Endometriosis Knowledge Among Emergency Medicine Providers: Diagnostic Skills and Symptom Recognition

Objective:

Results:

Introduction

Results | Characteristics | All participants n = 59a | |---|---| | Gender | | | Female | 35.0 (60.3%) | | Male | 22.0 (37.9%) | | Nonbinary | 1.0 (1.7%) | | Missing* | 1 | | Years in practice | | | 15 years | 5.0 (8.6%) | | 11–15 years | 9.0 (15.5%) | | 5–10 years | 18.0 (31.0%) | | Missing* | 1 | | Role | | | Attending physician | 26.0 (44.8%) | | Emergency medicine resident | 18.0 (31.0%) | | Fellow | 1.0 (1.7%) | | Nurse practitioner | 5.0 (8.6%) | | Physician assistant | 8.0 (13.8%) | | Missing* | 1 | | Frequency of gynecological complaints | | | Daily | 6.0 (10.3%) | | Less than once a month | 3.0 (5.2%) | | Never | 3.0 (5.2%) | | Several times per month | 21.0 (36.2%) | | Several times per week | 25.0 (43.1%) | | Missing* | 1 | | Knowledge of endometriosis | | | Moderately knowledgeable | 22.0 (40.0%) | | Not knowledgeable at all | 3.0 (5.5%) | | Somewhat knowledgeable | 29.0 (52.7%) | | Very knowledgeable | 1.0 (1.8%) | | Missing* | 4 | | Knowledge of endometriosis management | | | No | 21 (38.2%) | | Yes | 34.0 (61.8%) | | Missing* | 4 | | Frequency of endometriosis in differential | | | As a diagnosis of exclusion after I have ruled out emergent conditions | 31.0 (56.4%) | | Every time | 3.0 (5.5%) | | I do not consider this as a diagnosis in the emergency department | 8.0 (14.5%) | | When additional symptoms are suggestive of endometriosis | 13.0 (23.6%) | | Missing* | 4 | | Education and training on endometriosisb | | | Clinical practice | 25 (42.4%) | | Medical school | 40 (67.8%) | | Nurse Practitioner school | 7 (11.9%) | | Other sources | 1 (1.7%) | | Personal experience | 9 (15.3%) | | Physician assistant school | 8 (13.6%) | | Residency | 15 (25.4%) | | Knowledge on the percentage of women with endometriosis | | | 20% | 2.0 (3.6%) | | 11–15% | 30.0 (54.5%) | | 16–20% | 15.0 (27.3%) | | Missing* | 4 | | Dysmenorrhea symptoms as suspicious for endometriosis | | | Extremely likely | 2.0 (3.6%) | | Likely | 14.0 (25.5%) | | Not likely | 6.0 (10.9%) | | Somewhat likely | 9.0 (16.4%) | | Very likely | 24.0 (43.6%) | | Missing* | 4 | | Dyspareunia symptoms as suspicious for endometriosis | | | Extremely likely | 6.0 (10.9%) | | Likely | 15.0 (27.3%) | | Not likely | 6.0 (10.9%) | | Somewhat likely | 11.0 (20.0%) | | Very likely | 17.0 (30.9%) | | Missing* | 4 | | Acute pelvic pain symptoms as suspicious for endometriosis | | | Extremely likely | 1.0 (1.8%) | | Likely | 13.0 (23.6%) | | Not likely | 18.0 (32.7%) | | Somewhat likely | 18.0 (32.7%) | | Very likely | 5.0 (9.1%) | | Missing* | 4 | | Chronic pelvic pain symptoms as suspicious for endometriosis | | | Extremely likely | 5.0 (9.1%) | | Likely | 12.0 (21.8%) | | Not likely | 5.0 (9.1%) | | Somewhat likely | 3.0 (5.5%) | | Very likely | 30.0 (54.5%) | | Missing* | 4 | | Cyclical painful defecation symptoms as suspicious for endometriosis | | | Extremely likely | 1.0 (1.8%) | | Likely | 14.0 (25.5%) | | Not likely | 7.0 (12.7%) | | Somewhat likely | 9.0 (16.4%) | | Very likely | 24.0 (43.6%) | | Missing* | 4 | | Cyclical urinary disorders symptoms as suspicious for endometriosis | | | Extremely likely | 1.0 (1.8%) | | Likely | 15.0 (27.3%) | | Not likely | 9.0 (16.4%) | | Somewhat likely | 17.0 (30.9%) | | Very likely | 13.0 (23.6%) | | Missing* | 4 | | Menstrual cycle disorders (i.e., irregular/heavy bleeding, abnormal menstrual cycles) symptoms as suspicious for endometriosis | | | Extremely likely | 6.0 (10.9%) | | Likely | 19.0 (34.5%) | | Not likely | 5.0 (9.1%) | | Somewhat likely | 7.0 (12.7%) | | Very likely | 18.0 (32.7%) | | Missing* | 4 | | Fertility disorders symptoms as suspicious for endometriosis | | | Extremely likely | 4.0 (7.3%) | | Likely | 24.0 (43.6%) | | Not likely | 6.0 (10.9%) | | Somewhat likely | 8.0 (14.5%) | | Very likely | 13.0 (23.6%) | | Missing* | 4 | | Frequency of recommending pelvic exam | | | All of the time | 7.0 (12.7%) | | Most of the time | 32.0 (58.2%) | | Never | 1.0 (1.8%) | | Rarely | 6.0 (10.9%) | | Sometimes | 9.0 (16.4%) | | Missing* | 4 | | Frequency of ordering pelvic ultrasound | | | Most of the time | 19.0 (34.5%) | | Never | 3.0 (5.5%) | | Rarely | 3.0 (5.5%) | | Sometimes | 30.0 (54.5%) | | Missing* | 4 | | Referral for endometriosisb | | | General gynecologist | 52.0 (88.1%) | | Endometriosis specialist | 2.0 (3.4%) | | Outside organizations | 5.0 (8.5%) | | Free clinic | 2 (3.4%) | | Gynecologists consult in ER | 3 (5.1%) | | Primary care physician | 22.0 (37.3%) | | Public health clinic | 1.0 (1.7%) | | Management of endometriosisb | | | Acetaminophen | 42 (71.2%) | | Hormone contraception if there are no immediate plans for a pregnancy | 23 (39.0%) | | NSAIDs | 51 (86.4%) | | Opioids | 12 (20.3%) | | Warm compresses | 1 (1.7%) | | Medications prescribed for dysmenorrheab | | | Acetaminophen | 40 (67.8%) | | Hormone contraception if there are no immediate plans for a pregnancy | 35 (59.3%) | | NSAIDs | 52 (88.1%) | | Opioids | 6 (10.2%) | | Other | 1 (1.7%) | | Interest in more information | | | No | 12 (21.8%) | | Yes | 43.0 (78.2%) | | Missing* | 4 | | Preferred method of receiving informationb,c | | | Conference or grand rounds | 22.0 (51.2%) | | Online modules | 9.0 (20.9%) | | Clinical decision tool | 23.0 (53.5%) | | Written materials | 25.0 (58.1%) | | Podcast or video | 13.0 (30.2%) | | Reason for noninterest in additional informationd | | | I already have all the information I need | 5.0 (41.7%) | | Not relevant to my practice | 2.0 (16.7%) | | Not relevant to my practice, I already have all the information I need | 1.0 (8.3%) | | Other | 4.0 (33.3%) | | Missing* | 47 |

Conclusions Authors’ Contributions Abbreviations - APP - advanced practice provider - CME - continuing medical education - ED - emergency department - EM - emergency medicine - NSAIDs - nonsteroidal anti-inflammatory drugs Acknowledgments Author Disclosure Statement Funding Information

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