Week_5_Research_Summary_Document_Version_20_2021-10-10

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Chamberlain University College of Nursing *

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May 28, 2024

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LITERATURE SUMMARY TABLE PICOT QUESTION: In female patients experiencing dysmenorrhea ages 15-30, how does screening for endometriosis affect the length of time it takes to receive a medical diagnosis compared with no health screening within 12 months of symptoms onset. QUANTITATIVE STUDIES: Author/Title/Year (APA format): Cromeens/ Timing, delays and pathways to diagnosis of endometriosis: a scoping review protocol / 2021 Problem related to PICOT: Timing delay of endometriosis Purpose : To review and map the current international literature regarding pathways, timing and delay of diagnosis of endometriosis in order to define common concepts in literature and identify gaps for future examinations and intervention development. Sample/Population: All peer-reviewed and grey literature including people with endometriosis across all age groups. Specifically, literature reporting research on pathways, timing, or delay in diagnosis of endometriosis will be included in the review. The concept of ‘pathways’ includes research on influencing factors leading to a diagnosis such as the first provider consulted, specialty of providers, numbers of providers and numbers of emergency room visits as they relate to timing/delay of diagnosis. Data Collection Method: The extraction tool will be used to collect and chart data. The two reviewers will meet to resolve conflicts, hone their shared understanding of the extraction method and refine the extraction tool when needed. A third researcher will resolve unreconciled conflicts. Major Findings/Conclusions: The common problem of prolonged average times to diagnosis represents one of the most challenging aspects of endometriosis for the patients and their health- care providers. The scoping review of delay, timing, and pathways to diagnosis described in this protocol will survey the current scientific literature to identify gaps in the research across methods to encourage uniformity of terms and prevent duplication of efforts. Inter- national consensus on definitions and concepts while recognizing past research approaches to understand influencing factors, relationships, and impacts of delays in diagnosis of endometriosis will lead to more efficient research, targeted interventions, and ultimately improved outcomes for patients. Contribution to Review of the Literature: By reviewing this literature the gaps in healthcare became identifiable and places emphasis on the importance of uniformity of terms and concepts in studies pertaining to endometriosis to lead to more efficient research that will benefit endometriosis patients by closing the timing delay of diagnosis. Cromeens MG, Carey ET, Robinson WR , et al Timing, delays and pathways to diagnosis of endometriosis: a scoping review protocol BMJ Open 2021; 11: e049390. doi: 10.1136/bmjopen-2021-049390 QUALITATIVE STUDIES : Author/Title/Year (APA format): Dixon, Talbot, Hinton/ Navigating possible endometriosis in primary care: a qualitative study of GP perspectives/ 2021

LITERATURE SUMMARY TABLE Problem related to PICOT: diagnosis endometriosis in the primary care setting Purpose: To identify what general practitioners indicate as important considerations when presented with female patients with the possibility of endometriosis. Sample: interviews with 42 general practitioners from April 2019 to January 2020 Data Collection Method: S emi-structured scenario-based telephone interviews with 42 GPs from April 2019 to January 2020, based around a fictional scenario of a woman presenting to primary care with symptoms suggesting possible endometriosis. Interviews were thematically coded and analyzed. Key Findings/Themes: Women typically seek help first from their general practitioners in regards to dysmenorrhea and other symptoms of endometriosis, however this study found that general practitioners lacked the knowledge and awareness to diagnosis a patient with endometriosis as well as the vagueness of the symptoms making an endometriosis diagnosis difficult to pinpoint. Contribution to Review of the Literature: The contribution to review of the literature is that on average general practitioners simply don’t know enough about endometriosis to successfully diagnosis it or distinguish it from varying other illnesses. Dixon, S., McNiven, A., Talbot, A., & Hinton, L. (2021). Navigating possible endometriosis in primary care: A qualitative study of GP Perspectives. British Journal of General Practice , 71 (710). https://doi.org/10.3399/bjgp.2021.0030 MIXED METHODS STUDIES: Author/Title/Year (APA format): Le Roux, McCall, Bougie/ Therapeutic journey of adolescents and young adults with severe dysmenorrhea and endometriosis/ 2022 Problem related to PICOT: the therapeutic journey of adolescent endometriosis patients including disease presentation, obstacles to diagnosis and impact on quality of life. Purpose: to examine how adolescent patients with endometriosis presents, obstacles to their diagnosis and the impact of the disease on their quality of life. Sample: Participants were women under 28 years with severe dysmenorrhea in Kingston Health Sciences Centre in Kingston, Ontario. Data Collection Method: a mixed methods design, including a chart review, 94 item questionnaire that was analyzed using descriptive statistics and semi structured interviews that were coded using the constant comparative analysis method by two analyzers and inter-rater reliability, with all data compared using a cross sectional method. Key Findings/Themes/Conclusions: Young adults with severe dysmenorrhea and/or endometriosis presented with symptoms at an average of 13 years of age with 50% later receiving an endometriosis diagnosis at an average of seven years after symptom onset. The themes present in this mixed method study is that the journey with endometriosis is that treatment begins prematurely to a diagnosis with the majority of treatment being self-guided due to the lack of knowledge about endometriosis and women’s health by health care professionals leading to a delay in diagnosis. Contribution to Review of the Literature: This shows the struggle that most women with endometriosis face starting at a young age of being abandoned by their healthcare providers and

LITERATURE SUMMARY TABLE having to be their own stewards in healthcare due to a lack of knowledge by healthcare professionals. Le Roux, A., McCall, J., Pudwell, J., Pyper, J. S., & Bougie, O. (2022). Therapeutic journey of adolescents and young adults with severe dysmenorrhea and endometriosis. Journal of Endometriosis and Pelvic Pain Disorders , 14 (4), 183–191. https://doi.org/10.1177/22840265221116271 META-ANALYSIS STUDIES: Author/Title/Year (APA format): Méar, Fauconnier, Pineau, Vialard/ Polymorphisms and endometriosis: a systematic review and meta-analyses/ 2020 Problem related to PICOT: late diagnosis is prevalent with endometriosis patients which may correlate to disease progression and a worse response to treatment once initiated. Purpose: To conduct a systematic review and meta-analysis of the most regularly reported polymorphisms in order to identify those that might predispose to endometriosis and could potentially be using in screening. Search selection method: While using the MEDLINE database, publications on DNA polymorphisms in endometriosis was searched. Only polymorphisms reported by at least three separate studies could be used. Meta-Analysis Model: PRISMA guidelines were used Summary of Findings: This study identified potential markers for a genetic screening test for endometriosis. By combining a patient survey, a genetic screen with endometrial or serum biomarkers and an analysis of the family medical history it may be possible to identify women with a high predisposition to endometriosis, being a great future screening tool. Méar, L., Herr, M., Fauconnier, A., Pineau, C., & Vialard, F. (2020). Polymorphisms and endometriosis: A systematic review and meta-analyses. Human Reproduction Update , 26 (1), 73–103. https://doi.org/10.1093/humupd/dmz034 QUALITATIVE STUDIES: Author/Title/Year (APA format): Sims, Gupta, Missmer, Aninye/ Stigma and Endometriosis: A Brief Overview and Recommendations to Improve Psychosocial Well-Being and Diagnostic Delay/ 2021 Problem related to PICOT: The study reviews the impact of diagnostic delay in endometriosis patients on their overall psychosocial well-being. Purpose: To review literature to establish if there is a stigma with endometriosis patients that enhances a negative psychosocial experience as well as a delay in diagnosis timing. Sample/Population: 89 published literatures regarding endometriosis Data Collection Method: literature review of 89 endometriosis studies Major Findings/Conclusions: This study found that endometriosis stigma is vastly understudied and poses that in order to properly shine light on the overall complexity of endometriosis and the stigma that correlate to the psychosocial well-being of patients with endometriosis.

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