A design thinking approach to primary ovarian insufficiency.
Most clinicians are not prepared to provide integrated personal care to address all the clinical needs of women with primary ovarian insufficiency. Design thinking is an engineering methodology used to develop and evaluate novel concepts for systems operation. Here we articulate the need for a seamlessly integrated mobile health system to support genomic research as well as patient care. We also review the pathophysiology and management of primary ovarian insufficiency. Molecular understanding regarding the pathogenesis is essential to developing strategies for prevention, earlier diagnosis, and appropriate management of the disorder. The syndrome is a chronic disorder characterized by oligo/amenorrhea and hypergonadotropic hypogonadism before age 40 years. There may be significant morbidity due to: 1) depression and anxiety related to the loss of reproductive hormones and infertility; 2) associated autoimmune adrenal insufficiency or hypothyroidism; and 3) reduced bone mineral density and increased risk of cardiovascular disease related to estrogen deficiency. Approximately 5% to 10% of women with primary ovarian insufficiency conceive and have a child. Women who develop primary ovarian insufficiency related to a premutation in FMR1 are at risk of having a child with fragile X syndrome, the most common cause of inherited intellectual disability. In most cases of spontaneous primary ovarian insufficiency no environmental exposure or genetic mechanism can be identified. As a rare disease, the diagnosis of primary ovarian insufficiency presents special challenges. Connecting patients and community health providers in real time with investigators who have the requisite knowledge and expertise would help solve this dilemma.
ConoverSystems, Ashburn, VA, USA.
Lisa A
LA
Martin
ConoverSystems, Ashburn, VA, USA.
Alison G
AG
Porter
Reading Health System, Reading, PA, USA.
Vincent A
VA
Pelligrini
Reading Health System, Reading, PA, USA.
Peter F
PF
Schnatz
Reading Health System, Reading, PA, USA.
Xuezhi
X
Jiang
National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA.
Nicole
N
Kleinstreuer
National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA.
Janet E
JE
Hall
University of North Carolina School of Social Work, Chapel Hill, NC, USA.
Sarah
S
Verbiest
PricewaterhouseCoopers Public Services, McLean, VA, USA.
Jill
J
Olmstead
Oracle, Redwood City, CA, USA.
Ryan
R
Fair
University of Perugia, Perugia, Italy.
Alberto
A
Falorni
University of Milan and IRCCS Istituto Auxologico Italiano, Milan, Italy.
Luca
L
Persani
University of Pittsburgh, Pittsburgh, PA, USA.
Aleksandar
A
Rajkovic
Pennsylvania State University, University Park, PA, USA.
Khanjan
K
Mehta
Division of Intramural Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA - Lawrence_Nelson@nih.gov.
Lawrence M
LM
Nelson
D000293:Adolescent; D000328:Adult; D000818:Animals; D002908:Chronic Disease; D005260:Female; D005298:Fertility; D006176:Gynecology / Q000379:methods / Q000639:trends; D006801:Humans; D051379:Mice; D008875:Middle Aged; D009839:Oligomenorrhea / Q000503:physiopathology; D010053:Ovary / Q000503:physiopathology*; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D013598:Systems Theory; D055815:Young Adult