 days) are established by the third year after menarche in approximately 95% of girls, but cycles can remain irregular until the fifth year.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
What the sources say
- Not checked yetcites [64][65][66][67]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Accordingly, the persistence of oligomenorrhea (menstrual cycles longer than 45 days), secondary amenorrhea (absence of cycles for more than 3 months), or primary amenorrhea in girls with complete pubertal development and adult stature suggests the coexistence of androgen excess [71,78]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“While comedonal acne is common in adolescent girls, moderate or severe comedonal acne (i.e., 10 or more facial lesions) in early puberty or moderate inflammatory acne through the perimenarcheal years is uncommon (<5% prevalence) [42,43]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 1: What Are the Criteria for Clinical Evidence of Clinical Hyperandrogenism in the Adolescent Girl?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moderate to severe hirsutism constitutes clinical evidence of hyperandrogenism (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Recommendations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The reported prevalence for NCAH is 1 in 1,000 with an increased prevalence in specific ethnic groups [99]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 5: What Diagnostic Procedures Are Appropriate in Adolescents to Exclude Other Causes of Hyperandrogenism and Amenorrhea?
What the sources say
- Not checked yetcites [99] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Legro et al. [69] found that over 90% of adolescent females have 10 or more menstrual cycles per year (average menstrual interval 36.5 days) 3 years after menarche.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 3: What Are the Criteria for Evidence of Oligo-Anovulation in Adolescents?
What the sources say
- Not checked yetcites [69] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Follow-up of a different group of unselected healthy adolescents for 12 years showed tracking of androgen levels into adulthood; higher levels in adolescence were associated with lower fertility, suggesting evolving PCOS [59]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [59] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Follicle counts should not be utilized to define PCOM in adolescents (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No compelling criteria to define PCOM have been established for adolescents.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Rests on an assumption: No compelling criteria to define polycystic ovary morphology have been established for adolescents.
In the paper
“In a study of unselected schoolgirls with oligomenorrhea, 4% had hirsutism and 57% had elevated testosterone levels [58]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [58] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Until further research establishes definitive criteria, an ovarian volume >12.0 cm 3 (by formula for a prolate ellipsoid) can be considered en-”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Hormonal Findings Are Associated with Polycystic Ovaries?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lack of onset of menses by age 15 years or by more than 2-3 years after thelarche regardless of chronologic age is statistically uncommon and warrants evaluation and consideration of diagnoses such as PCOS (Level B).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Recommendations
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For these reasons, testosterone concentrations should be considered elevated when they are persistently greater than the adult female normative values according to assays performed by specialty laboratories with welldefined reference intervals.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A single androgen level >2 SD above the mean for the specific assay should not be considered to be evidence of hyperandrogenism in an otherwise asymptomatic adolescent girl (Level C).”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“Hence, PCOM is an inconsistent finding and does not invariably predict the development of PCOS [82]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > What Is the Prevalence of PCOM in Adolescents?
What the sources say
- Not checked yetcites [82] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Gambineri et al. [61] defined hyperandrogenism during the follicular phase as total testosterone concentrations >42 ng/dl using a LC-MS/MS assay.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 2: What Are the Criteria for Evidence of Biochemical Hyperandrogenism in the Adolescent Girl?
What the sources say
- Not checked yetcites [61] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“These trials have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance [148-160]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A diagnosis of PCOS can impact an adolescent's quality of life; this diagnosis can create early and unwarranted anxiety about future fertility for the young women and her family.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“PCOS is a common heterogeneous phenotype with features overlapping some features characteristic of normal pubertal development.”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Summary
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Longer duration trials (12 months or more) are very limited and are either open-labelled trials or lack placebocontrolled arms [133, 135, 161-163]”
§ The Diagnosis of Polycystic Ovary Syndrome during Adolescence > Question 7: Does a Diagnosis of PCOS during Adolescence Provide an Opportunity for Meaningful Intervention? What Are the Risks of Overdiagnosis?
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
No consensus exists on the clinical criteria for diagnosing androgen excess in adolescence.
“No consensus exists on the clinical criteria to reach the diagnosis of androgen excess in adolescence.”
The paper relies on this without support.
The definition of persistent oligomenorrhea is uncertain.
“However, the definition of 'persistent oligomenorrhea' is uncertain.”
The paper relies on this without support.
Detailed data are not available regarding the accuracy of predicting ongoing hyperandrogenic anovulation from a single elevated testosterone level.
“However, detailed data are not available regarding the accuracy of the prediction of ongoing hyperandrogenic anovulation from a single elevated testosterone level.”
The paper relies on this without support.
No data are available indicating how long hyperandrogenemia must continue to accurately predict persistence and development of polycystic ovary syndrome in adulthood.
“Further, no data are available indicating how long hyperandrogenemia must continue to accurately predict persistence and development of PCOS in adulthood.”
The paper relies on this without support.
No compelling criteria to define polycystic ovary morphology have been established for adolescents.
“No compelling criteria to define PCOM have been established for adolescents.”
The paper relies on this without support.
Available data are inconsistent regarding the usefulness of anti-Müllerian hormone in the diagnosis of polycystic ovary syndrome among adolescent girls.
“Available data are inconsistent regarding the usefulness of AMH in the diagnosis of PCOS among adolescent girls [92][93][94][95][96]”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Often each clinical symptom and comorbidity is treated separately, which can delay or obscure a diagnosis of PCOS and limit follow up care [3, 22, 23].”
From Challenges in diagnosis and health care in polycystic ovary syndrome in Canada: a patient view to improve health care (2023) · cites this paper as [23]
Experimental — accuracy not yet measuredIn the citing paper
“These similarities between normal pubertal development and the clinical features associated with PCOS confound the diagnosis in adolescent girls (Table 1) [125–127].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [127]
In the citing paper
“However, delineating appropriate diagnostic criteria for PCOS among adolescent girls has been problematic because irregular menses, cystic acne, mild hyperandrogenism, and multifollicular ovarian morphology occur during normal pubertal maturation.”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [127]
Citations
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Androgen Excess in Women: Experience with Over 1000 Consecutive Patients
Azziz, R., Sanchez, L. A., Knochenhauer, E. S., Moran, C., Lazenby, J., Stephens, K. C., Taylor, K., & Boots, L. R. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031122 · Cited by 1,132
Wild, R. A., Carmina, E., Diamanti-Kandarakis, E., Dokras, A., Escobar-Morreale, H. F., Futterweit, W., Lobo, R., Norman, R. J., Talbott, E., & Dumesic, D. A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2724 · Cited by 1,010
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Cited by
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Variations in the pattern of pubertal changes in boys
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Tanner, J. M., & Whitehouse, R. H. (1976) · Archives of Disease in Childhood · doi:10.1136/adc.51.3.170 · Cited by 3,137
Mechanisms of Insulin Action and Insulin Resistance
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Polycystic Ovary Syndrome: Definition, Aetiology, Diagnosis and Treatment
Escobar-Morreale, H. F. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2018.24 · Cited by 2,083
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Metadata
- Authors
- Witchel, S. F., Oberfield, S., Rosenfield, R. L., Codner, E., Bonny, A., Ibáñez, L., Pena, A., Horikawa, R., Gomez-Lobo, V., Joel, D., Tfayli, H., Arslanian, S., Dabadghao, P., Garcia Rudaz, C., & Lee, P. A.
- Affiliations
- Children's Hospital of Pittsburgh (US)
- Morgan Stanley Children's Hospital (US)
- University of Chicago (US)
- Nationwide Children's Hospital (US)
- Hospital Sant Joan de Déu Barcelona (ES)
- National Center For Child Health and Development (JP)
- Baylor College of Medicine (US)
- American University of Beirut Medical Center (LB)
- University of Pittsburgh (US)
- Sanjay Gandhi Post Graduate Institute of Medical Sciences (IN)
- Pennsylvania State University (US)
- ORCID
- Venue
- Hormone Research in Paediatrics
- Publisher
- S. Karger AG
- Published
- 2015
- Volume
- 83
- Issue
- 6
- Pages
- 376-389
- ISSN
- 1663-2818 (ISSN-L)
- 1663-2826
- OpenAlex
- W2053105417
- Cited by
- 3,113
- References
- 67
- Citations by year
- 2026: 17 · 2025: 119 · 2024: 197 · 2023: 328 · 2022: 357 · 2021: 237 · 2020: 231 · 2019: 276 · 2018: 244 · 2017: 223 · 2016: 206 · 2015: 187
- FWCI
- 43.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hormone Research in Paediatrics (publishedVersion)
- PubMed (publishedVersion)
- Universidad de Chile (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK040605)
- National Center for Research Resources (M01RR010732)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
- Keywords
- polycystic ovary syndrome, adolescents, diagnostic criteria, hyperandrogenism, oligoanovulation, polycystic ovary morphology, insulin resistance, hyperinsulinemia, obesity, amenorrhea, longitudinal assessment
- MeSH terms
- Adolescent, Female, Humans, Insulin Resistance, Polycystic Ovary Syndrome, Puberty, Hyperandrogenism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-05, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-05 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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