Recommendations for the Design of Epidemiologic Studies of Endometriosis

Victoria L. Holt, V L Holt, Noel S. Weiss, N S Weiss
Epidemiology (Cambridge, Mass.) · 2000 · vol. 11(6) , pp. 654–659 · doi:10.1097/00001648-200011000-00007 · PMID:11055625 · W2093946333
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This paper defines endometriotic disease as persistent and progressing ectopic endometrial tissue and recommends subject-selection strategies to improve the validity of epidemiologic studies.

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Abstract

This paper proposes a standard definition of endometriotic disease for epidemiologic studies and suggests subject-selection strategies to increase the validity of clinic- or population-based studies of the disease. Although endometriosis can be defined simply as the presence of ectopic endometrial tissue, emerging evidence indicates that to be pathologic, such tissue must persist and progress. The proposed disease definition incorporates the concepts of persistence and progression, and its use may increase the likelihood of observing true associations in etiologic studies. Potential threats to validity of substantial magnitude exist in both clinic- and population-based epidemiologic studies of endometriosis. In clinic-based studies, control subjects (infertility clinic patients, women delivering infants, or women undergoing tubal ligation) often are not representative of the population from which the cases arose, and bias can be considerable for behavioral and hormone-related exposures. In population-based studies, substantial case underascertainment may exist, and diagnosed cases may be a biased sample of all potential cases in the population. Although neither the ideal design nor the ideal case and control groups are likely to be achievable in epidemiologic studies of endometriosis, the subject-selection strategies suggested may improve the validity of studies that are obliged to depart from the ideal.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Bias Endometriosis Population Surveillance Research Design Adolescent Adult Case-Control Studies Endometriosis Endometriosis Female Humans Middle Aged Population Surveillance Reproducibility of Results

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (46)

Cited by (50)

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