Evaluating the Quality of Endometriosis Operative Reports Among High-Volume Endometriosis Surgeons

To evaluate the quality of operative reports for endometriosis surgeries performed by fellowship-trained, high-volume endometriosis surgeons.

In this retrospective review, 5 consecutive deidentified surgical reports per surgeon were evaluated by 2 reviewers. Each dictation was assigned a quality score (between 0 and 28), based on the number of components from the American Association of Gynecologic Laparoscopists (AAGL) classification system that were documented. The primary outcome was the proportion of reports for which the endometriosis AAGL 2021 stage could be assigned. Secondary outcomes included median dictation quality scores, proportion of dictations for fertility-preserving cases where the Endometriosis Fertility Index score could be assigned, individual quality score components, and quality score variation between surgeons, institutions, and reporting methods.

Overall, 82 operative reports were reviewed from 16 surgeons across 7 sites in Ontario. The AAGL stage could be assigned in 48/82 (59%) of cases, and the Endometriosis Fertility Index score could be assigned in 31/45 of fertility-preserving cases (69%). The median quality score was 57% (range 18%-86%). Only 13% of operative reports included comments on residual disease. Quality score consistency between reports was poor for a given surgeon (intraclass correlation coefficient 0.22; 95% CI 0.03-0.49). Quality scores differed significantly between surgeons (χ² = 30.6, df = 16, P = 0.015) and institutions (χ² = 19.59, df = 7, P = 0.007). Operative report quality score did not differ based on completion by trainee or staff, template use, or whether the report was completed by telephone or typed.

There is significant variability and inconsistency in endometriosis surgery documentation. There is a need to standardize surgical documentation for endometriosis surgeries, enhancing communication and ultimately patient care.