The role of a standardised ultrasound-reporting template to report and diagnose deep infiltrative endometriosis
Rebecca Bird, M.Sc., Cambridge University Hospitals NHS Foundation Trust
Background
Endometriosis affects up to 1 in 9 females and can take an average of 8 years to diagnose. The most common symptoms of endometriosis include chronic pelvic pain, painful bowel movements and infertility. Whilst NICE guidelines advise an ultrasound scan for when symptoms become severe or when intervention is unsuccessful, there is no national guidance on how practitioners should scan for endometriosis.
Aim
This study aimed to evaluate the use of a structured investigation and reporting template when diagnosing patients for potential endometriosis with ultrasound.
Methods
Diagnostic yields of both pre- and post-template assessments for sonographers and consultant radiologists were compared and analysed. Their experiences of using the template were recorded and discussed. In total, 355 patients were included in the study and statistical analysis calculated to evaluate reliability of the results.
Results
Diagnostic yields were improved following the implementation of the template. There was no statistical correlation between age and prevalence of endometriosis without or with template (P = 0.166 and 0.58 respectively). There was statistical correlation between increased age and prevalence of adenomyosis either without or with a template (P = 0.00069 and P = 0.000074 respectively). Template increased confidence in diagnosing endometriosis, but caused time pressures.
Conclusion
Sonographers' diagnostic yields increased with the use of a structured scan method and report template. They did, however, feel time pressure in using these, so adjustments would need to be made to scanning lists, further training and familiarisation with the template