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This supplementary material provides the analysis workbook and Python code for a systematic review and meta-analysis evaluating perioperative pelvic floor physical therapy in patients undergoing surgery for endometriosis. The authors detail statistical corrections regarding data estimation from randomized clinical trials, specifically addressing how means and standard deviations were calculated from quartile data to ensure reproducibility of the primary findings. The results indicate that physical therapy significantly reduced pain scores compared to controls, with a mean difference of -1.18 points on a 0 to 10 scale across three included trials involving 156 women. This paper is centrally about endometriosis — specifically analyzing adjunctive pelvic floor physical therapy as an intervention during surgical treatment for the condition.
Abstract
Supplementary materials for the systematic review and meta-analysis Perioperative Pelvic Floor Physical Therapy in Endometriosis Surgery: A Systematic Review and Meta-analysis. Contents. Supplementary_Analysis_Workbook.xlsx — a formula-driven workbook. Every extracted value sits in a labeled input cell and every reported estimate is a live formula, so changing an input recalculates the review. Sheets cover the inputs and their provenance, the median-to-mean conversion, the primary mean-difference analysis, the secondary standardised analysis, and the sensitivity analyses. Supplementary_Analysis_Code.py — a self-contained Python 3.11 script that performs the same computations independently, written without a meta-analysis package so each step is visible. README.md — full documentation of both files. The workbook and the script were written separately and agree to the precision reported in the manuscript. Results these files reproduce. Random effects (DerSimonian and Laird); 3 randomized clinical trials; 156 women randomized and 144 analyzed. Primary mean difference 1.20 points in favour of therapy (95% CI 0.46 to 1.93) on a 0 to 10 pain scale Q = 0.238 on 2 df, P = .89; I-squared 0%; tau-squared 0 Weights: Gabrielsen 52.2%, Muñoz-Gómez 41.7%, Del Forno 6.1% Secondary Hedges g -0.49 (95% CI -0.82 to -0.16) Leave-one-out -1.13 to -1.24; Del Forno change-score basis -1.04 (95% CI -1.61 to -0.46); Hartung-Knapp 95% CI -1.75 to -0.64 Data. All inputs are published summary statistics from the 3 included trials. No individual participant data were obtained or are contained here. Registration. PROSPERO CRD420261425140, registered 17 June 2026.
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Perioperative pelvic floor physical therapy in endometriosis surgery: analysis workbook and code for a systematic review and meta-analysis
Authors/Creators
- 1. Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
- 2. Arizona Center for Chronic Pelvic Pain, Phoenix, Arizona, USA
Description
Supplementary materials for the systematic review and meta-analysis Perioperative Pelvic Floor Physical Therapy in Endometriosis Surgery: A Systematic Review and Meta-analysis.
Changes in this version. This version supersedes version 1.0.0 and corresponds to the submitted manuscript. The version 1.0.0 files should not be used. Version 1.0.0 converted the one trial reporting medians and interquartile ranges with the Hozo minimum-median-maximum estimator, (Q1 + 2 × median + Q3) / 4. That estimator applies to a reported minimum, median and maximum. Del Forno et al 2021 reports a first quartile, a median and a third quartile, so the correct estimator is Wan et al 2014 scenario C3: mean = (Q1 + median + Q3) / 3 and SD = (Q3 − Q1) / eta(n), with eta(n) = 2 × Phi−1((0.75n − 0.125) / (n + 0.25)). The script in this version implements the Wan estimators and names the distinction explicitly so the two cannot be confused. Four further corrections are carried here. Each sensitivity block in the workbook now recomputes its own DerSimonian-Laird model rather than reusing the fixed-effect weights of the primary analysis. A combined exploratory analysis applying the pelvic-floor-direct restriction and the worst-pain outcome together is reported, giving −0.483 (95% CI −1.431 to 0.465), which includes no effect; it is a post hoc check and is not a worst case or a bound. The modified Hartung-Knapp interval is reported alongside the unmodified one, with the reason the unmodified interval is narrower at k = 3. Reporting bias is assessed by a registry-by-registry comparison rather than by a blanket statement. The headline estimates below have changed accordingly.
Contents.
- Supplementary_Analysis_Workbook.xlsx — a formula-driven workbook. Every extracted value sits in a labeled input cell and every reported estimate is a live formula, so changing an input recalculates the review. Each sensitivity block builds its own weights, Cochran Q, C and tau-squared. The file is saved with cached results, so it opens with values shown and recalculates to the same numbers.
- Supplementary_Analysis_Code.py — a self-contained Python 3.11 script that performs the same computations independently, written without NumPy, SciPy or any meta-analysis package so that every estimator is visible in the file.
- README.md — documentation of both files and of the corrections made in this version.
The workbook and the script were written separately and agree to the precision reported in the manuscript.
Results these files reproduce. Random effects (DerSimonian and Laird); 3 randomized clinical trials; 156 women randomized and 144 analyzed. Negative values favour physical therapy.
- Primary mean difference −1.18 points (95% CI −1.92 to −0.45) on a 0 to 10 pain scale, P = .001
- Q = 0.35 on 2 df, P = .84; I-squared 0%; tau-squared 0
- Weights: Gabrielsen 52.2%, Muñoz-Gómez 41.7%, Del Forno 6.1%
- Modified Hartung-Knapp 95% CI −2.79 to 0.42; unmodified Hartung-Knapp 95% CI −1.86 to −0.51
- Secondary Hedges g −0.48 (95% CI −0.81 to −0.15)
- Leave-one-out −1.11 to −1.24; Del Forno change-score basis −1.14 (95% CI −1.72 to −0.56)
- Pelvic-floor-direct restriction −1.11 (95% CI −2.07 to −0.15); Gabrielsen published contrast −1.13 (95% CI −1.84 to −0.42); worst-pain outcome −0.82 (95% CI −1.54 to −0.09)
- Combined exploratory analysis −0.483 (95% CI −1.431 to 0.465)
Data. All inputs are published summary statistics from the 3 included trials. No individual participant data were obtained or are contained here.
Registration. PROSPERO CRD420261425140, registered 17 June 2026.
Notes
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Related works
- References
- Journal article: 10.3390/jcm12093310 (DOI)
- Journal article: 10.1002/uog.23590 (DOI)
- Journal article: 10.1016/j.jphys.2025.09.012 (DOI)
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