Hierarchy of evidence for endometriosis diagnosis and surgery.

Philippe R. Koninckx, Koninckx P, Ussia A, Anastasia Ussia, Joerg Keckstein, J. Keckstein, Keckstein J, Adamyan L, L.V. Adamyan, Donnez J, Jacques Donnez, Martin D, Dan C. Martin, Wattiez A, Arnaud Wattiez
In: Authorea, Inc. · 2022 · doi:10.22541/au.165268818.82166961/v1 · W4280576582
preprint OA: gold CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-06 ⓘ

This review discusses the limited high-quality evidence for endometriosis diagnosis and surgery due to disease complexity and challenges in study design, emphasizing the need for expert collaboration.

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Abstract

Without an animal model and a non-invasive diagnosis, the pathophysiology of endometriosis is unclear and information is limited to symptomatic women. Lesions are biochemically variable. Medical therapy cannot be blinded and extensive surgery combines low numbers with variable difficulty and surgical skills. Experience is spread among specialists in imaging, medical therapy, infertility, pain and surgery. Besides the recent changes in interpreting statistical analyses, the limited good-quality evidence increases the importance of clinical experience. Therefore trial design, analysis and judgment of results should be done by experts in the different disciplines of endometriosis, before being translated into guidelines.

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Condition tags

endometriosisinfertility

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 ]

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