The 10 “Cardinal Sins” in the Clinical Diagnosis and Treatment of Endometriosis: a Bayesian Approach

Philippe R Koninckx; Anastasia Ussia; Stephan Gordts; Jörg Keckstein; Ertan Saridogan; Malzoni Mario; Assia Stepanian; António Gutierrez Setúbal; Leila Adamyan; Arnaud Wattiez

doi:10.20944/preprints202306.0970.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 13 June 2023 / Approved: 14 June 2023 / Online: 14 June 2023 (07:38:32 CEST)

Evidence-based data for endometriosis management are limited. Experiments are excluded without adequate animal models. Data are limited to symptomatic women and occasional observations. Hormonal medical therapy cannot be blinded if recognised by the patient. Randomised controlled trials are not realistic for surgery since a variable disease with low numbers. Each diagnosis and treatment is an experiment with an outcome and experience is Bayesian updating from the past. If the experience of many is similar, this has more value than an opinion. The combined experience of a group of endometriosis surgeons was used to discuss problems in the management of endometriosis. Considering endometriosis as several genetically/epigenetically different diseases is important for medical therapy. Imaging cannot exclude endometriosis and diagnostic accuracy is limited for superficial lesions, deep lesions, and cystic corpora lutea. Surgery should not be avoided for emotional reasons. Shifting infertility treatment to IVF without considering fertility surgery is questionable. The concept of complete excision should be reconsidered. Surgeons should introduce quality control and teaching should move to explain why it is done. The perception of information has a personal bias. These are the major problems in the management of endometriosis identified by the combined experience of endometriosis surgeons.

Endometriosis diagnosis; endometriosis therapy; endometriosis surgery; Bayesian statistics; evidence-based medicine

Medicine and Pharmacology, Clinical Medicine

Not displayed online.

Please leave your comment to this article below.

Mathematical equations can be typed in either LaTeX formats \\[ ... \\] or $$ ... $$, or MathML format <math> ... </math>. Try the LaTeX or MathML example.

Type equation:

Preview:

Copy equation into message below

Close menu

Please click a symbol to insert it into the message box below:

Please enter the link here:

Optionally, you can enter text that should appear as linked text:

Copy link into message below

Close menu

Please enter or paste the URL to the image here (please only use links to jpg/jpeg, png and gif images):

Copy image into message below

Close menu

Type author name or keywords to filter the list of references in this group (you can add a new citation under Bibliography):

No existing citations in Discussion Group

Wikify editor is a simple editor for wiki-style mark-up. It was written by MDPI for Sciforum in 2014. The rendering of the mark-up is based on Wiky.php with some tweaks. Rendering of mathematical equations is done with MathJax. Please send us a message for support or for reporting bugs.

Close menu

Please declare any conflicts of interest you may have with this paper, financial or otherwise.

I do not have a conflict of interest

I would like to declare a conflict of interest

Display my name on the website

Captcha

Renew

I accept the following conditions:

Comments must follow the standards of professional discourse and should focus on the scientific content of the article. Insulting or offensive language, personal attacks and off-topic remarks will not be permitted. Comments must be written in English. Preprints reserves the right to remove comments without notice. Readers who post comments are obliged to declare any competing interests, financial or otherwise.

* All users must log in before leaving a comment

Notify me about updates to this article or when a peer-reviewed version is published.

The 10 “Cardinal Sins” in the Clinical Diagnosis and Treatment of Endometriosis: a Bayesian Approach

Abstract

Keywords

Subject

Comments (0)