Nnoaham Kelechi E, Sivananthan Sivahami, Hummelshoj Lone, Jenkinson Crispin, Webster Premila, Kennedy Stephen H, Zondervan Krina T
Department of Public Health, University of Oxford, UK.
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK.
J Endometr. 2009;1(1):36-45.
Endometriosis can be difficult to diagnose clinically and models that use symptoms to predict whether the disease is present or not are based on limited patient populations. Endometriosis also influences health-related quality of life, but little is known about its impact across the world. We therefore initiated two integrated multicentre studies to collect prospective, standardised, epidemiological data, to 1) examine the global impact of endometriosis and relative effect of risk-factors, and 2) develop a symptom-based diagnostic tool.
(GSWH) and the (WHSS) prospectively recruit 18-45 year old women having a laparoscopy across 23 and 19 centres, respectively, worldwide. Women with a previous surgical diagnosis of endometriosis are excluded. Multi-lingual patient questionnaires and a surgical questionnaire, incorporating validated instruments, are used to collect the data. The GSWH aims to recruit >2,000 women by December 2009; the WHSS to recruit 1,000 women in each of the two model-generating and validation stages.
A six-week pilot study in Oxford, UK, established the feasibility of the study protocols. Of 32 eligible women, 27 participated (response rate - 84.4%); 26% completed the questionnaire online. Endometriosis was found in 47.4%. Extrapolating the recruitment rates from the pilot study, the target sample sizes for the GWSH and WHSS were deemed feasible.
Using standardised data collection, the GSWH and WHSS will provide insight into the global impact of endometriosis and develop a validated, symptom-based, diagnostic tool. They have the potential to provide the basis for future, longitudinal, follow-up studies and a collaborative Endometriosis Biobank implementing standardised collection of DNA and tissue samples.
子宫内膜异位症在临床上可能难以诊断,基于症状来预测疾病是否存在的模型所依据的患者群体有限。子宫内膜异位症还会影响与健康相关的生活质量,但人们对其在全球范围内的影响知之甚少。因此,我们启动了两项综合性多中心研究,以收集前瞻性、标准化的流行病学数据,1)研究子宫内膜异位症的全球影响及风险因素的相对作用,2)开发一种基于症状的诊断工具。
全球子宫内膜异位症协作组研究(GSWH)和世界子宫内膜异位症症状研究(WHSS)分别在全球23个和19个中心前瞻性招募18至45岁接受腹腔镜检查的女性。既往有手术诊断为子宫内膜异位症的女性被排除。使用多语言患者问卷和包含经过验证的工具的手术问卷来收集数据。GSWH的目标是到2009年12月招募超过2000名女性;WHSS在两个模型生成和验证阶段各招募1000名女性。
在英国牛津进行的为期六周的试点研究确定了研究方案的可行性。在32名符合条件的女性中,27名参与(应答率 - 84.4%);26%通过在线方式完成问卷。发现47.4%的女性患有子宫内膜异位症。根据试点研究的招募率推断,GSWH和WHSS的目标样本量被认为是可行的。
通过标准化的数据收集,GSWH和WHSS将深入了解子宫内膜异位症的全球影响,并开发一种经过验证的、基于症状的诊断工具。它们有可能为未来的纵向随访研究以及实施DNA和组织样本标准化收集的子宫内膜异位症生物样本库合作提供基础。