ASRM2012: Can endometriosis be predicted from symptoms?

San Diego, 24 October 2012

Results from the first global study to develop and externally validate predictive models of endometriosis were presented today at the 68th Annual Meeting of the ASRM.

Kelechi Nnoaham at the 68th Annual Meeting of the ASRM

Study coordinator, Kelechi Nnoaham MD DPhil, presented data from the World Endometriosis Research Foundation’s Women’s Health Symptoms Study (WHSS) [1], which set out to  asses whether endometriosis can be predicted from symptoms and a woman’s medical history.

Symptom-based models were generated, and externally validated, to clinically predict a diagnosis of endometriosis using data from a prospective study of women attending gynaecology clinics in 13 countries on five continents.

It was a two-phase study of 1,396 women aged 18-45 attending for a first surgery because of symptoms suggestive of endometriosis. Before surgery, participants completed a 25-item questionnaire assessing patient characteristics and symptoms. Post-surgery, surgeons completed a standard questionnaire on surgical findings.

Can endometriosis be predicted?

Our main finding was that  a combination of symptoms and a woman’s medical history with ultrasound findings could predict stage r-ASRM III/IV endometriosis with reasonably good accuracy (82.3% sensitivity and 75.8% specificity). However, stages r-ASRM I and II could not be predicted accurately,

said Dr Nnoaham, and concluded:

We have demonstrated that it is possible to predict the more severe types of endometriosis from symptoms – the most predictive ones being painful bowel movements (dyschezia) during a woman’s period and a history of ovarian cysts (endometrioma).  Predictive tools based on these models could help prioritise women for surgical investigation with a potential for a reduction in time to diagnosis and consequent treatment.

The complete findings of this study have been published in Fertility and Sterility [1].

Reference
  1. Nnoaham KE, et al. Developing symptom-based predictive models of endometriosis as a clinical screening tool: results from a multicenter study. Fertil Steril 2012;98(3):692-701.
Acknowledgment

The Women’s Health Symptoms Study was funded by the World Endometriosis Research Foundation (WERF) via an unrestricted grant by TAP Pharmaceuticals Inc (now Abbott Endocrine)

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