Page 92 - Diagnostic delay of endometriosis

level as well. Data on factors contributing to this part of the delay are still lacking and require further attention in order to improve care performance and reduce the delay in diagnosis. Endometriosis is diagnosed and treated in all gynaecologists’ practices in The Netherlands. There are no designated levels of expertise as in some other countries.13 The Dutch Society of Obstetrics and Gynaecology (Nederlandse Vereniging voor Obstetrie en Gynaecologie, NVOG) has adopted the ESHRE guideline ‘Management of women with endometriosis’14 and assumes that all gynaecologists are aware of its content. The ESHRE guideline provides recommendations on how the diagnosis of endometriosis should be established, “in an attempt to improve the knowledge of gynaecologists and other clinicians, and to decrease the diagnostic delay and the subsequent impact on the quality of life of women with endometriosis”.14 Currently, there are no studies regarding the implementation and clinical use of this ESHRE guideline. This study is undertaken to investigate agreement with and adherence to the ESHRE guideline “Management of women with endometriosis” and to assess factors influencing the diagnostic delay of endometriosis from the gynaecologist point of view.
Material and methods
Data collection
A nationwide cross-sectional questionnaire study was performed among all hospitals in The Netherlands. One gynaecologist involved in the care for women with endometriosis from every hospital was invited to complete the questionnaire. After consent, a digital questionnaire was sent between May and July 2016 (NETQ Healthcare BV, Utrecht, The Netherlands). Gynaecologists who gave consent to participate in this study but did not complete the questionnaire before the deadline received a reminder by email after one to two weeks and eventually an additional reminder by telephone.
Questionnaire
An expert panel, including specialists in reproductive medicine (DB), endometriosis (AN) and guideline implementation (WN) was composed for the development of the questionnaire. The questionnaire consisted of 56 questions, both multiple choice (n=38) and open ended (n=18), which addressed demographic variables relating to the organisation of care, collaboration between medical professionals, opinion about centralisation of endometriosis care, current endometriosis care and diagnostic delay. Current
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