Validation study of nonsurgical diagnosis of endometriosis.
OBJECTIVE
To determine whether the surgical diagnosis of endometriosis can be predicted using symptoms, signs, and ultrasound findings.


METHODS
Prospective study (study sample); retrospective record review (test sample).


METHODS
Hospital of Desio (study sample) and Mangiagalli Hospital (test sample), Italy.


METHODS
Ninety women scheduled to undergo laparoscopy or laparotomy (study sample); 120 women who underwent laparoscopy (test sample).


METHODS
The study sample group was interviewed before surgery about infertility and dysmenorrhea, dyspareunia, and noncyclic pelvic pain and each member had a pelvic examination and a transvaginal ultrasound. At surgery, endometriosis was noted. For the test sample, the same information was abstracted from medical records after laparoscopy.


METHODS
The ability of symptoms, signs, and ultrasound to predict endometriosis at surgery. A classification tree was developed with the study sample and evaluated with the test sample.


RESULTS
Ovarian endometriosis, but not nonovarian endometriosis, could be reliably predicted with noninvasive tools. Ultrasound and examination best predicted ovarian endometriosis, correctly classifying 100% of cases with no false positive diagnoses in the study sample. Similar results were found in the test sample.


CONCLUSIONS
Noninvasive tools may be used to identify women with ovarian, but not nonovarian endometriosis, with excellent agreement with surgical diagnosis.
Eskenazi
B
B
School of Public Health, University of California, CA, Berkeley 94720-7360, USA. eskenazi@uclink4.berkeley.edu
Warner
M
M
Bonsignore
L
L
Olive
D
D
Samuels
S
S
Vercellini
P
P
D000328:Adult; D004715:Endometriosis / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000175:diagnosis; D010808:Physical Examination; D011446:Prospective Studies; D012189:Retrospective Studies; D014463:Ultrasonography