Meinhold-Heerlein Ivo, Zeppernick Magdalena, Wölfler Monika Martina, Janschek Elisabeth, Bornemann Sebastian, Holtmann Laura, Oehmke Frank, Salehin Darius, Scheible Chi Mi, Brandes Iris, Vingerhagen-Pethick Sigrid, Cornelius Claus-Peter, Boosz Alexander, Krämer Bernhard, Sillem Martin, Bühler Klaus, Keckstein Jörg, Schweppe Karl-Werner, Zeppernick Felix
Zentrum für Frauenheilkunde und Geburtshilfe der Justus Liebig-Universität Gießen, Gießen, Germany.
Frauenklinik der medizinischen Universität Graz, Graz, Austria.
Geburtshilfe Frauenheilkd. 2023 May 23;83(7):835-842. doi: 10.1055/a-2061-6845. eCollection 2023 Jul.
Endometriosis significantly reduces patients' 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. 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. 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. 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.
子宫内膜异位症显著降低了患者的生活质量，此外还给医疗保健和社会保障系统带来负担。目前尚无子宫内膜异位症治疗的质量指标。子宫内膜异位症患者的护理情况必须被视为不充分。QS ENDO旨在记录德语区、奥地利和瑞士（DACH）地区现有的护理质量，并引入子宫内膜异位症诊断和治疗的质量指标，作为子宫内膜异位症护理质量保证的一部分。第一阶段，即QS ENDO Real，通过问卷调查记录了当前护理的实际情况。第二阶段，即QS ENDO Pilot，调查了在特定的一个月内于认证的子宫内膜异位症中心接受手术治疗的435名患者的治疗情况。使用一个在线工具收集了关于9个要点的信息，这些要点涵盖了患者既往病史和临床诊断过程。对手术报告进行了审查，以获取有关手术方式、检查部位、任何组织学检查结果、分类系统的使用以及切除状态的信息。85.3%的患者被问及了所有4个关于他们既往病史的问题。34.5%的患者完成了所有5个诊断步骤。67.1%的患者记录了描述疾病潜在部位所需的3个区域。84.1%的患者采集了组织学检查样本。94.7%的手术对子宫内膜异位症进行了分期。46.1%的患者使用了复杂病例所需的rASRM和ENZIAN分类组合。81.6%的手术实现了完全切除。通过QS ENDO Pilot首次记录了认证的子宫内膜异位症中心的护理质量。尽管认证标准很高，但仍有大量所需指标被遗漏。
