ESHRE guideline: management of women with endometriosis
ESHRE guideline: management of women with endometriosis
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DOI：
10.1093/humrep/det457
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发表时间：
2014-03-01
影响因子：
6.1
通讯作者：
Nelen, W.
中科院分区：
文献类型：
--
作者：
Dunselman, G. A. J.;Vermeulen, N.;Nelen, W.
研究问题：根据文献中的最佳证据，子宫内膜异位症患者的最佳治疗方法是什么？总结回答：使用ESHRE指南开发手册的结构化方法，制定了83条建议，回答了子宫内膜异位症女性最佳管理的22个关键问题。欧洲人类生殖与胚胎学会（ESHRE）诊断和治疗子宫内膜异位症的指南（2005年）多年来一直是子宫内膜异位症最佳临床护理的参考点，研究设计、规模、持续时间：本指南由该领域的一组专家使用ESHRE指南制定手册的方法编制，包括对文献进行彻底的系统检索，对截至2012年1月的纳入论文进行质量评估，并在指南组内就所有建议达成共识。为了确保子宫内膜异位症妇女的意见，患者代表是指南制定小组的一部分。此外，在指南的范围界定和审查阶段收集了患者和其他临床输入信息。参与者/材料，环境，方法：不适用。主要结果和机会的作用：该指南提供了83条关于子宫内膜异位症的诊断、子宫内膜异位症相关疼痛和不孕症的治疗以及偶然发现该疾病的妇女的管理的建议（无疼痛或不孕），对预防疾病和/或疼痛症状复发，对治疗有子宫内膜异位症病史的患者的绝经期症状，以及对子宫内膜异位症和恶性肿瘤的可能关联。局限性，预防的原因：我们确定了几个领域在子宫内膜异位症妇女的护理中缺乏有力的证据。这些领域是通过根据指南小组成员的专家意见制定良好做法要点（GPP）来解决的。由于83例子宫内膜异位症女性管理建议中有32例不能基于高水平证据，因此是GPP，指导小组制定了研究建议，以指导今后的研究，目的是增加证据。
STUDY QUESTION: What is the optimal management of women with endometriosis based on the best available evidence in the literature?SUMMARY ANSWER: Using the structured methodology of the Manual for ESHRE Guideline Development, 83 recommendations were formulated that answered the 22 key questions on optimal management of women with endometriosis.WHAT IS KNOWN ALREADY: The European Society of Human Reproduction and Embryology (ESHRE) guideline for the diagnosis and treatment of endometriosis (2005) has been a reference point for best clinical care in endometriosis for years, but this guideline was in need of updating.STUDY DESIGN, SIZE, DURATION: This guideline was produced by a group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to January 2012 and consensus within the guideline group on all recommendations. To ensure input from women with endometriosis, a patient representative was part of the guideline development group. In addition, patient and additional clinical input was collected during the scoping and review phase of the guideline.PARTICIPANTS/MATERIALS, SETTING, METHODS: NA.MAIN RESULTS AND THE ROLE OF CHANCE: The guideline provides 83 recommendations on diagnosis of endometriosis and on the treatment of endometriosis-associated pain and infertility, on the management of women in whom the disease is found incidentally (without pain or infertility), on prevention of recurrence of disease and/or painful symptoms, on treatment of menopausal symptoms in patients with a history of endometriosis and on the possible association of endometriosis and malignancy.LIMITATIONS, REASONS FOR CAUTION: We identified several areas in care of women with endometriosis for which robust evidence is lacking. These areas were addressed by formulating good practice points (GPP), based on the expert opinion of the guideline group members.WIDER IMPLICATIONS OF THE FINDINGS: Since 32 out of the 83 recommendations for the management of women with endometriosis could not be based on high level evidence and therefore were GPP, the guideline group formulated research recommendations to guide future research with the aim of increasing the body of evidence.