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      QS ENDO Pilot – A Study by the Stiftung Endometrioseforschung (SEF) on the Quality of Care Provided to Patients with Endometriosis in Certified Endometriosis Centers in the DACH Region Translated title: QS ENDO Pilot – eine Studie der Stiftung Endometrioseforschung (SEF) zur Versorgungsqualität von Patientinnen mit Endometriose in den zertifizierten Endometriosezentren der DACH-Region

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          Abstract

          Introduction Endometriosis significantly reduces patientsʼ quality of life and is additionally a burden on healthcare and social security systems. There are currently no quality indicators for the treatment of endometriosis. The care of patients with endometriosis must be considered inadequate. QS ENDO aims to record the quality of care available in the DACH region and to introduce quality indicators for the diagnosis and treatment of endometriosis as part of providing quality assurance in endometriosis care. The first phase, QS ENDO Real, recorded the reality of current care using a questionnaire. The second phase, QS ENDO Pilot, investigated the treatment of 435 patients who underwent surgical treatment within a defined one month period in certified endometriosis centers.

          Material and Methods An online tool was used to gather information about 9 points which covered both prior patient history and the process of clinical diagnosis. Surgery reports were reviewed to obtain information about the surgical approach, the investigated sites, findings of any histological examinations, the use of classification systems, and information about resection status.

          Results 85.3% of patients were asked all 4 questions about their prior medical history. All 5 diagnostic steps were carried out in 34.5% of patients. The 3 areas needed to describe potential sites of disease were recorded in 67.1% of patients. Samples for histological examination were taken in 84.1% of patients. The endometriosis stage was classified in 94.7% of surgeries. A combination of the rASRM and the ENZIAN classifications, which is needed for complex cases, was used in 46.1% of patients. Complete resection was achieved in 81.6% of surgical procedures.

          Conclusion For the first time, the quality of care in certified endometriosis centers has been recorded using QS ENDO Pilot. Despite the high certification standards, a substantial number of required indicators were omitted.

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          Most cited references39

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          Pathogenesis and pathophysiology of endometriosis.

          Originally described over three hundred years ago, endometriosis is classically defined by the presence of endometrial glands and stroma in extrauterine locations. Endometriosis is an inflammatory, estrogen-dependent condition associated with pelvic pain and infertility. This work reviews the disease process from theories regarding origin to the molecular basis for disease sequelae. A thorough understanding of the histopathogenesis and pathophysiology of endometriosis is essential to the development of novel diagnostic and treatment approaches for this debilitating condition. Copyright © 2012 American Society for Reproductive Medicine. All rights reserved.
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            Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries.

            To assess the impact of endometriosis on health-related quality of life (HRQoL) and work productivity. Multicenter cross-sectional study with prospective recruitment. Sixteen clinical centers in ten countries. A total of 1,418 premenopausal women, aged 18-45 years, without a previous surgical diagnosis of endometriosis, having laparoscopy to investigate symptoms or to be sterilized. None. Diagnostic delay, HRQoL, and work productivity. There was a delay of 6.7 years, principally in primary care, between onset of symptoms and a surgical diagnosis of endometriosis, which was longer in centers where women received predominantly state-funded health care (8.3 vs. 5.5 years). Delay was positively associated with the number of pelvic symptoms (chronic pelvic pain, dysmenorrhoea, dyspareunia, and heavy periods) and a higher body mass index. Physical HRQoL was significantly reduced in affected women compared with those with similar symptoms and no endometriosis. Each affected woman lost on average 10.8 hours (SD 12.2) of work weekly, mainly owing to reduced effectiveness while working. Loss of work productivity translated into significant costs per woman/week, from US$4 in Nigeria to US$456 in Italy. Endometriosis impairs HRQoL and work productivity across countries and ethnicities, yet women continue to experience diagnostic delays in primary care. A higher index of suspicion is needed to expedite specialist assessment of symptomatic women. Future research should seek to clarify pain mechanisms in relation to endometriosis severity. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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              Revised American Society for Reproductive Medicine classification of endometriosis: 1996.

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                Author and article information

                Journal
                Geburtshilfe Frauenheilkd
                Geburtshilfe Frauenheilkd
                10.1055/s-00000020
                Geburtshilfe und Frauenheilkunde
                Georg Thieme Verlag KG (Rüdigerstraße 14, 70469 Stuttgart, Germany )
                0016-5751
                1438-8804
                23 May 2023
                July 2023
                1 May 2023
                : 83
                : 7
                : 835-842
                Affiliations
                [1 ]Zentrum für Frauenheilkunde und Geburtshilfe der Justus Liebig-Universität Gießen, Gießen, Germany
                [2 ]Frauenklinik der medizinischen Universität Graz, Graz, Austria
                [3 ]LKH Villach, Villach, Austria
                [4 ]MMF Research GmbH, Münster, Germany
                [5 ]Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover, Germany
                [6 ]Johanniter GmbH; Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany
                [7 ]Drammen Hospital, Drammen, Norway
                [8 ]Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
                [9 ]Universitätsfrauenklinik Tübingen, Tübingen, Germany
                [10 ]Stiftung Endometriose-Forschung, Westerstede, Germany
                [11 ]Praxisklinik am Rosengarten, Mannheim, Germany
                [12 ]Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätskliniken des Saarlandes, Homburg/Saar, Germany
                [13 ]Frauenärzte am Staden, Saarbrücken, Germany
                [14 ]Klinik für Frauenheilkunde und Fortpflanzungsmedizin Universitätsklinikum Jena, Jena, Germany
                [15 ]Endometriosezentrum Keckstein, Villach, Austria
                [16 ]Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
                [17 ]Rehaklinik für Gynäkologie, Eisenmoorbad AG, Bad Schmiedeberg, Germany
                Author notes
                Correspondence/Korrespondenzadresse Prof. Ivo Meinhold-Heerlein, MD Zentrum für Frauenheilkunde und Geburtshilfe der Justus Liebig-Universität Gießen Klinikstraße 3335392 GießenGermany ivo.meinhold-heerlein@ 123456gyn.med.uni-giessen.de
                Article
                GebFra-2023-01-1932-O
                10.1055/a-2061-6845
                10317557
                37404976
                bed3c448-ee1b-428d-ab87-bd759c7ceb2b
                The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ )

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                History
                : 13 January 2023
                : 19 March 2023
                Categories
                GebFra Science
                Original Article/Originalarbeit

                endometriosis,quality assurance,reality of current care,healthcare research

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