$200 reward for help on looking at “blind spots” in endometriosis

Dan Martin MD is seeking help in looking at “blind spots” in his data base on literature needed for clinical decisions when treating endometriosis.

There is a US$200 reward for peer reviewed, published, articles that are abstracted in PubMed, which show statistically significant difference in outcomes (pain, tenderness, fertility, change in appearance, or other outcomes) of surgery or medical therapy.

These must be based on histology that is positive compared with histology that is negative for visually diagnosed endometriotic lesions in humans. See Walter et al [1] for comparison study.

Decisions on endometriosis therapy are based on several definitions that are not always related. This can lead to application of data based on any appearance definition to patients who have a specific appearance or a histologic definition.

This is not an evidence based or scientific based approach.
It may lead to inappropriate therapy.
A concentration on biopsy positive patients implies that we can ignore or discount patients who have a laparoscopic diagnosis of endometriosis but have histologically negative biopsies.

There is a large body of literature on accuracy of confirmation of endometriosis but not a corresponding literature on the accuracy of histologic diagnosis of other peritoneal and pelvic abnormalities. This can contribute to:

Identification of psammoma bodies, endosalpingiosis, Walthard Rests, low malignant potential tumor, and other pathology as endometriosis.
An assumption that if we think it is endometriosis then other significant pathology is not present.
Possibly diagnosing cancer as endometriosis when biopsies are not done.

Data to support the use of biopsy to confirm management of endometriosis is missing

The use of biopsy results to confirm endometriosis is pleasing from a theoretical level regarding accuracy. But there is no data to support the use of biopsy to confirm endometriosis for patient management. This is contrasted with the use of biopsies to clarify other look-a-like diseases.

Dr Martin needs peer reviewed, published articles that are abstracted in PubMed. These need to show statistically significant difference in outcomes (pain, tenderness, fertility, change in appearance or other outcomes) of surgery or medical therapy based on histology that is positive as compared with histology that is negative for endometriosis.

$200 reward for papers

There is a $200 reward to the first physician to send any paper that is not listed on Dr Martin’s website. There will be as many rewards as there are papers.

Dr Martin also needs additional articles that study endometriosis histology and include the histology for both endometriosis and other lesions in the same article. The only reward for those will be his thanks. If the article is not in English, an English translation of the abstract and of the statistical analysis is needed. The citation for the articles and the names of those who win the money will be posted on his website, which also carries a list of papers already recognised.