An evidence‐based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis

Hugh S Taylor, G David Adamson, Michael P Diamond, Steven R Goldstein, Andrew W Horne, Stacey A Missmer, Michael C Snabes, Eric Surrey, Eric S. Surrey, Robert N Taylor
International Journal of Gynecology & Obstetrics · 2018 · vol. 142(2) , pp. 131–142 · doi:10.1002/ijgo.12521 · PMID:29729099 · W2801197782
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This review of the literature compares the diagnostic accuracy of clinical assessment versus surgical visualization and histology for symptomatic endometriosis.

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Abstract

Challenges intrinsic to the accurate diagnosis of endometriosis contribute to an extended delay between the onset of symptoms and clinical confirmation. Intraoperative visualization, preferably with histologic verification, is considered by many professional organizations to be the gold standard by which endometriosis is diagnosed. Clinical diagnosis of symptomatic endometriosis via patient history, physical examination, and noninvasive tests, though more easily executed, is generally viewed as less accurate than surgical diagnosis. Technological advances and increased understanding of the pathophysiology of endometriosis warrant continuing reevaluation of the standard method for diagnosing symptomatic disease. A review of the published literature was therefore performed with the goal of comparing the accuracy of clinical diagnostic measures with that of surgical diagnosis. The current body of evidence suggests that clinical diagnosis of symptomatic endometriosis is more reliable than previously recognized and that surgical diagnosis has limitations that could be underappreciated. Regardless of the methodology used, women with suspected symptomatic endometriosis would be well served by a diagnostic paradigm that is reliable, conveys minimal risk of under- or over-diagnosis, lessens the time from symptom development to diagnosis, and guides the appropriate use of medical and surgical management strategies.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Diagnostic Techniques, Obstetrical and Gynecological Diagnostic Techniques, Surgical Endometriosis Evidence-Based Medicine Symptom Assessment Diagnostic Techniques, Obstetrical and Gynecological Diagnostic Techniques, Surgical Endometriosis Endometriosis Female Humans Reproducibility of Results Symptom Assessment Symptom Assessment

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 (74)

Cited by (50)

Source provenance

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License: CC0 · commercial use OK