{"paper_id":"ba803d46-370a-4295-b0ac-86c4e2fac6b8","body_text":"Clues to revising the conventional diagnostic algorithm for endometriosis\nCorresponding Author\nAndrew Spiers\nDepartment of Obstetrics and Reproductive Medicine, Angers University Hospital, Angers, France\nEndometriosis Expert Center – Pays de la Loire, Angers, France\nCorrespondence\nAndrew Spiers, Department of Gynecology-Obstetrics, Angers University Hospital, 4 Rue Larrey, 49100 Angers, France.\nEmail: [email protected]\nSearch for more papers by this authorHorace Roman\nFranco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France\nSearch for more papers by this authorMegan Wasson\nDepartment of Gynecologic Surgery, Mayo Clinic, Phoenix, Arizona, USA\nSearch for more papers by this authorCharles Chapron\nDepartment of Gynecology Obstetrics and Reproductive Medicine, Cochin University Hospital, Paris, France\nDepartment ‘Development, Reproduction and Cancer’, Institut Cochin, INSERM U1016, Descartes University, Paris, France\nSearch for more papers by this authorPascal Rousset\nDepartment of Diagnostic and Interventional Imaging, Lyon Sud University Hospital, Lyon, France\nSearch for more papers by this authorFrançois Golfier\nDepartment of Obstetrics and Reproductive Medicine, Lyon South University Hospital, Lyon, France\nEndometriosis Expert Center – Steering Committee of the EndAURA Network, Lyon, France\nSearch for more papers by this authorRaffaele Fauvet\nDepartment of Obstetrics and Reproductive Medicine, Cote De Nacre University Hospital, Caen, France\nSearch for more papers by this authorLéa Delbos\nDepartment of Obstetrics and Reproductive Medicine, Angers University Hospital, Angers, France\nEndometriosis Expert Center – Pays de la Loire, Angers, France\nSearch for more papers by this authorMathieu Poilblanc\nDepartment of Obstetrics and Reproductive Medicine, Lyon South University Hospital, Lyon, France\nEndometriosis Expert Center – Steering Committee of the EndAURA Network, Lyon, France\nSearch for more papers by this authorVincent Lavoué\nDepartment of Obstetrics, Gynecology and Human Reproduction, University of Rennes, Rennes, France\nSearch for more papers by this authorErick Petit\nDepartment of Obstetrics and Reproductive Medicine, Paris Saint Joseph Hospital, Paris, France\nSearch for more papers by this authorFrédérique Perotte\nDepartment of Obstetrics and Reproductive Medicine, Paris Saint Joseph Hospital, Paris, France\nSearch for more papers by this authorCherif Akladios\nDepartment of Obstetrics and Reproductive Medicine, Strasbourg University Hospital, Strasbourg, France\nSearch for more papers by this authorBenjamin Merlot\nFranco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France\nSearch for more papers by this authorThomas Dennis\nFranco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France\nSearch for more papers by this authorAnne Sophie Boudy\nDepartment of Gynecology-Obstetrics and Medicine of Reproduction, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorBenjamin Fedida\nDepartment of Radiology, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorPierre Leguevaque\nDepartment of Gynecological Surgery, CHU Rangueil, Toulouse, France\nSearch for more papers by this authorLudivine Genre\nDepartment of Radiology, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorClothilde Hennetier\nDepartment of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France\nSearch for more papers by this authorMorgane Perrin\nDepartment of Gynecological Surgery, CHU Rangueil, Toulouse, France\nSearch for more papers by this authorPatrice Crochet\nDepartment of Gynecological Surgery, CHU Rangueil, Toulouse, France\nSearch for more papers by this authorClaire-Marie Roger\nDepartment of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France\nSearch for more papers by this authorElodie Chantalat\nDepartment of Radiology, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorPierre Collinet\nHôpital Privé le Bois, Groupe Ramsay Lille Métropole, Lille, France\nSearch for more papers by this authorHervé Fernandez\nDepartment of Obstetrics and Reproductive Medicine, Paris Sud University Hospital, Kremlin Bicetre APHP, Paris, France\nSearch for more papers by this authorPhilippe Descamps\nDepartment of Obstetrics and Reproductive Medicine, Angers University Hospital, Angers, France\nEndometriosis Expert Center – Pays de la Loire, Angers, France\nSearch for more papers by this authorSofiane Bendifallah\nDepartment of Surgery, Americain Hopsital of Paris, Neuilly sur seine, France\nSearch for more papers by this authorCorresponding Author\nAndrew Spiers\nDepartment of Obstetrics and Reproductive Medicine, Angers University Hospital, Angers, France\nEndometriosis Expert Center – Pays de la Loire, Angers, France\nCorrespondence\nAndrew Spiers, Department of Gynecology-Obstetrics, Angers University Hospital, 4 Rue Larrey, 49100 Angers, France.\nEmail: [email protected]\nSearch for more papers by this authorHorace Roman\nFranco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France\nSearch for more papers by this authorMegan Wasson\nDepartment of Gynecologic Surgery, Mayo Clinic, Phoenix, Arizona, USA\nSearch for more papers by this authorCharles Chapron\nDepartment of Gynecology Obstetrics and Reproductive Medicine, Cochin University Hospital, Paris, France\nDepartment ‘Development, Reproduction and Cancer’, Institut Cochin, INSERM U1016, Descartes University, Paris, France\nSearch for more papers by this authorPascal Rousset\nDepartment of Diagnostic and Interventional Imaging, Lyon Sud University Hospital, Lyon, France\nSearch for more papers by this authorFrançois Golfier\nDepartment of Obstetrics and Reproductive Medicine, Lyon South University Hospital, Lyon, France\nEndometriosis Expert Center – Steering Committee of the EndAURA Network, Lyon, France\nSearch for more papers by this authorRaffaele Fauvet\nDepartment of Obstetrics and Reproductive Medicine, Cote De Nacre University Hospital, Caen, France\nSearch for more papers by this authorLéa Delbos\nDepartment of Obstetrics and Reproductive Medicine, Angers University Hospital, Angers, France\nEndometriosis Expert Center – Pays de la Loire, Angers, France\nSearch for more papers by this authorMathieu Poilblanc\nDepartment of Obstetrics and Reproductive Medicine, Lyon South University Hospital, Lyon, France\nEndometriosis Expert Center – Steering Committee of the EndAURA Network, Lyon, France\nSearch for more papers by this authorVincent Lavoué\nDepartment of Obstetrics, Gynecology and Human Reproduction, University of Rennes, Rennes, France\nSearch for more papers by this authorErick Petit\nDepartment of Obstetrics and Reproductive Medicine, Paris Saint Joseph Hospital, Paris, France\nSearch for more papers by this authorFrédérique Perotte\nDepartment of Obstetrics and Reproductive Medicine, Paris Saint Joseph Hospital, Paris, France\nSearch for more papers by this authorCherif Akladios\nDepartment of Obstetrics and Reproductive Medicine, Strasbourg University Hospital, Strasbourg, France\nSearch for more papers by this authorBenjamin Merlot\nFranco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France\nSearch for more papers by this authorThomas Dennis\nFranco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux, France\nSearch for more papers by this authorAnne Sophie Boudy\nDepartment of Gynecology-Obstetrics and Medicine of Reproduction, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorBenjamin Fedida\nDepartment of Radiology, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorPierre Leguevaque\nDepartment of Gynecological Surgery, CHU Rangueil, Toulouse, France\nSearch for more papers by this authorLudivine Genre\nDepartment of Radiology, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorClothilde Hennetier\nDepartment of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France\nSearch for more papers by this authorMorgane Perrin\nDepartment of Gynecological Surgery, CHU Rangueil, Toulouse, France\nSearch for more papers by this authorPatrice Crochet\nDepartment of Gynecological Surgery, CHU Rangueil, Toulouse, France\nSearch for more papers by this authorClaire-Marie Roger\nDepartment of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France\nSearch for more papers by this authorElodie Chantalat\nDepartment of Radiology, Hôpital Tenon, Sorbonne University, Paris, France\nSearch for more papers by this authorPierre Collinet\nHôpital Privé le Bois, Groupe Ramsay Lille Métropole, Lille, France\nSearch for more papers by this authorHervé Fernandez\nDepartment of Obstetrics and Reproductive Medicine, Paris Sud University Hospital, Kremlin Bicetre APHP, Paris, France\nSearch for more papers by this authorPhilippe Descamps\nDepartment of Obstetrics and Reproductive Medicine, Angers University Hospital, Angers, France\nEndometriosis Expert Center – Pays de la Loire, Angers, France\nSearch for more papers by this authorSofiane Bendifallah\nDepartment of Surgery, Americain Hopsital of Paris, Neuilly sur seine, France\nSearch for more papers by this authorAbstract\nEndometriosis is a complex gynecologic disorder characterized primarily by symptoms of pelvic pain, infertility, and altered quality of life. National and international guidelines highlight the diagnostic difficulties and lack of conclusive diagnostic tools for endometriosis. Furthermore, guidelines are becoming questionable at an increasingly rapid rate as new diagnostic techniques emerge. This work aims to provide a knowledge synthesis of the relevance of various diagnostic tools and to assess areas of improvement of conventional algorithms. MEDLINE and Cochrane Library databases were searched from January 2021 to December 2023 using relevant key words. Articles evaluating the diagnostic relevance and performance of various tools were included and independently reviewed by the authors for eligibility. Included studies were assessed using the GRADE and QUADAS-2 tools. Of the 4204 retrieved articles, 26 were included. While anamnesis and clinical examination do contribute to diagnostic accuracy, their level of evidence and impact on the diagnostic process remains limited. Although imaging techniques are recommended to investigate endometriosis, ultrasonography remains highly operator dependent. Magnetic resonance imaging appears to exhibit higher sensitivities than ultrasound. However, concerns persist with regards to the terminology, anatomical definition of lesions, and accuracies of both ultrasound and magnetic resonance imaging. Recently, several biological markers have been studied and cumulative evidence supports the contribution of noncoding RNAs to the diagnosis of endometriosis. Marginal improvements have been suggested for anamnesis, clinical examination, and imaging examinations. Conversely, some biomarkers, including the saliva microRNA signature for endometriosis, have emerged as diagnostic tools which inspire reflection on the revision of conventional diagnostic algorithms.\nCONFLICT OF INTEREST STATEMENT\nAS, PD, and SB serve as advisory board members for Ziwig. No other authors report any conflicts of interest.\nDATA AVAILABILITY STATEMENT\nData sharing is not applicable to this article as no new data were created or analyzed in this study.\nSupporting Information\n| Filename | Description |\n|---|---|\n| ijgo15840-sup-0001-TableS1.docxWord 2007 document , 48 KB |\nTable S1: Summary of the key characteristics for each of the included studies (N = 26). |\nPlease note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.\nREFERENCES\n- 1Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020; 382(13): 1244-1256. doi:10.1056/NEJMra1810764\n- 2Brandes I, Kleine-Budde K, Heinze N, et al. 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BJOG. 2023; 130(4): 396-406. doi:10.1111/1471-0528.17348\nCiting Literature\nArticle Metrics\nTotal unique accesses to an article’s full text in HTML or PDF/ePDF format.More metric information\nScite metrics\nExplore this article's citation statements on scite.ai\nShare QR Code\nGenerating QR code\nQR code copied to clipboard!\nSomething went wrong while generating your QR code. Please try again in a moment. If the issue persists, refresh the page or contact support.\nExport citation\nUnable to load citation data. Please try again in a moment.\nHow to cite\nElkins, L. J., & Spiegelman, M. (2021). pyUserCalc: A revised Jupyter notebook calculator for uranium-series disequilibria in basalts. Earth and Space Science, 8, e2020EA001619. https://doi.org/10.1029/2020EA001619\nDownload Citation\nIf you have the appropriate software installed, you can download article citation data to the citation manager of your choice. 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