{"paper_id":"354b5c1b-df5b-42bb-91e0-733e872a1eb6","body_text":"Offizielles Organ:  AGRBM,  BRZ,  DVR,  DGA,  DGGEF ,  DGRM,  D·I·R,  EFA,  OEGRM,  SRBM/DGE\nKrause & Pachernegg  GmbH, Verlag für Medizin und Wirtschaft, A-3003 Gablitz\nJournal für\nReproduktionsmedizin \nund Endokrinologie\n– Journal of Reproductive Medicine and Endocrinology –\nAndrologie • Embryologie & Biologie • Endokrinologie • Ethik & Recht • Genetik \nGynäkologie • Kontrazeption • Psychosomatik • Reproduktionsmedizin • Urologie\nIndexed in EMBASE/Excerpta Medica/Scopus\nwww.kup.at/repromedizin\nOnline-Datenbank mit Autoren- und Stichwortsuche\nPattern of Endometriosis Care in German-speaking\nCountries: the QS ENDO Project\nZalewski M, Zeppernick F, Wölfler MM, Janschek E\nKeckstein J, Sillem M, Schweppe KW\nMeinhold-Heerlein I\nJ. Reproduktionsmed. Endokrinol 2017; 14 (6), 311-312\n\n\n20.-21. März 2026\nUniversitätsmedizin Mainz\nENDOKRINOLOGIE & FERTILITÄT\nFÜR KLINIK & PRAXIS\nWeitere Informationen\n& Anmeldung unter\nEinladung zu unserer wissenschaftlichen Veranstaltung Endo-Ferti-Forum\nBrücke(n) zwischen Unikliniken und Praxen an Rhein und Main(z)\n– die aus dem bisherigen Format „Ferti Forum“ ab 2026 hervorgeht –\nFreuen Sie sich auf spannende Vorträge und den lebendigen Austausch mit Kolleg:innen und Expert:innen aus Klinik und\nPraxis. Freitagabend laden wir Sie herzlich zu einem entspannten Empfang ein –\neine perfekte Gelegenheit, Kontakte zu knüpfen und den T ag genussvoll ausklingen zu lassen.\nWissenschaftliche Leitung: Univ.-Professorin Annette Hasenburg, Dr. Susanne Theis, Universitätsmedizin Mainz,\nSanitätsrat Dr. Werner Harlfinger, BVF Rheinland-Pfalz Dr. Rüdiger Gaase, BVF Hessen Dr. Klaus J. Doubek\nSchirmherrschaften: Prof. Nicole Sänger, Uniklinik Bonn, Prof. Jan-Steffen Krüssel, Uniklinik Düsseldorf,\nDr. Annette Bachmann, Uniklinik Frankfurt am Main, Prof. Christine Skala, Uniklinik Köln\n\n311\nPattern of Endometriosis Care in  \nGerman-speaking Countries: the QS ENDO Project\nM. Zalewski1*, F. Zeppernick1*, M. M. Wölfler1,2, E. Janschek3, J. Keckstein3, M. Sillem4, K.-W. Schweppe5, I. Meinhold-Heerlein1;  \nfor the QS Endo committee members of the Stiftung Endometrioseforschung (SEF)\n „ Introduction\nEndometriosis is a common disorder af-\nfecting approximately 10–15% of repro-\nductive-age women [1]. It is character -\nized by the presence of endometrial-like \ntissue outside the uterine cavity. Typical \nsymptoms include dysmenorrhea, pelvic \npain and subfertility.\nThe symptoms and treatment-related ef-\nfects of endometriosis often affect young, \nactive women during their economical-\nly productive lives, which – the medical \nchallenges aside – causes a substantial fi-\nnancial burden on the health-care system \n[2, 3]. One of the main reasons for the \nhigh impact on patients’ quality of life \n(QoL) is the long delay in diagnosis. Pa-\ntients often experience a lag time of up to \n10 years between the onset of symptoms \nand diagnosis [4, 5]. The effects of deal-\ning with debilitating pain combined with \nthe emotional impact of sub-fertility fur-\nther complicate the patient’s situation.\nIt seems obvious that more research is \nneeded to determine physician and pa-\ntient factors that influence diagnostic and \ntreatment decisions in endometriosis.\nThe positive changes obtained by bench-\nmarking in the treatment of ovarian can-\ncer was one of the major drivers motivat-\ning the bid to repeat that success story in \nthis, one of the main medical challeng-\nes facing young women during their pro-\nductive lives [6]. Work on ovarian can-\ncer demonstrated that the creation of a \nquality assurance program (QS OV AR) \nresulted in overall improvement in the \nquality of care of patients with  ovarian \ncancer. While adherence to treatment \nguidelines varied markedly early in the \nstudy [7], rates of staging and treatment \naccording to guidelines improved over \ntime with continued participation in the \nprogram. The QS OV AR program also \ndemonstrated that the structure and size \nof the hospital did not have a signifi-\ncant impact on survival. The only trans-\nparent treatment facility characteristic \nthat significantly impacted the progno-\nsis of ovarian cancer was participation in \nclinical studies [6]. One study on ovari-\nan cancer found that the likelihood of a \npatient receiving a recommended thera-\npy grew when providers received train-\ning [8].\n „ QS ENDO Project\nStandardized quality indicators for treat-\nment of endometriosis have yet to be es-\ntablished. This lack of standards repre-\nsents a hurdle to improving the quality of \ntreatment, and it is one which ought to be \novercome. In view of the success of the \nQS OV AR program, we hope that the im-\nplementation of a quality assurance pro-\ngram in endometriosis (QS ENDO) will \nhelp to raise the standard of endometriosis \ncare in German-speaking countries and \ngain better adherence to treatment guide-\nlines. Furthermore, we hope that the pro-\ngram will have positive effects in terms of \nshortening the lag time between the on-\nset of symptoms and diagnosis, reducing \nnon-beneficial surgical interventions and \nimproving patient satisfaction or QoL.\nThe QS ENDO program is to proceed in \nfour phases: QS ENDO Real, QS ENDO \nPilot, QS ENDO Study and QS ENDO \nReceived: August 31, 2017; accepted after revision: October 5, 2017 (responsible Editor: Dr. K. Bühler, Stuttgart)\n*contributed equally\nFrom the 1Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, Germany; the 2Department of Gynecology and Obstetrics, University Hospital Graz, \n Austria; the 3Department of Obstetrics and Gynecology, Villach General Hospital, Villach, Austria; the 4Clinic at the Rosengarten, Mannheim; and the 5Department of Obstetrics \nand Gynecology, Ammerland Clinic, Westerstede, Germany\nCorrespondence: Prof. Dr. Ivo Meinhold-Heerlein, Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52070 Aachen;  \ne-mail: imeinhold@ukaachen.de\nDas Qualitätssicherungsprogramm QS ENDO wurde initiiert, um die Versorgungsrealität für Endometriose in der DACH-Region (Deutschland, Österreich, \nSchweiz) zu erfassen.\nDie erste Phase (QS ENDO Real) wird einen Überblick über die aktuelle Versorgung von Endometriosepatientinnen erbringen. In der zweiten Phase (QS \nENDO Pilot) werden die tatsächlichen Behandlungen an Endometriosezentren der Stufe II und III innerhalb eines einmonatigen Zeitraumes abgefragt. In Pha-\nse III (QS ENDO Study) wird diese Abfrage auf alle behandelnden Kliniken in der DACH-Region ausgeweitet.\nDas QS ENDO-Projekt wird als erstes Programm dieser Art ein umfassendes Verständnis der tatsächlichen Versorgungsrealität liefern. Dies soll dabei \nhelfen, Qualitätsindikatoren für die Diagnostik und Therapie der Endometriose zu generieren.\nSchlüsselwörter: Endometrioseversorgung, Qualitätssicherung, Qualitätsindikatoren\nThe implementation of a quality assurance program in endometriosis QS ENDO was initiated to evaluate the actual pattern of endometriosis care in Ger -\nman-speaking countries.\nAfter the first phase (QS ENDO Real) which will yield an overview of the current endometriosis care, phase II (QS ENDO Pilot) will be retrieving the actual \ncare of the patients during a 1-month period in all high-level certified endometriosis centers. In phase III (QS ENDO Study), a representative, comprehensive \nanalysis of care across all treating facilities of the German-speaking countries is planned.\nThe QS ENDO project will be the first program of its kind to acquire a profound understanding of the pattern and quality of endometriosis care, which will \nhelp to generate quality indicators for diagnosis and treatment. J Reproduktionsmed Endokrinol_Online 2017; 14 (6): 311–2.\nKey words: Endometriosis care, quality assurance, quality indicators\nJ Reproduktionsmed Endokrinol_Online 2017; 14 (6)\nFor personal use only. Not to be reproduced without permission of Krause & Pachernegg GmbH.\n\nPattern of Endometriosis Care in German-speaking Countries: the QS ENDO Project\n312\nFollow up. The four phases shall be im-\nplemented in stages over course of the \ncoming decade.\nThe aim of Phase I (QS ENDO Real) is \nto obtain a comprehensive overview of \ncurrent availability and quality of care of \npatients with endometriosis in German-\nspeaking countries.\nDuring Phase II (QS ENDO Pilot), cent-\ners already certified as high-level endo-\nmetriosis specialist centers (Levels II \nand III) by the Stiftung Endometriose-\nforschung (SEF) will be asked to pro-\nvide detailed records of all patients diag-\nnosed and treated within a 1-month peri-\nod. Each of the approximately 60 cen ters \nshould report on an average of 10 con-\nsecutive patients.\nDuring Phase III (QS ENDO Study), \nall gynecologic treatment facilities in \nthe German-speaking countries (the so-\ncalled DACH region) will be asked to re-\nport on a sample of patients during a spe-\ncific treatment period. This will enable a \nrepresentative, comprehensive analysis \nof care across the region. The number of \npatients whose care each facility will be \nasked to track as part of the study will be \nmatched to the facility’s size and struc-\nture based on the results of Phase I.\nPhase IV (QS ENDO Follow-up) is in-\ntended to follow up on care and outcomes \nfor patients documented during Phases II \nand III in order to generate  valid data on \nthe efficacy of treatment.\nThe purpose of Phase I (QS ENDO \nReal) is to evaluate the pattern and quali-\nty of endometriosis care in the Europe-\nan countries in which the predominate \nevery day language is German, or in other \nwords, in the so-called DACH countries \nof Germany (D), Austria (A) and Swit-\nzerland (CH).\nAll gynecology departments in the \nDACH region will be contacted via regu-\nlar mail and asked to provide a descrip-\ntion of the current quality of care of en-\ndometriosis patients. A two-page ques-\ntionnaire will be supplied to facilitate \nreporting. The parameters of the ques-\ntionnaire were developed by a panel of \n25 experts during a 3-day workshop on \nquality management in endometriosis \ntreatment which took place at the Weis-\nsensee Conference of the scientific board \nof the Stiftung Endometrioseforschung \n(SEF) in Austria in 2016. The goal is a \nresponse rate of at least 10–20%.\nIn general, the questionnaire includes \nseveral structural as well as content-re-\nlated questions:\n – Apart from the size and structure of \nthe treatment facility, information \nabout human resource management \nas well as providers’ level of educa-\ntion and training are surveyed.\n – The questionnaire asks a responding \nphysician to estimate the number of \npatient contacts as well as the num-\nber and type of surgical interventions \nwhich take place and\n – another set of questions focuses on \nthe assessment of certain symptoms \nand diagnostic steps, e.g., the evalua-\ntion of dysmenorrhea or the use of \ntransvaginal ultrasound for an effec-\ntive and efficient patient work-up.\nTo our knowledge, the QS ENDO pro-\nject will be the first effort spanning the \nDACH region to acquire a profound un-\nderstanding of the pattern and quality of \nendometriosis care, which will help to \ngenerate quality indicators for treatment.\nA strength of the concept of QS ENDO \nReal is that it provides a pen-to-paper re-\nsponse setting, creating a low threshold \nfor respondents to be willing to partici-\npate; but the very same feature might \nalso be seen as a weaknesses in that re-\nspondents may overestimate or underes-\ntimate some data.\nFinally, we would add that the potential \nbias caused by respondents approximat-\ning numbers of patients during Phase I \nwill be corrected during Phases II and \nIII. In those phases (QS ENDO Pilot \nand Study), information will be gathered \nabout actual diagnostics and treatments \nperformed in consecutive patients based \non real patient data rather than on esti-\nmates.\nAs the questionnaires for Phase I were \ndistributed in 2016, we expect to be able \nto publish the results of QS ENDO Real \nby the end of 2017.\n „ Acknowledgements\nQS Endo committee members: Du-\nbravko Barisic, Alexander Boosz, Iris \nBrandes, Gerald Fischerlehner, Nan-\nnette Grübling, Bernhard Krämer, Frank \nOehmke, Peter Oppelt, Ralf Rothmund, \nDarius Salehin, Chi Mi Scheible, Mi-\nriam Schempershofe, Vanadin Seifert- \nKlauss, Omar Shebl, Sigrid Vinger -\nhagen-Pethick, Peter Widschwendter, \nPauline Wimberger.\n „ Conflict of Interest\nThe authors have no conflict of interest \nto disclose.\nReferences\n1. Burney RO, Giudice LC. Pathogenesis and pathophysiology of \nendometriosis. Fertil Steril 2012; 98: 511–9.\n2. Ulrich U, Buchweitz O, Greb R, Keckstein J, von Leffern I, et \nal.; German and Austrian Societies for Obstetrics and Gyneco-\nlogy. National German Guideline (S2k): Guideline for the Dia-\ngnosis and Treatment of Endometriosis: Long Version – AWMF \nRegistry No. 015-045. Geburtshilfe Frauenheilkd 2014; 74: \n1104–18.\n3. Simoens S, Dunselman G, Dirksen C, Hummelshoj L, Bokor A, \net al. The burden of endometriosis: costs and quality of life of \nwomen with endometriosis and treated in referral centres. Hum \nReprod 2012; 27: 1292–9.\n4. Nnoaham KE, Hummelshoj L, Webster P . Impact of endometri-\nosis on quality of life and work productivity: a multicenter study \nacross ten countries. Fertil Steril 2011; 96: 366–73.\n5. Hudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P , et al. \nDiagnostic delay for endometriosis in Austria and Germany: \ncauses and possible consequences. Hum Reprod 2012; 27: \n3412–6.\n6. du Bois A, Rochon J, Lamparter C, Pfisterer J. Impact of cent-\ner characteristics on outcome in ovarian cancer in Germany. \nZentralbl Gynakol 2005; 127: 18–30.\n7. du Bois A, Rochon J, Lamparter C, Pfisterer J. The Quality \nAssurance Program of the AGO Organkommission OVAR (QS-\nOVAR): Pattern of Care and Reality in Germany 2001. Zentralbl \nGynakol 2005; 127: 9–17.\n8. Muñoz KA, Harlan LC, Trimble EL. Patterns of care for women \nwith ovarian cancer in the United States. J Clin Oncol 1997; 15: \n3408–15.\nJ Reproduktionsmed Endokrinol_Online 2017; 14 (6)\n\nHaftungsausschluss\nDie in unseren Webseiten publizierten Informationen richten sich ausschließlich an geprüfte \nund autorisierte medizinische Berufsgruppen und entbinden nicht von der ärztlichen Sorg-\nfaltspflicht sowie von einer ausführlichen Patientenaufklärung über therapeutische Optionen \nund deren Wirkungen bzw. Nebenwirkungen. Die entsprechenden Angaben werden von den \nAutoren mit der größten Sorgfalt recherchiert und zusammengestellt. Die angegebenen Do-\nsierungen sind im Einzelfall anhand der Fachinformationen zu überprüfen. Weder die Autoren, \nnoch die tragenden Gesellschaften noch der Verlag übernehmen irgendwelche Haftungsan-\nsprüche.\nBitte beachten Sie auch diese Seiten:\nImpressum Disclaimers & Copyright Datenschutzerklärung\nMitteilungen aus der Redaktion\ne-Journal-Abo\nBeziehen Sie die elektronischen Ausgaben dieser Zeitschrift hier.\nDie Lieferung umfasst 4–5 Ausgaben pro Jahr zzgl. allfälliger Sonderhefte.\nUnsere e-Journale stehen als PDF-Datei zur Verfügung und sind auf den meisten der markt-\nüblichen e-Book-Readern, Tablets sowie auf iPad funktionsfähig.\n Bestellung e-Journal-Abo\nHaftungsausschluss\nDie in unseren Webseiten publizierten Informationen richten sich ausschließlich an  geprüfte \nund autorisierte medizinische Berufsgruppen und entbinden nicht von der ärztlichen Sorg-\nfaltspflicht sowie von einer ausführlichen Patientenaufklärung über therapeutische Optionen \nund deren Wirkungen bzw. Nebenwirkungen. Die entsprechenden Angaben werden von den \nAutoren mit der größten Sorgfalt recherchiert und zusammengestellt. Die angegebenen Do-\nsierungen sind im Einzelfall anhand der Fachinformationen zu überprüfen. Weder die  Autoren, \nnoch die tragenden Gesellschaften noch der Verlag übernehmen irgendwelche Haftungs-\nansprüche.\nBitte beachten Sie auch diese Seiten:\nImpressum Disclaimers & Copyright Datenschutzerklärung\nMitteilungen aus der Redaktion\ne-Journal-Abo\nBeziehen Sie die elektronischen Ausgaben dieser Zeitschrift hier.\nDie Lieferung umfasst 4–5 Ausgaben pro Jahr zzgl. allfälliger Sonderhefte.\nUnsere e-Journale stehen als PDF-Datei zur Verfügung und sind auf den meisten der markt-\nüblichen e-Book-Readern, Tablets sowie auf iPad funktionsfähig.\n Bestellung e-Journal-Abo\nBesuchen Sie unsere Rubrik\n Medizintechnik-Produkte\nInControl 1050 \nLabotect GmbH\nAspirator 3 \nLabotect GmbH\nPhilips Azurion:  \nInnovative Bildgebungslösung\nNeues CRT -D Implantat  \nIntica 7 HF-T QP von Biotronik\nArtis pheno \nSiemens Healthcare Diagnostics GmbH","source_license":"CC0","license_restricted":false}