A proof of concept that experience-based management of endometriosis can complement evidence-based guidelines

A Wattiez, Arnaud Wattiez, L Schindler, Anastasia Ussia, A Ussia, R Campo, J Keckstein, G Grimbizis, Grigoris Grimbizis, C Exacoustos, C. Exacoustós, William Kondo, W Kondo, C Nezhat, Ceana Nezhat, M Canis, Michel Canis, R L De Wilde, Rudy Leon De Wilde, C Miller, Catriona Miller, A Fazel, B Rabischong, A Graziottin, Alessandra Graziottin, Philippe R. Koninckx, P R Koninckx
Facts, views & vision in ObGyn · 2023 · vol. 15(3) , pp. 197–214 · doi:10.52054/fvvo.15.3.094 · PMID:37742197 · PMC10643008 · W4387001844
article OA: gold CC0 ⤵ 8 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study proposes and validates a method to quantify collective clinical experience in endometriosis management, showing it aligns with evidence-based guidelines and offers a Bayesian prior for future research.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

The paper presents a proof of concept for measuring clinicians’ experience-based management of endometriosis by treating each diagnosis and treatment decision as an “experiment” with an outcome that can update future management. Surgery-oriented clinicians with experience in more than 50 endometriosis surgeries answered experience- and knowledge-based questions on 0–10 visual analogue scales, reflecting collective management experience in over 10,000 women. The authors found experience-based management ratings were overall comparable, with more than 75% of responses scoring ≥8/10, while knowledge-based answers were more variable due to debated issues and differences between experts and non-experts. The paper explicitly frames the results as a Bayesian prior intended to be confirmed, refuted, or updated by further observations. This paper is centrally about endometriosis — it documents how collective, experience-based endometriosis management can be measured and positioned alongside evidence-based medicine.

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Abstract

Background: Management of endometriosis should be based on the best available evidence. The pyramid of evidence reflects unbiased observations analysed with traditional statistics. Evidence-based medicine (EBM) is the clinical interpretation of these data by experts. Unfortunately, traditional statistical inference can refute but cannot confirm a hypothesis and clinical experience is considered a personal opinion. Objectives: A proof of concept to document clinical experience by considering each diagnosis and treatment as an experiment with an outcome, which is used to update subsequent management. Materials and Methods: Experience and knowledge-based questions were answered on a 0 to 10 visual analogue scale (VAS) by surgery-oriented clinicians with experience of > 50 surgeries for endometriosis. Results: The answers reflect the collective clinical experience of managing >10.000 women with endometriosis. Experience-based management was overall comparable as approved by >75% of answers rated ≥ 8/10 VAS. Knowledge-based management was more variable, reflecting debated issues and differences between experts and non-experts. Conclusions: The collective experience-based management of those with endometriosis is similar for surgery-oriented clinicians. Results do not conflict with EBM and are a Bayesian prior, to be confirmed, refuted or updated by further observations. What is new?: Collective experience-based management can be measured and is more than a personal opinion. This might extend EBM trial results to the entire population and add data difficult to obtain in RCTs, such as many aspects of surgery.

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Condition tags

endometriosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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