Endometriosis classification systems: an international survey to map current knowledge and uptake

Area of Science:

• Gynecology
• Surgical Innovation
• Clinical Practice Research

Background:

• Several endometriosis classification systems exist, but their clinical practice uptake is unknown.
• Clinicians need standardized methods for reporting endometriosis staging and severity.

Purpose of the Study:

• To determine the most frequently used endometriosis classification system.
• To identify reasons for system preference or avoidance.
• To assess clinician interest in a new, simple surgical descriptive system for endometriosis.

Main Methods:

• A cross-sectional survey was conducted among 1178 clinicians managing endometriosis.
• The survey focused on the Revised American Society for Reproductive Medicine (rASRM) classification, endometriosis fertility index (EFI), and ENZIAN classification.
• Data analysis identified statistically significant differences among user groups regarding system use and challenges.

Main Results:

• 75.5% of clinicians use a classification system, with rASRM being the most known and used.
• EFI and ENZIAN systems are known by many but used by few.
• Lack of clinical relevance was the primary issue cited with existing systems.

Conclusions:

• Clinicians widely desire a new, simple, and clinically relevant surgical descriptive system for endometriosis.
• This supports future development of a new system to achieve standardized reporting.
• Understanding user expectations is key for the universal adoption of a new endometriosis classification system.