Cross-sectional study for derivation of a cut-off value for identification of a timely versus late diagnosis of endometriosis based on analytical and descriptive research methods

Iris Brandes, Katja Kleine‐Budde, Nicole R. Heinze, Sebastian Binder, Constanze Klug, Cordula Schippert, Andreas D. Ebert, Gülden Halis
In: Research Square · 2022 · doi:10.21203/rs.3.rs-1876912/v1 · W4288052542
preprint OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study derived a five-year cut-off value to distinguish between timely and delayed endometriosis diagnoses, identifying early symptom onset as a key risk factor for diagnostic delay.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This cross-sectional preprint aimed to derive a systematically calculated cut-off value distinguishing short versus long diagnostic delay in endometriosis, using descriptive statistics and analytical methods on German population data from the EndoCost study. The investigators assessed correlations and performed logistic regression and discriminant analysis on shortDD versus longDD using various disease-related variables. A 5-year diagnostic delay cut-off significantly differentiated shortDD from longDD across disease-related factors, and early onset of endometriosis-related symptoms was identified as the most important risk factor for long diagnostic delay. The authors note the work is based on relatively sparse publications and is a preprint that has not been peer reviewed. This paper is centrally about endometriosis — specifically deriving a 5-year threshold to define timely versus late diagnosis of endometriosis.

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Abstract

Abstract BackgroundEndometriosis is a benign, hormone-dependent, chronic inflammatory gynecological disease accompanied by cyclic and acyclic pelvic pain and other complaints. The long lists of research recommendations in the AWMF guideline [5] and ESHRE Endometriosis Guideline [6] show that there is still a great need for research in all aspects of the disease. Diagnostic delay, defined as the mean time between symptom onset and confirmed diagnosis, is a particular problem associated with endometriosis. Some quantitative and qualitative studies have investigated possible reasons for this. A range of physician-related [7, 8] and patient-related factors [9] as well as stigmatization of the topic of menstruation by society have been identified [10, 11]. The consequences of the disease being diagnosed late (or too late) on the course of disease, the quality of life and the costs of the disease have already been documented in studies [12, 13]. However, a systematically derived cut-off value that clearly distinguishes between short and long delay is still lacking. Therefore, the aim of our study was to derive a threshold value for the definition of a target corridor for endometriosis diagnosis based on descriptive and analytical methods.MethodsSince our review of the rather sparse publications on diagnostic delay did not yield satisfactory results, we used descriptive statistics and location parameters to calculate a cut-off value for German population data from the EndoCost study. Statistical methods were used for correlation analysis of shortDD versus longDD (correlation analysis and logistic regression) and group membership (discriminant analysis). ResultsFive years was identified as the cut-off value that significantly differentiated between shortDD and longDD based on various disease-related variables. This suggests that endometriosis should be definitively diagnosed within less than five years to minimize the risk of an unfavorable course of the disease. Our findings confirmed that an early onset of endometriosis-related symptoms is the most important risk factor for a long diagnostic delay. Consequently, adolescent females should receive increased attention as an especially vulnerable group. Evidently, there is an urgent need to develop adequate concepts to improve the endometriosis education and care among this target group.

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endometriosis

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