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Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study
OBJECTIVE: To assess the diagnostic performance of preoperative application of the Enzian classification (cEnzian) using surgical findings as reference standard. DESIGN: A prospective international non‐interventional study. SETTING: Twelve endometriosis centres in four European countries (Austria, G...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796328/ https://www.ncbi.nlm.nih.gov/pubmed/35596694 http://dx.doi.org/10.1111/1471-0528.17235 |
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author | Enzelsberger, Simon‐Hermann Oppelt, Peter Nirgianakis, Konstantinos Seeber, Beata Drahoňovský, Jan Wanderer, Leopold Krämer, Bernhard Grübling, Kristin Nannette Kundu, Sudip Salehin, Darius Mierzwinski, Maciej Krentel, Harald Hermann, Philipp Wagner, Helga Shebl, Omar Schäfer, Sebastian |
author_facet | Enzelsberger, Simon‐Hermann Oppelt, Peter Nirgianakis, Konstantinos Seeber, Beata Drahoňovský, Jan Wanderer, Leopold Krämer, Bernhard Grübling, Kristin Nannette Kundu, Sudip Salehin, Darius Mierzwinski, Maciej Krentel, Harald Hermann, Philipp Wagner, Helga Shebl, Omar Schäfer, Sebastian |
author_sort | Enzelsberger, Simon‐Hermann |
collection | PubMed |
description | OBJECTIVE: To assess the diagnostic performance of preoperative application of the Enzian classification (cEnzian) using surgical findings as reference standard. DESIGN: A prospective international non‐interventional study. SETTING: Twelve endometriosis centres in four European countries (Austria, Germany, Switzerland and Czech Republic). POPULATION: 1062 women with endometriosis surgery. METHODS: Extent of endometriosis was preoperatively classified using the cEnzian classification based on gynaecological examination and/or transvaginal ultrasound (TVS) and/or magnetic resonance imaging (MRI). After subsequent surgery, the surgeon classified the intraoperative findings using the Enzian classification. MAIN OUTCOME MEASURES: Sensitivity, specificity, PPV, NPV, LR(+), LR(−) and accuracy were calculated. Conditional frequencies of intraoperative Enzian codings and the corresponding 95% confidence intervals were computed for each preoperative coding and visualised in plots. RESULTS: Although overall consistency of cEnzian and Enzian was poor (35.14%, 95% confidence interval 32.26–38.03), high specificities and negative predictive values (NPVs) of the cEnzian compartments could be demonstrated. Looking at the individual parts of the Enzian classification, the poorest diagnostic performance was detected for compartment B and the highest PPVs were found for category 3 lesions (>3 cm), independent of the compartment. CONCLUSIONS: Using the Enzian classification in a non‐invasive setting is a useful tool providing us with an ‘at a glance’ summary of the diagnostic workup regarding deep endometriosis with high specificities and NPVs. An attempt to merge the two new endometriosis classification systems (#Enzian and AAGL 2021) seems reasonable taking into consideration the respective advantages of each other. |
format | Online Article Text |
id | pubmed-9796328 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97963282022-12-30 Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study Enzelsberger, Simon‐Hermann Oppelt, Peter Nirgianakis, Konstantinos Seeber, Beata Drahoňovský, Jan Wanderer, Leopold Krämer, Bernhard Grübling, Kristin Nannette Kundu, Sudip Salehin, Darius Mierzwinski, Maciej Krentel, Harald Hermann, Philipp Wagner, Helga Shebl, Omar Schäfer, Sebastian BJOG RESEARCH ARTICLES OBJECTIVE: To assess the diagnostic performance of preoperative application of the Enzian classification (cEnzian) using surgical findings as reference standard. DESIGN: A prospective international non‐interventional study. SETTING: Twelve endometriosis centres in four European countries (Austria, Germany, Switzerland and Czech Republic). POPULATION: 1062 women with endometriosis surgery. METHODS: Extent of endometriosis was preoperatively classified using the cEnzian classification based on gynaecological examination and/or transvaginal ultrasound (TVS) and/or magnetic resonance imaging (MRI). After subsequent surgery, the surgeon classified the intraoperative findings using the Enzian classification. MAIN OUTCOME MEASURES: Sensitivity, specificity, PPV, NPV, LR(+), LR(−) and accuracy were calculated. Conditional frequencies of intraoperative Enzian codings and the corresponding 95% confidence intervals were computed for each preoperative coding and visualised in plots. RESULTS: Although overall consistency of cEnzian and Enzian was poor (35.14%, 95% confidence interval 32.26–38.03), high specificities and negative predictive values (NPVs) of the cEnzian compartments could be demonstrated. Looking at the individual parts of the Enzian classification, the poorest diagnostic performance was detected for compartment B and the highest PPVs were found for category 3 lesions (>3 cm), independent of the compartment. CONCLUSIONS: Using the Enzian classification in a non‐invasive setting is a useful tool providing us with an ‘at a glance’ summary of the diagnostic workup regarding deep endometriosis with high specificities and NPVs. An attempt to merge the two new endometriosis classification systems (#Enzian and AAGL 2021) seems reasonable taking into consideration the respective advantages of each other. John Wiley and Sons Inc. 2022-06-03 2022-11 /pmc/articles/PMC9796328/ /pubmed/35596694 http://dx.doi.org/10.1111/1471-0528.17235 Text en © 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | RESEARCH ARTICLES Enzelsberger, Simon‐Hermann Oppelt, Peter Nirgianakis, Konstantinos Seeber, Beata Drahoňovský, Jan Wanderer, Leopold Krämer, Bernhard Grübling, Kristin Nannette Kundu, Sudip Salehin, Darius Mierzwinski, Maciej Krentel, Harald Hermann, Philipp Wagner, Helga Shebl, Omar Schäfer, Sebastian Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study |
title | Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study |
title_full | Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study |
title_fullStr | Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study |
title_full_unstemmed | Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study |
title_short | Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study |
title_sort | preoperative application of the enzian classification for endometriosis (the cenzian study): a prospective international multicenter study |
topic | RESEARCH ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796328/ https://www.ncbi.nlm.nih.gov/pubmed/35596694 http://dx.doi.org/10.1111/1471-0528.17235 |
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