Management of endometriosis in general practice: the pathway to diagnosis

Pugsley Z, Zoë Pugsley, Ballard K, Karen Ballard
The British journal of general practice : the journal of the Royal College of General Practitioners · 2007 · vol. 57(539) , pp. 470–6 · PMID:17550672 · PMC2078174 · W1818705725
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This study analyzed primary care records to find that women with endometriosis experience a median diagnostic delay of 9.0 years, often involving multiple GP consultations and unhelpful ultrasounds.

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Abstract

BACKGROUND: The prevalence of endometriosis is estimated to be around 10%. Diagnosis is through visualisation of the lesions, mostly via laparoscopy. Studies reveal that there is an average delay in the diagnosis of endometriosis of between 8 and 12 years. Little is known about the reasons for delays in diagnosis women's experiences of primary care prior to diagnosis. AIM: To investigate women's experiences of endometriosis from first presentation to diagnosis. DESIGN OF STUDY: Retrospective analysis of data collected from primary care records in four general practices. SETTING: General practice in south-east England. METHOD: Women with a Read Code diagnosis of endometriosis were recruited to the study. Details of consultations, investigations, and referrals related to endometriosis were recorded from the notes. Data were analysed using descriptive statistics. RESULTS: The prevalence of endometriosis in women aged over 16 years was 1.44%. A third of women had consulted their GP six or more times before being diagnosed. Ultrasound was frequently requested by GPs, but was helpful in diagnosing endometriosis in only 10.6% of women who underwent a scan. Thirty-nine per cent of women were referred to gynaecologists two or more times before a positive diagnosis was made. The median time from first presentation with symptoms to diagnosis was 9.0 years (interquartile range = 4.5-13.5 years). CONCLUSION: Repeated consultations and negative investigations contribute to a median delay of 9.0 years before diagnosis of endometriosis. Further research into GPs' interpretation of symptoms and patients' experiences of negative investigations and consultations may lead to a more positive outcome for women with this condition.

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Condition tags

endometriosis

MeSH descriptors

Clinical Competence Endometriosis Family Practice Adolescent Adolescent Adult Adult Clinical Competence Clinical Competence Early Diagnosis Early Diagnosis Endometriosis Endometriosis England England Family Practice Family Practice Female Female Humans

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (16)

Cited by (50)

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