Screening

New Screening Method for Endometriosis Diagnosis

A new screening method that uses scores generated from patient questionnaires may be an effective tool in screening for endometriosis.

To address unnecessary delays in the diagnosis of endometriosis after symptom onset, researchers conducted a case-control study, which included 2527 individuals who underwent exploratory surgery for benign gynecological pathologies in a French referral center from 2005 to 2018.

All participants completed questionnaires on 5 painful symptoms a month prior to surgery. Following surgery, patients were categorized into 2 groups. One group included 1195 individuals with histologically proven endometriosis, and the control group included 1332 individuals who did not have endometriotic lesions during surgery.

Using the patient questionnaires and epidemiological data, the researchers measured 2 scores: score 1 was based on predicted occurrence of endometriosis; and score 2 was based on participants’ self-evaluation of pain.

Both scores were evaluated at 3 levels: highly specific (identifying correctly patients without the disease), highly sensitive (identifying patients with the disease), and maximum sensitivity and specificity for the overall best classification.

The results indicated that score 1 had a C-index of 0.81 (95% CI, 0.79-0.83). The score 1 levels were 25 or greater (specificity of 91%; 95% CI, 89-93), less than 11, (specificity of 91%; 95% CI, 89-93), and 18 or greater (specificity of 75%; 95% CI, 70-76).

Score 2 had a C-index of 0.75 (95% CI, 73-77). The score 2 levels were 24 or greater (specificity of 82%; 95% CI, 73-77), less than 7 (sensitivity of 92%; 95% CI, 90-94), and 17 or greater (specificity of 62%; 95% CI, 58-65).

Both scores were validated by an internal and external population.

“A score based only on a patient questionnaire could allow identification of a population at high risk of endometriosis,” researchers concluded. “This strategy might help referral to specialized radiologists for a non-surgical endometriosis scan.”

 

—Leigh Precopio

 

Reference:

Chapron C, Lafay-Pullet MC, Santulli P, et al. A new validated screening method for endometriosis diagnosis based on patient questionnaires. Clin Med. 2022;44:101263. doi:10.1016/j.eclinm.2021.101263

 

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