Page 54 - Diagnostic delay of endometriosis

related to the GPs’ working practice, e.g. GPs’ experience, and number of patients with complaints suggestive of endometriosis according to the GP. Twenty-eight questions tested the actual knowledge of endometriosis, six questions explored diagnostic and treatment strategies and six questions related to GPs’ self assessment of their knowledge of endometriosis and need for education. The remaining questions were miscellaneous. The knowledge questions were multiple choice, and the strategy questions were both open- ended and multiple choice. Answers to the open-ended questions were categorized by MZ. To compose the categories, the answers most alike were clustered. Correction for guessing was applied.10 The final score on knowledge was applied only if at least 90% of questions were completed (26 or more). The questionnaire could not be validated because of the informative nature of the study and because no comparable studies were undertaken previously. The diagnostic delay represents the time from start of symptoms until diagnosis and comprises the time until first medical consultation at the GP office (patient delay) and the time from first GP consultation to diagnosis. In this study, the diagnostic delay reflects the GP’s interpretation of these time intervals.
Data collection
The study population consisted of GPs located in practices in the region of Arnhem, the Netherlands. GPs were recruited at the beginning of the annual education meeting on gynaecology for GPs at the Rijnstate Hospital in Arnhem, or by email. This referral centre is specialized in the diagnosis and multidisciplinary treatment of endometriosis and is recommended by the Dutch Endometriosis Society, the endometriosis patient interest group. For GPs who answered the questionnaire on both occasions, only the answers given on the first occasion (at the start of the education meeting) were taken into account. This study was considered exempt from institutional review board or ethics committee approval because no individual patient data are involved as indicated by the Central Committee on Research Involving Human Subjects, The Hague.
Analysis
Statistical analysis was carried out using IBM SPSS Statistics version 22.0 (IBM Corp, Armonk, NY, USA). Descriptives, T-Test and Pearson Correlation were used for analysis. Data are presented as mean with standard deviation unless stated otherwise. P < 0.05 was considered statistically significant.
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