Faculty Opinions recommendation of ENDORECT: a preoperative score to accurately predict rectosigmoid involvement in patients with endometriosis.

M. Louise Hull
In: Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · 2019 · doi:10.3410/f.735544476.793559198 · W4232300585
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A preoperative score called ENDORECT, based on digital exam, ultrasound, MRI, and symptoms, accurately predicts rectosigmoid endometriosis involvement.

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Abstract

Could we construct and validate a preoperative score to predict rectosigmoid involvement in endometriosis (RE)?SUMMARY ANSWER: We developed a simple preoperative score (ENDORECT) to predict RE.WHAT IS KNOWN ALREADY: Accurate preoperative classification is important to optimize the surgical approach for patients with endometriosis but there is currently no reliable first-line examination to determine RE.STUDY DESIGN, SIZE, DURATION: This was a single-centre observational study including all women (N = 119) who underwent complete surgery for endometriosis between January 2011 and June 2016 in the Gynaecological Department of the University Hospital of Poissy Saint-Germain en Laye.PARTICIPANTS/MATERIALS, SETTING, METHODS: Of the 119 women, 47 had RE and 72 did not.Two-thirds of the patients were randomly selected to derive the predictive score based on multiple logistic regression with internal validation by bootstrap.We used information from a self-assessment questionnaire, digital and speculum examination, transvaginal ultrasound and MRI.The score was then applied to the remaining sample of patients for validation. MAIN RESULTS AND THE ROLE OF CHANCE:Four variables were independently associated with RE: palpation of a posterior nodule on digital examination (aOR=5.6;95%CI [1.7-21.8]); a UBESS score of 3 on ultrasonography (aOR=4.9;; RE infiltration on MRI (aOR=6.8;);and presence of blood in the stools during menstruation (aOR=5.2;).The ROC-AUC of the model was 0.86 (95%CI [0.77-0.94])and the bootstrap procedure showed that the model was stable.The ENDORECT score was derived from these four criteria and three risk groups were identified: the high-risk group (score>17) had a probability of RE of 100% with an specificity (Sp) of 100%, postive likelihood ratio (Lr+)>10; the intermediate-risk group (score: 7-17) had a probability of RE of 42%; and the low-risk group (score=0), with a sensitivity (Se) of 97%, negative likelihood ratio (Lr-) of 0.07 and a probability of RE of 5%.In the validation cohort, a score >17 predicted RE with an Sp of 96, Lr+ of 9.2, and probability of RE of 83%.Patients in this sample with a score=0, had an Se of 100%, Lr-of 0 and a probability of RE of 0%.

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Condition tags

endometriosis

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 (31)

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