Page 140 - Diagnostic delay of endometriosis
P. 140

obviously benefits from educating medical professionals as well. Information about normal menstruation and which symptoms may reflect a condition such as endometriosis can be provided by GPs, for example during consultations concerning contraception. In general, medical professionals play an important role in population-wide health education and patient empowerment. The efforts of patient interest groups are equally important, and collaboration between medical professionals and patient interest groups can lead to the transmission of high quality information about both physiological and pathological aspects of menstruation and reproduction on a wide variety of occasions.
Some limitations related to the design of the study need to be considered. First, it is likely that from the invited professionals, those who are most interested in endometriosis have responded. It is unclear whether this has influenced the results. However, efforts have been made to successfully include professionals from different types of hospitals and practices, and there is some evidence that agreement to participate in consensus development groups is unrelated to years since qualification, specialty, sex or level of degrees.39 Second, although the response rates were high, some response bias may have occurred as not all panel members took part in all four rounds mainly because of time restriction and complexity of the procedure. Especially the second round questionnaire, in which panel members were provided with graphic individual and group feedback, appeared challenging for some of the panel members. A number of interventions required detailed knowledge of for instance the education program of medical professionals or the organization of health care, which may pose difficulties in the assessment of these interventions by patients. This might have led to a more prominent role of the most motivated panel members and higher educated patient representatives. Finally, the completeness of the list of interventions is a point of discussion. The extraction of potential interventions from the literature and experts’ opinion was done with great care, but the list submitted to the expert panel may not be completely comprehensive. Future interventions should be adapted to fit the needs of specific circumstances in different regions with regard to organization of health care or cultural beliefs. For instance, interventions directed at the education of general practitioners may not apply to countries without a strongly positioned primary care. Overall, the results of the consensus procedure are likely to be applicable in other countries, given the diversity of the expert panel and similarities in health care organization in many developed countries, as well as the versatile target audience of the selected interventions.
138 | Chapter 7
































































































   138   139   140   141   142