Start Free

Synthetic data only. Never enter patient information; nothing is sent or stored. For clinicians. Not FDA cleared.

CPE-010 · synthetic case PCOS-FX-08

17-hydroxyprogesterone 340 ng/dL

Non-classic CAH possible.

Synthetic · no real patientAuthored by Biod · reviewed by Dr. AmaralPCOS engine v1.0.0

Purpose: Non-classic CAH possible.

Inputs the engine received

Cycles and clinical signs

Age
22 years
Years since menarche
9 years
Cycles per year
6
Hirsutism, modified Ferriman–Gallwey score
11

Laboratory and imaging

TSH
2 mIU/L
Prolactin
9 ng/mL
17-hydroxyprogesterone (early follicular, morning)
340 ng/dL

What the engine reports

Priority

Possible non-classic congenital adrenal hyperplasia

PC-09

An early-follicular-phase 17-hydroxyprogesterone of 200 ng/dL or more raises non-classic CAH. An ACTH-stimulation test can confirm or exclude it. Treatment differs from PCOS.

Detected clinical pattern

Another Cause Is Present or Unexcluded

The features resemble PCOS, but a cause that must be addressed first is present. PCOS is a diagnosis of exclusion.

  • Criteria met: 2 of 3 criteria

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Consider an ACTH-stimulation test to confirm or exclude non-classic CAH.

Differentials, pitfalls and contradicting signals

  • The features meet the criteria, but another cause is present or unexcluded; PCOS is a diagnosis of exclusion.

Missing information

  • Total testosterone with SHBG (high-quality assay).
Evidence and rule trace · 4 rules

PC-02Criterion: irregular cycles

Inputs: 6 cycles a year

Irregular cycles / ovulatory dysfunction.

PC-03Criterion: hyperandrogenism

Inputs: hirsutism mFG 11

Clinical or biochemical hyperandrogenism.

PC-09Non-classic congenital adrenal hyperplasia possible

Inputs: 17-hydroxyprogesterone 340 ng/dL

Non-classic congenital adrenal hyperplasia possible.

PC-MISS-01Information needed

Inputs: work-up incomplete

The tests needed to complete criteria and exclusions are not all entered.

Evidence

  • EV-PCOS-2023 · Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469.
  • EV-ROTTERDAM-2004 · Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-47.
  • EV-ES-HIRSUTISM-2018 · Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(4):1233-1257.
  • EV-ES-NCCAH-2018 · Speiser PW, Arlt W, Auchus RJ, et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(11):4043-4088.

Physician adjudication required. Clinical decision support for physician review. This output applies published criteria to the values entered. It does not diagnose, exclude other causes by itself, or choose contraception, ovulation induction or any treatment. Physician adjudication is required.

Change the values

The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.

Criteria met (adults need 2 of 3)

  1. ✓ 0 of 3

    No criterion met

  2. ✓ 1 of 3

    Not enough

  3. ● 2 of 3

    Criteria met if causes are excluded

  4. ○ 3 of 3

    All three present

Cycles and clinical signs

6 or more (4 or more in some ethnicities).

Laboratory and imaging

25 ng/mL is assumed when empty.

Endovaginal ultrasound. Not used in adolescents.

Cardiometabolic, sleep, mood and fertility

Live result · computed in your browser

Priority

Possible non-classic congenital adrenal hyperplasia

PC-09

An early-follicular-phase 17-hydroxyprogesterone of 200 ng/dL or more raises non-classic CAH. An ACTH-stimulation test can confirm or exclude it. Treatment differs from PCOS.

Detected clinical pattern

Another Cause Is Present or Unexcluded

The features resemble PCOS, but a cause that must be addressed first is present. PCOS is a diagnosis of exclusion.

  • Criteria met: 2 of 3 criteria

Recommended next steps

For physician consideration. Urgent review always comes first.

  1. 1Consider an ACTH-stimulation test to confirm or exclude non-classic CAH.

Differentials, pitfalls and contradicting signals

  • The features meet the criteria, but another cause is present or unexcluded; PCOS is a diagnosis of exclusion.

Missing information

  • Total testosterone with SHBG (high-quality assay).
Evidence and rule trace · 4 rules

PC-02Criterion: irregular cycles

Inputs: 6 cycles a year

Irregular cycles / ovulatory dysfunction.

PC-03Criterion: hyperandrogenism

Inputs: hirsutism mFG 11

Clinical or biochemical hyperandrogenism.

PC-09Non-classic congenital adrenal hyperplasia possible

Inputs: 17-hydroxyprogesterone 340 ng/dL

Non-classic congenital adrenal hyperplasia possible.

PC-MISS-01Information needed

Inputs: work-up incomplete

The tests needed to complete criteria and exclusions are not all entered.

Evidence

  • EV-PCOS-2023 · Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469.
  • EV-ROTTERDAM-2004 · Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-47.
  • EV-ES-HIRSUTISM-2018 · Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(4):1233-1257.
  • EV-ES-NCCAH-2018 · Speiser PW, Arlt W, Auchus RJ, et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(11):4043-4088.

Physician adjudication required. Clinical decision support for physician review. This output applies published criteria to the values entered. It does not diagnose, exclude other causes by itself, or choose contraception, ovulation induction or any treatment. Physician adjudication is required.

More pcos cases

PCOS-FX-01

Irregular cycles and hirsutism, exclusions complete

A 26-year-old with 8 cycles a year and an mFG of 9.

PCOS-FX-02

Irregular cycles and polycystic ovaries

No hyperandrogenism, 22 follicles per ovary.

PCOS-FX-03

Hyperandrogenism and polycystic ovaries with regular cycles

Ovulatory phenotype.

PCOS-FX-04

Irregular cycles only

One criterion is not enough.

PCOS-FX-05

Criteria met, no exclusion tests

TSH, prolactin and 17-OHP missing.

PCOS-FX-06

Prolactin 68 ng/mL

Another cause of oligomenorrhea.

All pcos cases

Try Biod in your practice

The Clinical Intelligence Layer — transforming fragmented clinical information into structured intelligence for clinician review and action.

Start Free for 3 Months (opens in a new tab)Send us a message

Contact Biod